ON RECORD

00:00:01:21 - 00:00:32:13
Unknown
Welcome to the On Record podcast. This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio and technology, and innovative ways to support their organizations objectives. My name is Mike Anzalone and my co-host is Carmen Haak. And our guest today is Karen McDonough. Karen is the Clinical Director for the Speech, Language and Hearing Clinic at Northeastern University.

00:00:32:14 - 00:01:03:15
Unknown
Welcome, Karen. Thanks for having me. So before we hop in, why don't you tell us a little bit about yourself and your professional journey and how you got to Northeastern University? Sure. I've been a speech language pathologist or SLP for over 30 years. I've worked with adults and children of all ages in acute care, inpatient and outpatient rehab schools, private practice everywhere.

00:01:03:15 - 00:01:39:17
Unknown
And one of my favorite parts of those jobs was always supervising students, clinical fellows, mentoring new staff. So when a position opened at northeastern in 2019 for a clinical supervisor in their SLP grad program, I jumped at the chance to take that position. I was a clinical supervisor in the on campus clinic, the speech, language and hearing center for a few years, and also worked as an off site clinical coordinator, which connected students with their offsite supervisors.

00:01:39:17 - 00:02:06:21
Unknown
And then when the position of SLP clinic director opened, I took on that role. And so now the SLP clinic director and an assistant clinical professor, and that's where I am today. Sounds like you have a supervisor role. That's your personal mission of mentorship. How does that tie into your organization's mission and what they focus on as the core objectives and outcomes?

00:02:07:01 - 00:02:31:12
Unknown
Well, the mission at the Bouvet College of Health Sciences, where we are at northeastern, it's basically advanced academic excellence to promote health care to everyone across the lifespan. So yes, mentoring is so important to me, and a huge part of that. And I know you're going to ask about video technology and where that might fit into that too.

00:02:31:12 - 00:02:57:07
Unknown
And that plays a huge role in what we do with our teaching and mentoring. So along those lines, Karen, I know that you you won the supervisor excellent award couple of years in a row, which speaks to how you develop clinicians. So talking about video, can you walk us through how you use video review and feedback feedback loops to coach your students and their clinical placements?

00:02:57:07 - 00:03:26:13
Unknown
And what does that process really look like? Yeah, absolutely. So we have really two things. We have video in the classroom and then we have video in the clinic. So before any of our students can ever work with the clients, they're supposed to have 25 guided observation hours. And so in order to do that, a lot of times they can't get in live to observe sessions and things like that.

00:03:26:13 - 00:03:56:07
Unknown
So in the classroom, I can share videos of sessions that we've conducted, both diagnostic and therapeutic. I share those with the students, and then we have discussions about them and thinking about what went well and why, and what might you do differently as a clinician. So we definitely use technology in the classroom. But then also in our clinic we have seven treatment rooms.

00:03:56:09 - 00:04:34:00
Unknown
And so each treatment room has a camera set up. And we record every single one of our sessions diagnostic and therapy. And I can be watching live. Families can watch live from a room where we have a few of the laptops set up. I can watch from home if I needed to check in on somebody, but basically we're watching, taking notes, able to provide student feedback, and we record all those sessions too, so that we can review later and so that the students can review later.

00:04:34:02 - 00:05:01:05
Unknown
Our students have to take data as they're working with clients, and that's a real challenge when you're a brand new clinician. It's a challenge for anyone, but it's a challenge for brand new clinicians. So to be able to play back that video and to then watch how they worked with the client, how the client responded, then they're able to take that and say, okay, what did I do?

00:05:01:05 - 00:05:25:17
Unknown
Well, what do I want to do again next time? What kind of data did I maybe miss? While I thought I was collecting everything that I was collecting? And then what can I do for the next session in those sessions? Do you use video as a summit of tool, or more of a formative tool, or maybe a combination of both?

00:05:25:18 - 00:06:11:10
Unknown
I'd say, well, probably a combination, but I, you know, the the thing is, we use those videos to then teach in the classroom. So we're using those to say, and we try not to use them when we have students still there. So I would never take a video of a current student and play it for a classroom of their peers, but we take ones that are maybe a couple years older and use those in the classroom, but also we use those to sit and work with students and talk about, you know, what might help them grow as clinicians themselves, and also looking at what the client's doing and what their reactions were and how they

00:06:11:10 - 00:06:35:07
Unknown
can then figure out what they should do for their next sessions. I see. Can I circle back to a question I have about observation, and how when you have family members engaging in observation? And Mike, he and I were chatting about this prior to our podcast today. How are you supporting family members? Being able to look into the sessions from a remote location?

00:06:35:09 - 00:07:01:04
Unknown
So all of our well, the majority of our sessions are in person. Some of them are teleprompters via zoom. So if it's a child, for instance, over zoom, the family member has to be there. A parent or guardian has to be there, they have to be present. And then most of our sessions are in person, in which the parent or guardian is in person or a family member.

00:07:01:04 - 00:07:25:08
Unknown
If they're an adult, someone is usually with them, and that person can then watch through the mirror. They can do that, or they can sit in our observation room and watch from the laptops, and so I can sit with them and talk about as a clinical supervisor, I could sit with them and say, notice what they're doing here.

00:07:25:09 - 00:07:52:03
Unknown
This is something you might want to try at home. Family members can chime in and say, you know, they never done this before. How do I get them to do this? Or she's asking him this, but he thinks she means that. Can we go into the room and and change things? So it really gives us so much opportunity for the families to be involved, not only with the live sessions.

00:07:52:03 - 00:08:14:04
Unknown
If we have to go in and, you know, work with them, work with the client, if the if the child's crying and needs his mom, we can see that and go right in, but also for home. What are some of the things that are working well? And we can then say, this is something you might want to implement at home to encourage them to continue this growth.

00:08:14:08 - 00:08:47:16
Unknown
Do you find there's a a big difference working with adults and then working with smaller children from an observational perspective, not necessarily from an observational perspective. There's always a difference in that you're probably doing more family teaching if it's a child. So I might be spending a little more time with the parents during that session, or the parent might be in with them during that session.

00:08:47:16 - 00:09:12:13
Unknown
And for many of our adult clients, they are more independent. So you don't have to do that. And somebody watching might be a family member who's watching, but doesn't necessarily need the guidance that you would for parent or guardian of a small child. Digging into Mike's question a little deeper, when we have a child, perhaps in a therapy space, do they bounce around a little bit more?

00:09:12:14 - 00:09:34:18
Unknown
Is it more of a target moving object kind of identify where that individual is going to be and have crystal clear audio to hear them and see their minimal actions or small gestures that tell a story. 100% I am so grateful for cameras that move or.

00:09:34:20 - 00:10:00:01
Unknown
We do have some dead spots. You know, there are some spots that child will find that the camera just can't find them. But for the most part, we're able to track them. So very often if like let's say a supervisor is in with the client and the graduate student and the family member and they're all in the therapy room, they might ask me to man the camera so that I'm following the child around.

00:10:00:01 - 00:10:30:02
Unknown
So we always want that ability to be able to track them. So yes, they do move around. And I'm very grateful for those cameras. The microphones are tougher because they hang from the ceiling. And so there are some clients who are just incredibly quiet and that makes a huge difference. It's very hard. You'll see me sometimes leaning in a lot to to just hear exactly what they're saying when I'm supervising, because I can't.

00:10:30:04 - 00:10:50:16
Unknown
The mic might not be catching everything that they're saying so that that can be a little bit of a challenge. But for the most part, we just turn our laptops up as high as we can, as low as need be. It's there, very loud and rowdy, but for the most part, yes, they move around and we're able to track them.

00:10:50:18 - 00:11:24:12
Unknown
I just wanted to ask because it sounds like you're using some of perhaps the features of your video recording solution in the software. How important is ease of use in becoming a tool that you're using, whether you have force to use it or if it's enjoyable to use? How important is that in your evaluation? It's so important because there's so many things we might miss if we don't have that camera on the time and the graduate student, there are things that we really need to make sure we're capturing, to make sure we're collecting the accurate data, especially for students.

00:11:24:12 - 00:11:54:20
Unknown
If they're assessing a child and they need to see some of their, you know, their movements, what are they pointing to in the pictures, things like that. If we can't capture that, we might miss that. If the student wasn't able to get that data in real time. I'm kind of curious, Karen, you, as you're referring to your clients and patients, this is this is a service that you're providing the local community.

00:11:54:21 - 00:12:26:12
Unknown
How how do you work with the community in terms of, you know, bringing in clients and, and who do you work with when you when you bring them in? So it is a speech language and hearing center. So we have audiologists on staff who see many of the clients throughout our community. We have veterans coming in. We have just various people throughout the community that come in to have their hearing assessed and get hearing aids.

00:12:26:15 - 00:12:53:06
Unknown
Our graduate students are typically not involved in that aspect. They are involved in speech and language side of things. So that's where I come into play, and it's a lot of word of mouth. Many people know that we exist. We have an on campus clinic. The rates are very low because it is student clinicians who are all seen by licensed, overseen by licensed supervisors.

00:12:53:06 - 00:13:29:20
Unknown
But we also reach out to the community in schools. They spread the word. We have a summer literacy program, and oftentimes the people that come to that tell other people about that in their school systems, and then they want to come for articulation or language therapy. So really it's it's a combination. I'd say a word and word of mouth in the community and also us reaching out to school systems and nearby hospitals and other facilities.

00:13:30:00 - 00:13:58:00
Unknown
You know, one of the questions a lot of our potential clients that we work with ask quite often in a similar type of environment, is surrounding patient consent to be recorded and things of that sort. How do you go about and what guidance could you provide our listeners in terms of that, that process? Yeah, well, we have to have written consent.

00:13:58:01 - 00:14:24:18
Unknown
Verbal is definitely not enough. We have to have written consent. So we have consent forms for all of our clients. And sometimes if they, you know, decide, no, I don't want to be recorded. We do try to explain that this is educational and this is really benefits our students, and it is for their learning. It is not that we are, you know, publicizing any of these sessions or anything like that.

00:14:24:18 - 00:14:50:02
Unknown
It is really for student learning. So almost all usually they they sign the consents and we're fine. Some will sign consent that you can use these for other purposes. And some will say it's only for the educational purposes, and then some will absolutely refuse and say, I do not want to be recorded at all. And we just honor that.

00:14:50:02 - 00:15:22:14
Unknown
We don't record those sessions. And in those situations, do you do you have a special therapy room or you just kind of turn the cameras off, cameras off? We still have to be able to view them, so we just don't record them. Gotcha. Okay. Well, yeah, that makes a lot of sense. Also, one of the things that I'm hearing more often with our other speech and language clients is they're starting to do a lot of interprofessional work with, let's say, nursing simulation.

00:15:22:15 - 00:15:51:10
Unknown
Is that something that your program is getting involved with? Huge. With that? Yes, absolutely. I just did one with our SLP students, along with pharmacy, where we gave them a case of a client that had Mis and how would they work together? How would they work individually. And then we actually had an in-person debrief so that they could all meet each other and have discussions.

00:15:51:10 - 00:16:18:00
Unknown
And that was fabulous. We have one with the physical therapy students that we do in our SIM lab at northeastern. We'll be doing that in a few weeks, where they go in and they work with a, a client, a client, a patient who's a, you know, an actor who comes in and they have aphasia or some other issues going on.

00:16:18:00 - 00:16:42:07
Unknown
And the party and the SLP students will go in and do an assessment on them. So yes, we we have lots in the works with this. Let's see, I'm kind of curious what is the like the career path look like for a speech and language student. So there's so many places you can work, so much you can do.

00:16:42:08 - 00:17:08:01
Unknown
And it's one of the things I always love to tell students is you don't have to know exactly what you want to do. Under the umbrella of speech language pathology, you know you can work in early intervention going into people's homes. You can run a private practice or work for a private practice. You can do home care. You can work in an acute care hospital.

00:17:08:02 - 00:17:43:21
Unknown
You can work in inpatient or outpatient rehab. You can do research in a university. You can work in the public schools or collaboratives. So there are so many different ways you can go under the umbrella of still being an SLP. Can I ask how how are you attracting students? Obviously name recognition is huge, but for this specific program, I feel like there's a new layer of media happening with like TikTok videos and speech language pathologist offering content there and just driving interest in this discipline.

00:17:43:21 - 00:18:10:20
Unknown
Where do you see it? Do you see this being like a very strong career path to the future? Tell us more about that. Honestly, you know, I don't think we've had to do a lot to attract students to it. We get hundreds of applications every year. Hundreds. So it is definitely a growing field. It's certainly far more applications than when I was, you know, going to school.

00:18:11:02 - 00:18:38:00
Unknown
So I don't think it's something that we've had to actively publicize. However, you know, we're working at the university, we need to make sure that they understand our program and how our program might be different than another program. You know, we are in a big city, and, you know, there are others that are much more rural and have a smaller amount of students attending.

00:18:38:03 - 00:19:10:20
Unknown
We are very fortunate that so many of our alumni work in the area, and that provides us with offsite supervisors for our students, so that there's lots of opportunities for them to go into the hospitals, in the schools, and in various private practices when they have to do their practicum. So I think it's more about the program. That's what we're promoting more than the the actual career path in that evolution.

00:19:10:20 - 00:19:36:07
Unknown
You've seen, as you mentioned, the changes and the growth that's happened in this field since you first started. When it comes to technology, would you describe how you've seen that evolve since you first started as well? Oh, sure. It was technology back then, but we actually recorded our sessions on VCR tapes. It was also before HIPAA was a big thing.

00:19:36:07 - 00:20:01:10
Unknown
So we brought those VCR tapes home to review, which would never be okay at this point. But we did. We had things on VCR. You think about classrooms. They wheeled in a TV with a VCR. If they showed something in the classroom, you had projectors and slides. And then even when I started at northeastern, we were using DVDs.

00:20:01:10 - 00:20:33:16
Unknown
So you had to go to the huge machine, all the DVD players, and we went in and we'd have to select the right one, put the DVD in and make sure we hit record, then run into the room to start the session. And so about about a year into working at northeastern, we started with the digital recordings, which, you know, now we can schedule the recordings, which is huge, to be able to just set those up so they're ready to go at the beginning of the semester.

00:20:33:17 - 00:20:58:19
Unknown
And so we can still manually go in if we needed to extend anything or change anything, but we can set those up in advance. And so huge changes in that. And then in the classroom side of things, I mean, the fact that I can just bring my laptop and everything is projected through my laptop, all of the content for the courses, you know, that's huge.

00:20:58:19 - 00:21:30:09
Unknown
And then I can play the videos that we have recorded in our sessions in the clinic and use those for guided observations in the classroom. So yeah, technology has changed quite a bit. I feel like Mike is about to say, you know, where is it going so well. But before I go there, I the what just cropped into my mind was, you know, a lot of universities will invest in this technology.

00:21:30:09 - 00:21:59:17
Unknown
And ultimately the investment is as an educator you're educating students. And so the technology really is designed for to support student success and student learning. I'm kind of curious how your students what their feedback is in using video. Well, you know, none of us want to be video recorded. I.

00:21:59:19 - 00:22:28:18
Unknown
And I usually hit record, you know, if we have a zoom session, I'll hit record after I go off screen. And, you know, so really wants to be recorded. However, they will say that it was it's just vital to their learning because it's so stressful when you are a new clinician and you are working with clients in a session, it's overwhelming and you can come out.

00:22:28:18 - 00:22:50:04
Unknown
It's sort of like giving a speech. You come out sometimes and say, I don't even remember what I said. I was so nervous. You know, I just, I don't know, I didn't take my data. I didn't follow all the prompts that I thought I was going to do. I feel like I really messed up. And then, you know, they'll watch and say, oh, okay, wait, I did do this.

00:22:50:04 - 00:23:11:10
Unknown
I did do that. I just sort of blacked out a little, didn't remember it. But there's also subtleties that they'll miss and they'll say, I didn't even notice that the child was doing this, or I didn't even notice that the mom had helped at this point with something. So it's really great that they're able to look at that after the fact.

00:23:11:10 - 00:23:40:21
Unknown
So as much as they don't love seeing or hearing themselves, they are grateful for the opportunity to go back and check that data. They also have to write notes after every session. And so in order for that to be accurate, they really need that. They rely on that feedback. After. So virtually every guess that we've had on the podcast, ultimately the topic of AI comes up.

00:23:41:01 - 00:24:14:02
Unknown
So I'm kind of curious to get your take on what excites you about AI, what concerns you about AI, and how you may be going about thinking about implementing AI, if you haven't already? Yeah, I think AI for treatment materials is fantastic. You could say, let's say you're working on essays with a child. You could say, you know, to ChatGPT or whatever format you're doing.

00:24:14:02 - 00:24:52:13
Unknown
Clod. Anything you could say. Give me a list of 20 sentences using S in the initial position of the words, you could say, give me a story, write a story using essays and so, you know, things like that. That's fantastic. The amount of time that saves is just wonderful. It's a great tool to have. Where we have to be very, very careful is things like if we're saying evidence based practice, it really has to be evidence based practice.

00:24:52:13 - 00:25:18:14
Unknown
And when you plug in for references from AI, you can sometimes get false references. So and we check those as supervisors. And you have to make sure that these are actual references. The other thing is, you know, HIPAA compliance, you can't put in a whole bunch of client information and then say, give me a treatment plan for this person.

00:25:18:14 - 00:25:50:15
Unknown
That's not okay. So you really have to be careful of that. So there are great parts to it, but there's also parts that, you know, in a clinic you have to be wary of. Well, I had the opportunity of visiting your clinic last year. It's a beautiful clinic. Before we wrap up, Karen, is there anything else that you'd like to share with our listeners, maybe those listeners who are maybe just getting into the field of speech and language pathology.

00:25:50:16 - 00:26:18:02
Unknown
Maybe they're looking to set up a video system in their clinic, lessons learned, challenges that you've overcome, things of that sort. Sure. Yeah. I would say for the most part, challenges are fairly minor. Sometimes it's user error, mis timing, recording, things like that. Why fee issues can cause a lot of glitches with the system. So you have to be careful there.

00:26:18:02 - 00:26:41:05
Unknown
I would say make sure you have whatever video system you're using. You have their support on speed dial just in case you have cell phone number two don't you? Yeah. Yeah, yeah. Sometimes it's, you know, you'll you'll hear from me. I need you immediately. You know, this is where I need. I need help right the second. So we definitely need that.

00:26:41:06 - 00:27:11:14
Unknown
We lie heavily on tech support, but also you want to make sure that before you have a system that you check into HIPAA compliance. We had many meetings with our HIPAA compliance office officers, as well as with IBS, so that we could make sure that we were being HIPAA compliant with all of our recordings. And you want to make sure that your IT department can support you.

00:27:11:14 - 00:27:44:21
Unknown
That's really important before you install a new system. Well, this has been a great conversation. How can our listeners get in touch with you if they have an interest in learning more about your program? Sure. They can email me. It's CAA, MC Deon oh, you at northeastern, I have a team's number (617) 373-7831. Well thanks, Karen. We appreciate your time.

00:27:45:03 - 00:27:48:14
Unknown
Thanks so much. Take care.

00:27:48:16 - 00:28:03:05
Unknown
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzalone and Carmen Haak and produced by Kyle Shelstad. Find us online at IPIVS.com/onrecord and on social media at Intelligent Video Solutions.