Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department (Legacy)

Department of Education

Committee Chair

Bauder, Debra K.

Author's Keywords

Communication disorders; Pediatrics; Augmentative & alternative communication; Pediatric training; Resident education; American Council of Graduate Medical Education


Pediatricians--Training of; Speech disorders in children


Children with general communication impairments as well as complex communication needs rely on pediatricians to prescribe the services of speech language pathologists. In light of this continuing and increasing need, it is important to ascertain whether medical residents are receiving the necessary training in their educational program to fulfill their role. We need to understand how pediatric residents perceive their current level of abilities particularly within the framework of the current ACGME competencies. The purpose of this dissertation was to identify possible differences across pediatric resident levels regarding competence within three constructs, Medical Education, Medical Knowledge and Professional Practice, with a specific focus on communication disorders and augmentative and alternative communication (AAC). A MANOVA was used to address the first three of five research questions. Upon analysis of the MANOVA, the main effect was significant for differences among the three groups of residents in their average levels of self reported competence in the three constructs. Further paired comparisons found differences across pediatric levels for Medical Education and Medical Knowledge. The fourth research question investigated the effects of demographic variables on residents' perceived competency across the three constructs. These demographic variables included gender, rotation completion, pediatric specialization educational methods, and educational time. Independent t- tests were completed with Bonferroni adjustment as well as correlation coefficients. Significant findings within these variables provide further understanding of current and future pediatric resident training. The final research question investigated the perspectives of pediatric residents regarding communication disorders and AAC as part of their training. This question provided qualitative data gathered through responses to several open-ended questions. Residents were confident in their ability to identify a communication disorder or a need for AAC and make referrals. At the same time, residents expressed concerns regarding educational training and appeared to not grasp the entirety of their roles. The results of this study provide evidence for some improvements within residents' perceived competence for referrals and knowledge base. Yet, it appears that improvements are still needed regarding residents' educational opportunities, and understanding of their role within the provision of services for children with communication disorders and needing AAC. Follow-up of this current investigation by educational leaders and continued research within this field will support this effort.