Étude exploratoire des pratiques de supervision du raisonnement clinique des orthophonistes superviseur·es

Introduction: Clinical reasoning is a multidimensional and complex process at the core of clinical practice. Internships appear to be essential for the development of high-quality clinical reasoning. In Speech and Language Therapy (SLT), some research shows that clinical reasoning develops in a similar way to other health professions, but none has examined the supervision of clinical reasoning in SLT. This study focuses on the supervision strategies used by Speech and Language Therapists supervisors, to identify and characterize the presence of clinical reasoning. Methods: Ten interviews with stimulated recall were conducted with SLT supervisors based on a video of an educational exchange between the SLT supervisor and her trainee. The interviews were transcribed, coded and subjected to inductive and deductive thematic analysis. Results: SLT supervisors develop clinical reasoning processes similar to those used by other health professionals. Intuitively, they use supervision strategies known to be effective in supporting the teaching alliance and developing their trainees'professional identity and clinical reasoning. These supervision strategies are influenced by factors related to the trainees, to the SLTs supervisors and to similarities between clinical and pedagogical skills. Conclusion: SLT supervisors use clinical reasoning processes in their practice, often unconsciously, and wish to pass these on to their trainees. Formalizing clinical reasoning in Speech and Language Therapy and making it explicit to SLT supervisors would strengthen their sense of pedagogical competence, promote interprofessional practice using common terms and, ultimately, improve the quality of care.