We all hate the ‘F’ word, but some speech pathology students do fail clinic: can this difficulty developing clinical competence be predicted?

All speech pathology (SP) students in Australia must achieve entry-level clinical competence at the end of their degrees to graduate and enter the profession. Little is known about predictors of competence development. This thesis describes three reviews and four studies investigating predictors of the difficulty developing competence some students experience, with Astin’s Input-Environment-Output (I-E-O) model as a conceptual framework. A mixed methods approach was used to answer the questions informed by the narrative review: What input and environment factors contribute to students’ difficulty developing competence at different program stages (Output)? Is there value in screening the communication skills of first year students to identify any who may have difficulty developing competence? A systematic review on predictors of successful entry to health professions identified predictors across professions and degree types: students’ discipline knowledge, academic skills, and test-taking ability. A scoping review in SP students found similar but inconsistent predictors. A two part quantitative study investigated this and other input and environment predictors of difficulty developing competence, for third (Study 1) and final year (Study 2) students. Both input and environment predictors were identified, different for at risk and failing students at both levels. The screener identified most of the input predictors. Key input factors can be identified by a first year communication screener. A two part qualitative study investigated the views of staff (Study 3) and students (Study 4) on the value of such a screnner. Both staff and final year students valued such a screener. Predictors of students likely to have difficulties developing competence can be identified early in an undergraduate program. As it is possible to identify students who may have difficulty developing competence before placements begin, future research should investigate effective ways to support them