The Role of Research and the State of Research Training Within Communication Sciences and Disorders

Introduction and Statement of the Problem

During their relatively brief histories, the professions of speech-language pathology and audiology have undergone enormous change. From their beginnings as an academic discipline, forged by a small number of university professors in the 1930s and 1940s, they have evolved to become recognized human service professions in the 1990s, involving tens of thousands of providers serving the needs of millions of clients with communication disorders. ^[1]

Initially, the primary function of educators was to create a body of knowledge about the discipline, and to impart that knowledge to students. There was little systematic preparation of students for clinical practice. The role of educators, however, has expanded over the years. The current primary responsibility of most of our nearly 300 educational programs is preparing practitioners to provide clinical services to individuals with communication disorders.

Despite the evolution of educators and educational programs, the educational model for preparing students has, with few exceptions, remained unchanged: students pursue academic degrees within university settings (see Saxman, 1991, for a historical perspective). The stability of this educational model is contrasted with the dramatic change, described above, in the nature of the education provided.

Although expanded clinical training is appropriate for the preparation of practitioners, the evolution toward professional education can also be observed at the doctoral level. Some PhD programs within the discipline do not have a strong research focus (American Speech-Language-Hearing Association, 1978; Flower, 1985; Ludlow, 1986). For example, Counihan (1982) noted that the PhD increasingly is being used as a credential for non research-related activities, including advanced clinical training. Inevitably, this trend will be exacerbated if the increased emphasis on practitioner training within PhD programs is advocated widely within the professions.

Currently, the appropriateness of existing educational models for preparing practitioners is being discussed extensively (see, for example, Ad Hoc Committee on Professional Education in Audiology Technical Report, 1992). Alternative models for preparing practitioners may be adopted. However, PhD programs within the discipline must have research training as their primary focus. Students being awarded the PhD must be prepared to conduct research relevant to the discipline and professions. As significant as the current debate regarding educational models for preparing practitioners is to the future of the professions, we must not pursue solutions to the problems of preparing practitioners that will further erode the scientific base upon which the professions are built.

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Background and Interpretation

As science-based professions, speech-language pathology and audiology require an expanding knowledge base from which new diagnostic and therapeutic methods can derive. Obviously, the professions cannot rely on serendipity to reveal more effective clinical procedures; neither will clinical experience alone suffice. Rather, the creation of new clinical methods should result from the combined efforts of different groups engaged in a variety of activities, from researchers conducting very basic experimentation concerning fundamental processes and mechanisms in communication to practitioners delivering clinical services to clients with communication disorders. Especially critical to the development of new clinical methods are researchers who bridge the gap between basic research and clinical practice. A fundamental task of these researchers is to apply newly discovered basic knowledge and emerging technology to issues of clinical practice. Researchers trained in the discipline of communication sciences and disorders are especially well suited to this role, due both to their knowledge of clinical issues and to their experience conducting systematic research.

The professions of speech-language pathology and audiology cannot rely primarily on researchers from other disciplines to create knowledge that will have direct relevance to clinical practice. The major part of this responsibility must be assumed by researchers trained in the discipline. Without a consistent flow of new research relevant to the professions, speech-language pathology and audiology will stagnate. If we fail to provide an expanding knowledge base, the inevitable outcome will be loss of autonomy for the professions, leaving us with a technical, rather than professional, image among other health care providers. In large measure, it is the capacity to create its own knowledge base and clinical methods that distinguish autonomous human service professions from technical occupations. As noted by Kent (1983, p. 76), “A profession that provides its own research base is much more in charge of its own destiny than a profession that doesn't.” From this perspective, further evolution of the PhD degree away from a primary research emphasis could have considerable negative impact on the future of the professions.

In addition to the eroding research focus in some PhD programs, other factors such as the increased difficulty recruiting students into research training and limited Federal dollars to support research have contributed to the current situation: We are faced with declining enrollment in our doctoral programs, a reduced number of doctoral programs dedicated to training new researchers and in which systematic programs of research are conducted, and diminished resources to support research (American Speech-Language-Hearing Association, 1991; Cooper, Mann, Helmick, Newberry, & Ripich, 1988; Koenigsknecht, 1988). If this situation continues, we will be faced with additional reductions in the number of educators trained in the discipline who are competent to provide research training and mentoring to our PhD students. The inevitable combined effect of these trends is that we will have even fewer persons educated within the discipline who are actively engaged in research. A critical shortage of trained researchers already exists (Folkins, 1990). At present, fewer than one percent of ASHA affiliates are engaged in research as their primary employment function (American Speech-Language-Hearing Association, 1992). The impact of further reductions in the number of researchers on the long-term viability and autonomy of speech-language pathology and audiology is one of the most serious problems facing the professions.

Because of the interdependence of practitioners and researchers, it is essential to include the implications for research and researcher training in any discussions of appropriate educational models for preparing practitioners. Discussions of the various degrees offered in the discipline (i.e., primarily the Master's and PhD) may be obscured by inconsistent use of terminology. It is important in such discussions that science, research, practice, and scholarship be defined clearly and used consistently. Science is the body of knowledge that is at the base of the professions—the reservoir of information that is available. This body of knowledge is created through many endeavors, including structured experimentation and clinical observations. Research refers to a systematic process for creating new knowledge, guided by the rules of experimental design and measurement. These rules are inherently conservative with regard to the acceptance of new hypotheses and are designed to minimize the possibility that the researcher's previous experiences will influence or bias the outcome of the research endeavor. Consequently, the methods of research are often more constrained than those of clinical practice. Practice is the application of knowledge (including clinical experience) to clients with communication disorders. This process is guided by the needs of the client and, ultimately, evaluated by the degree of well-being achieved by the client through clinical diagnosis or intervention. Finally, scholarship is the systematic pursuit of knowledge.

It is clear from these definitions that science and scholarship are common to both research and practice. Any suggestion that science and scholarship are not fundamental to clinical practice distorts reality and complicates productive discussions of these issues. Training in science is essential for both researchers and practitioners. However, training in science is not the same as training in research. The former involves the acquisition of the body of knowledge that is the foundation upon which the professions are based. The latter involves the mastery of the formal methods of systematic inquiry. Whereas acquisition of the body of knowledge that constitutes the discipline and forms the basis of the professions (i.e., science) is absolutely essential in the training of practitioners, acquiring a high degree of competence in research methods is not essential. Similarly, although mastery of the science of the professions is fundamental to conducting research of particular relevance to the professions, researchers need not be actively engaged in clinical practice in order to conduct their work. Both researchers and practitioners, however, profit considerably from exposure to the methods, problems, questions, and short- and long-term goals of the other group. Further, it is their exposure to clinical issues and practices that makes researchers trained in the discipline especially qualified to conduct research relevant to the professions.

Although science and scholarship are not unique to either research or practice, it is clear that research and clinical practice are different. Both involve inquiry and problem solving, but they have different purposes, use different methods, and invoke different rules for determining success (Kent, 1983). Scholarship for practitioners is assessed, not in terms of the application of the principles of research, but in terms of the effective application of the scientific body of knowledge to clients with communication disorders.

Training in either research or clinical practice does not necessarily create competence in the other. Research and clinical practice involve fundamentally different skills that, for the most part, must be acquired independently. Further, most individuals have neither the time, nor the motivation, to acquire a high degree of expertise in both activities (Ludlow, 1986). In short, although the concept of the so-called scientist-practitioner may be generally regarded as the ideal, it has not proved to be widely attainable in any of the human service professions, including speech-language pathology and audiology (Kent, 1985).

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Recommendations

Although new educational models for training practitioners may evolve, a PhD in communication sciences and disorders must be reaffirmed as the recognized degree for training researchers. Expanding the scope of the PhD to encompass a primary focus on clinical practice will only inflict further damage on the integrity of the PhD as a research degree within the discipline. It must be assumed that persons awarded the PhD in communication sciences and disorders have received extensive training in research methods and that they are prepared to engage in research relevant to the discipline and professions of speech-language pathology and audiology.

Without a cadre of highly trained researchers constantly creating new knowledge, the future of speech-language pathology and audiology as autonomous professions is in serious jeopardy. Facilitating the development of new researchers, therefore, should be among the Association's highest priorities. Fundamental to this process must be the development of a consensus regarding the importance of maintaining the PhD as a research degree, as well as the essential characteristics of PhD programs within the discipline.

Programs leading to the PhD should provide extensive training in research methods and experience in conducting research relevant to the discipline and to the professions. Specifically, students pursuing the PhD need to:

1. participate in a variety of research-relevant training experiences, in addition to the dissertation, that span the entire scope of the research process,

2. experience a curriculum appropriate to research training, and

3. receive mentoring suitable to the assumption of the career researcher role.

Educational programs offering the PhD should be encouraged to adhere to the principles articulated in this report. Because of the interdependence of practitioners and researchers, such adherence may be the best investment that these programs can make to ensure the long-term viability of speech-language pathology and audiology as autonomous professions.

Notes