Impact of technology based intervention training on knowledge attitude and practice among speech language pathology students Running head: Technology Based Training in SLP students

Impact of technology based intervention training on knowledge attitude and practice among speech language pathology students Running head: Technology Based Training in SLP students | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of technology based intervention training on knowledge attitude and practice among speech language pathology students Running head: Technology Based Training in SLP students D Thanuja, U Navitha, S Sundaresan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9218802/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract With the increasing role of technology in clinical practice, digital tools have become integral to the training of Speech-Language Pathology (SLP) students. However, many students still lack adequate exposure and training in applying technology-based interventions in clinical settings. This study aimed to evaluate the impact of such interventions on enhancing the clinical practice readiness skills of SLP students. A quasi-experimental, pre-post design was employed, conducted in four phases: Phase 1: Development and validation of the survey questionnaire, Phase 2: Pre-training survey, Phase 3: Technology-based training program, Phase 4: Post-training survey. A total of thirty-seven final-year undergraduate and postgraduate students from the Department of Audiology and Speech-Language Pathology participated in a KAP survey before a structured training program. The program covered technology-based intervention methods, app selection guidelines, and app exploration. The survey evaluated students’ knowledge of technology-based rehabilitation tools, confidence in their use, perceived benefits of tech-focused training, and awareness of digital aids that enhance learning. There was a clear increase in agreement regarding the integration of technology into clinical training, with improved confidence and perceived usefulness of digital tools in therapy delivery. Overall, the study demonstrated a notable impact of technology-based interventions in enhancing the clinical practice readiness skills of SLP students. Clinical practice service delivery technology-based SLP intervention tele practice Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Introduction Technology based behavioural Health Care intervention involving the delivery of evidence-based practices through computers, mobile applications, web-based applications, or any other technological platform are being rapidly developed. The rapid advancement in technology have effectively positioned the technology-based intervention in the fore front of behavioural Healthcare intervention. From mobile apps to teletherapy platforms and simulation-based environments, digital tools now offer opportunities for students to engage with clinical content in ways that are interactive, scalable, and increasingly reflective of real-world practice [ 1 ]. Despite these advancements, many SLP students enter clinical settings with limited exposure to technology-based interventions. In health profession education, the emphasis on clinical practice readiness primarily revolves around students' ability to exhibit knowledge, comprehension, and synthesis of concepts and abilities essential for client-centred care and practice [ 2 ]. The necessity for organised and experienced education in this field is thoroughly documented. Recent studies [ 3 ] highlight the significance of practical experience, structured simulations, and educational modules that specifically address the use of digital tools in clinical reasoning, therapy planning, and client interaction. Furthermore, as the profession transitions to technology-enhanced service models — such as tele practice, mobile health, and AI-assisted therapies — student readiness must align to guarantee high-quality, client-centred care [ 4 ]. The scarcity of comprehensive instruments for monitoring student outcomes in tele practice education significantly restricts research on the application of outcome measures in this domain. Recently, McGill & Dennard [ 5 ] published findings from a survey administered to various speech-language pathology graduate schools, which assessed students' assessments of their knowledge and clinical competencies concerning tele practice. In their study, hardly 20% of respondents indicated having experience in delivering tele practice services. Students with greater experience in providing tele practice services and those farther advanced in their graduate degrees had stronger confidence in their knowledge and skills compared to their less experienced counterparts [ 5 ]. Thus, there is a critical need to address the gap between the rapid expansion of technology-based service delivery and the limited formal training provided to SLP students. The current study aims to create, administer, and assess a structured training program to enhance SLP students' Knowledge, Attitudes, and Practices (KAP) about technology-based service delivery. This study will enhance the existing evidence for technology integration in allied health education by offering practical insights for curriculum improvement. Method The current study employed a quasi-experimental, pre-post intervention strategy and followed a purposive sampling method. Ethical clearance was obtained from the Institutional Ethics Committee prior to the initiation of the study. Participants The survey form was filled in by a total number of thirty-seven students that included twenty-seven under graduate and ten post graduate students from the department of Audiology and Speech Language Pathology. All the participants were recruited based on the following inclusion and exclusion criteria. Inclusion Criteria Final-year undergraduate or graduate SLP students. Currently in or scheduled for supervised clinical practicum. Basic proficiency in using computers/tablets/smartphones. Exclusion Criteria Over 6 months of prior telepractice/tech-based intervention experience. Uncorrected visual, hearing, cognitive or motor impairments affecting participation. Unwilling or unable to follow the study schedule. Procedure The study was carried out in four phases. Phase I was the development and validation of the survey questionnaire. Phase II was the data collection from the students on the survey form prior to the intervention strategy. Phase III was the training program which revolves around medical education, focusing on the use of technology to enhance student learning & education. Phase IV was again the data collection on the survey form following the training program given to the students. Phase I The survey questionnaire was framed by the authors of the study. The questions were framed in such a way that they targeted the areas of Knowledge, Attitude and Practice of an SLP student’s clinical practice readiness in delivering the rehabilitation services using any type of technology-based methods. The survey questions were then validated by three SLPs with a minimum of five working years of experience in the field. Also, it was ensured that the validators had a minimum of one year experience in handling speech language therapy via tele practice methods or any other technology-based methods. They rated each item of the questionnaire on a four-point Likert scale of highly appropriate (score 4), appropriate (score 3), somewhat appropriate (score 2), not appropriate (score 1). Content validity index of 0.94 was obtained indicating an excellent level of content validity for the framed survey questionnaire. The comments and suggestions given by the validators were incorporated in the survey form that mainly included the rephrasing of the questions included in the survey. The final survey form included a total of 21 questions that contained 3 under demographic section, 5 related to the Knowledge, 5 related to the Attitude, 5 related to the Practice and 3 under Feedback section. The responses for each of the item were collected through open ended questions, Likert rating scale (strongly agree, agree, neutral, disagree, strongly disagree), yes-no-somewhat format, and multiple-choice format. The final questionnaire was converted to a google survey form and the responder link was generated for circulation among the students. Phase II The responder link for the google survey form was circulated among the UG and PG students who were enrolled for the voluntary participation in the current study. All the participants were informally assessed for any difficulty that affect the study participation. The students were explained about the research gaps that led to the purpose and objective of the present study prior to the collection of their responses on the survey form. In the initial section of the survey form itself, a brief description was given about the study followed by the informed consent from the participants. The responses were collected only from those students who gave voluntary participation for the survey and training programme that focussed on augmentation of SLP Student's clinical practice readiness in Service Delivery Using Technology-Based Intervention Method. It took approximately 7 to 10 minutes for an SLP student to complete the survey and the responses were saved automatically for the analysis. Phase III : The training sessions were basically instructor-led with guidance provided by the principal investigator over two separate days for UG and PG students respectively. Each session lasted approximately 90–120 minutes and was conducted in a classroom equipped with digital resources. Following were the topics of the training programme: 1. Technology-based intervention methods available, 2. Guidelines to select the appropriate intervention application, 3. Exploration of the apps available, 4. Student training using simulation therapy, 5. Tele practice guidelines [ 6 ]. With the aid of PowerPoint slides, and demonstration videos, the author introduced students to various available technology platforms, therapy applications, technology specifications required to use such apps, benefits and challenges that were commonly encountered when using any such technology-based intervention methods for service delivery in the field of SLP. The session was quite interactive and students participated actively in the discussion during the training programme. Positive comments were received from the respondents after the completion of the training programme as it enhanced their learning skills for service delivery. Phase IV The same survey questionnaire link was generated in a different name- “post lecture” to collect their responses after the training programme. Students who responded to the baseline survey and attended the programme were reassessed using the same survey upon completion of the programme. There was no attrition of the students throughout the study period. The data were systematically collected, organized, and analysed using appropriate statistical procedures in SPSS software. Results Table 1 presents the descriptive statistics (mean and standard deviation) of the participants’ responses across the Knowledge, Attitude, and Practice (KAP) domains before and after the training program. An overall improvement in post-intervention scores was observed across all items, suggesting positive changes in the participants' knowledge, attitudes, and practices related to the topic following the training. Table 1 Pre- and Post-Intervention Mean (SD) Scores of KAP Items (N = 37) Item Domain Pre-Mean (SD) Post Mean (SD) K1 Knowledge 2.30 (0.74) 2.89 (0.39) K3 Knowledge 1.89 (0.84) 2.49 (0.73) K4 Knowledge 2.27 (0.45) 2.76 (0.44) K5 Knowledge 1.73 (0.45) 1.95 (0.23) A1 Attitude 3.49 (1.15) 4.22 (0.95) A2 Attitude 3.24 (0.93) 4.14 (1.08) A3 Attitude 3.65 (1.16) 4.27 (0.99) A4 Attitude 3.51 (1.24) 4.51 (0.90) A5 Attitude 3.97 (1.26) 4.38 (1.19) P1 Practice 1.49 (0.51) 1.54 (0.51) P2 Practice 1.03 (0.16) 1.08 (0.28) P3 Practice 4.03 (1.09) 4.59 (0.99) P4 Practice 3.86 (1.00) 4.41 (1.07) P5 Practice 1.43 (0.77) 2.11 (0.99) Knowledge section When the pre and post responses were compared, there was an evident shift in student’s awareness about the available digital tools in therapy. For Question 1 - “Are you aware of technology-based intervention applications used in SLP service delivery?” (K1), the proportion of students answering "Yes" increased from 45.9% pre-training to 91.9% post-training. Those responding "No" dropped from 16.2% to 2.7%, and "Somewhat" from 37.8% to 5.4%, indicating a significant improvement in awareness (see Fig. 1 – Question 1 under Knowledge domain). Figure 1 Question 1 “Are you aware of technology-based intervention applications used in SLP service delivery?” After attending the lecture, for the Question 2 and 4 under Knowledge domain, they were able to name some therapy apps and technology platforms used for speech and language therapy other than AAC that was commonly accessed by them in their clinic. For Question 3 under the Knowledge domain, participants demonstrated a clearer understanding of the benefits of using technology-based aids in therapy following the training program. For Question 5 – “Do you know the optimum specifications (RAM, processor speed, etc.) a device should have to use a therapy application effectively?” – the percentage of students answering "Yes" rose from 73% pre-training to 94.6% post-training, while "No" responses declined from 27% to 5.4%, demonstrating improved understanding of the technical requirements (see Fig. 2 – Question 5 under Knowledge domain). Attitude section In this section, their post lecture responses indicated a dramatic increase in their confidence and understanding towards the use of digital tools for speech and language therapy. The findings of this section are represented in the Fig. 3, 4 , 5 , 6 , 7 respectively. Figure 3 Question 1: I believe technology-based methods enhance my understanding of real-life clinical service delivery Question 2: I am confident in my ability to provide rehabilitation services using technology-based methods Overall, the results under the section “Attitude’ advocate that the targeted training programme certainly enhanced students’ attitudes, accentuating the value of structured exposure to technology-based clinical tools in SLP education. Practice section There was a prominent positive trend in students' willingness to integrate technology into future service delivery, as well as improved understanding of its practical applications in adult neurogenic communication disorders. For the Question 1 exploring the clinical readiness among the SLP students revealed that only 43.2% of the respondents had ever designed or planned a therapy session using technology-based tools, while the remaining 56.8% had not engaged in such practices prior to the intervention. This gap indicates limited pre-training exposure to real-world tech-based clinical application. Question 2 identifying challenges associated with incorporating technology into clinical training, participants were allowed to select multiple options. The most frequently reported challenge was “Lack of training/exposure”, cited by 91.9% of students, followed by “Limited access to tools or software” (78.4%), “Time constraints in curriculum” (70.3%), and “Not confident with technology” (56.8%). Only three participants (8.1%) reported experiencing no challenges, highlighting the prevalent barriers to implementing technology in academic and clinical settings. For the Question 3, “Do you think applying technology in your future clinical practice will help you deliver better service?”, strong agreement increased from 43.2% pre-training to 78.4% post-training. Responses marked “Agree” dropped from 29.7% to 13.5%, and “Neutral” responses decreased significantly from 16.2% to 2.7%, suggesting that students became more decisive and positive about the role of technology post-intervention. Similarly, in response to the Question 4 “Do you think a formal module or elective course focused on tech-based service delivery methods is essential?”, strong agreement rose from 29.7% to 67.6%, reinforcing students’ demand for structured academic exposure to technology in clinical training. This was accompanied by a decline in “Agree” from 37.8% to 16.2% and “Neutral” responses from 24.3% to 10.8%. Question 5, When asked about prior exposure to formal training in technology use for speech and language therapy, 59.5% (n = 22) reported having received such training, while 37.8% (n = 14) had not. One participant (2.7%) was self-taught. These findings highlight the need for structured training modules to ensure consistent competence in tech-based clinical approaches. Feedback section Majority of the participants who took part in the study recommended for such training to be introduced into standard SLP curriculum to prepare students for evolving clinical demands. They found the lecture and the demonstration videos very helpful in building their insights about the technological options available and that they are welcoming more such training programmes in future, as part of their curriculum. The Shapiro-Wilk test indicated a deviation from normality (p < 0.05) for the study variables, denoting non-normal distribution. Hence, non-parametric tests like Wilcoxon Signed Rank Test was carried out. Wilcoxon Signed-Rank Test Results: The Wilcoxon Signed-Rank Test revealed statistically significant improvements across multiple domains (see Table 1 ). In the Knowledge domain, all items (K1, K3, K4, K5) demonstrated significant increases in post-test scores compared to pre-test scores (p < .05), with Z-values ranging from − 2.530 to -3.674. Similarly, in the Attitude domain, four of the five items (A1 to A4) showed significant positive changes (p < .01). However, item A5 did not exhibit a statistically significant difference (Z = -1.436, p = .151). In the Practice domain, items P3, P4, and P5 displayed significant improvements (p .05), possibly indicating limited hands-on exposure or practical application opportunities during the intervention period. These results suggest that the intervention had a statistically measurable impact across most domains, particularly in knowledge and parts of attitude and practice. Discussion The current study attempted to study the effect of a training program on the Knowledge, Attitudes, and Practices of Undergraduate and Postgraduate SLP students concerning about the usage of technology-based intervention methods; for an improved clinical practice readiness. The overall results revealed that there is an augmentation of student’s clinical practice readiness skills supporting the necessity of integrating the technology-based treatment options in SLP academic curriculum. In the knowledge section, significant shift in the awareness about the technology platforms, specifications for using any such therapy application suggested the future benefit of such academic programs for the SLP students in increasing their clinical capabilities. These were further supported by another study done by Bhattarai et al. [ 7 ] where the most essential clinical skill for an SLP providing tele service was the knowledge on how to select an appropriate tele material for rehabilitation. Participants showed increased competence and awareness of various clinical apps suitable for therapy. Further Hansen et al. [ 8 ] highlights the need for academic programs to incorporate technology training to prepare students for modern clinical practices. Additionally, works done by Hill and Miller [ 9 ] and Bajaj and Karuppali [ 10 ] stressed the importance of education of technology and relevant training among the SLPs, asserting that an effective service delivery in the modern era requires clinicians to be aware of the technological advancements in their respective fields. Supporting results were obtained from the current study signifying that focussed education has evidently raised the student’s practice readiness levels for service delivery. On questions pertaining to their attitude towards incorporating such educational methods for enhancing their clinical skills also revealed positive shift on the post-survey responses. Their confidence in using technology and understanding about technology-based aids has increased after the program. In this section the respondents scoring was high for the inclusion of such technology tools in SLP curriculum and hands on training as well for the skill transfer to actual clinical settings. Similar study carried out by Grogan-Johnson et al., [ 11 ] mentioned the importance behind inclusion of tele practice applications in the curriculum for SLP students. Another experiment by Mohan et al., [ 12 ] also stressed upon the need for a short-term training course in tele practice for professionals. This training enhances understanding and reduces resistance to digital tools. Mytsyk et al. [ 13 ] explored student SLPs' perceptions of digital technologies and found that their intention to adopt these tools was strongly influenced by performance and effort expectancy, social influence, and available support. The study emphasised the importance of institutional training, digital skill development, and resource accessibility in shaping student confidence and readiness to integrate technology into future clinical practice. Dudding and Justice [ 14 ] also demonstrates that embedding tele practice into academic programs significantly enhances students' preparedness and confidence in using digital tools. In the practice section, their responses showed a greater willingness to adopt these technology aids into their clinical practice in future. According to Worek A et al., [ 2 ] there existed a positive correlation between the hands-on experience in delivering tele practices and their confidence levels in handling such therapy services. Howell et al. [ 4 ] found that integrating simulation-based modules into SLP education significantly improved students’ confidence, clinical reasoning, and readiness for real-world practice. These results are supportive of the notion of our current study for encouraging more exploration of such technology platforms, applications, and aids to gain confidence in providing tele rehabilitation services. There is a dearth of such applications being developed in this technology era. Each SLP student must put effort in bombarding themselves with such tele practice applications and explore them for their clinical practice. Conclusion The current study was aimed to address the gap between the rising use of technology in speech-language pathology practice and the limited structured training provided to students. Results demonstrated that the usage of a targeted, technology-based intervention significantly improved SLP students' clinical practice readiness. This study highlights the importance of structured, hands-on training and sustained institutional and curricular support to effectively integrate technology into speech-language service delivery across diverse contexts. Declarations Acknowledgments The authors acknowledge the Pro- Vice Chancellor, Dean-Medical, Dean-AHS and HoD ENT and HoD ASLP, support in accomplishing this study. We are also extent gratitude to Department of Science and Technology (DST), SEED/TIDE scheme for supporting to conduct the study. We are grateful to the Faculty of Medicine and Health Sciences, SRM MCH& RC, SRMIST, Kattankulathur for bearing the defrayed costs of publishing this article. Authors’ Contributions The first and second authors conceptualized the study. The first author collected and analysed the data. The manuscript was drafted and revised by both the first and second authors. The supervising author provided clinical oversight, contributed to the study design and interpretation of the findings, and critically reviewed the manuscript. All authors approved the final version of the manuscript for submission. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Statement of Informed Consent and Ethical Approval Verbal Informed Consent was taken from all the participants. The study was carried out in accordance with the principles as enunciated in the Declaration of Helsinki. The study was accorded Ethical Committee Approval vide Institutional Ethics Committee SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, with the reference No. 1836/IEC/2019 dated on 12.12.2019. Data Availability The datasets generated and analysed during the current study are available from the corresponding author on reasonable request. References Boyd C. Technology-based interventions: exploring new models of care and navigating new ethical dilemmas [Internet]. University of Kansas School of Social Welfare; Hope and Wellness Resources; [cited 2026 Mar 24]. Worek A, Sabo KK, Eddy EZ, Plummer L, Baldwin J, Reidy PA, et al. Students TeLE-AlL: self-efficacy and self-reflection as measures of student success in telepractice training. Educ Sci . 2022;12(5):302. doi:10.3390/educsci12050302. Rao PS, Yashaswini R. Telepractice in speech-language pathology and audiology: prospects and challenges. J Indian Speech Lang Hear Assoc . 2018;32(2):67. doi:10.4103/jisha.jisha_39_17. Howells S, Cardell EA, Waite MC, Bialocerkowski A, Tuttle N. A simulation-based learning experience in augmentative and alternative communication using telepractice: speech pathology students’ confidence and perceptions. Adv Simul . 2019;4(S1). doi:10.1186/s41077-019-0113-x. McGill M, Dennard Q. Graduate students’ perspectives toward telepractice at the COVID-19 global pandemic onset. Perspect ASHA Spec Interest Groups . 2021;6(4):841–854. doi:10.1044/2021_persp-20-00231. Chatterjee I, Banik A, Ravi SK, Yuvaraj P, Kumar P, Kumar S, et al. Telepractice guidelines for audiology and speech-language pathology services in India [Internet]. Indian Speech-Language and Hearing Association; 2020 [cited 2026 Mar 24]. Available from: https://www.ishaindia.org.in/downloads/TELEPRACTICE-GUIDELINES.pdf Bhattarai B, Sanghavi T, Panchakshari AB. Experience delivering telepractice services among upcoming and working professionals of speech language pathology. J Health Allied Sci NU . 2021;12(4):441–447. doi:10.1055/s-0042-1743550. Hansen TN, Bjornsen AL, DeVeney SL. Use of tablet technology: a pilot program for graduate students in speech-language pathology. Teach Learn Commun Sci Disord . 2017;1(1). doi:10.30707/tlcsd1.1hansen. Hill AJ, Miller LE. A survey of the clinical use of telehealth in speech-language pathology across Australia [Internet]. Int J Speech Lang Pathol . 2012;14(3):110–117. Available from: https://espace.library.uq.edu.au/view/UQ:289481 Bajaj G, Karuppali S. Knowledge, attitudes, and practices of speech language pathologists in India about telerehabilitation services during the COVID-19 pandemic. CoDAS . 2022;34(6). doi:10.1590/2317-1782/20212021193. Grogan-Johnson S, Meehan R, McCormick K, Miller N. Results of a national survey of preservice telepractice training in graduate speech-language pathology and audiology programs. Contemp Issues Commun Sci Disord . 2015;42(Spring):122–137. doi:10.1044/cicsd_42_s_122. Mohan HS, Anjum A, Rao PK. A survey of telepractice in speech-language pathology and audiology in India. Int J Telerehabil . 2017;9(2):69–80. doi:10.5195/ijt.2017.6233. Mytsyk H, Kovachov S, Suchikova Y. From acceptance to implementation: student speech-language pathologists’ perspectives on using digital technologies in practice. Disabil Rehabil Assist Technol . 2025:1–15. doi:10.1080/17483107.2025.2472262. Dudding CC, Justice LM. An e-supervision model. Commun Disord Q . 2004;25(3):145–151. doi:10.1177/15257401040250030501. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 11 May, 2026 Reviewers agreed at journal 08 May, 2026 Reviewers agreed at journal 16 Apr, 2026 Reviewers invited by journal 16 Apr, 2026 Editor assigned by journal 30 Mar, 2026 Submission checks completed at journal 28 Mar, 2026 First submitted to journal 28 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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5","display":"","copyAsset":false,"role":"figure","size":31027,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eQuestion 3: I feel the need for hands-on training with digital tools for enhancing my clinical competency skills\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/728046678b22eb74d159a47f.png"},{"id":107706776,"identity":"791ef9bd-fa52-4187-b3a7-1920ef8f4f1a","added_by":"auto","created_at":"2026-04-24 09:18:43","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":32575,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eQuestion 4: Incorporating tech-based simulation tools into SLP curriculum will improve skill transfer to actual clinical settings.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/3cc141a42fadee5ae3994579.png"},{"id":107702269,"identity":"5683ac3e-de1a-4dca-af20-d387e4598a98","added_by":"auto","created_at":"2026-04-24 08:22:58","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":36625,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eQuestion 5: SLP students should be encouraged to independently explore and apply digital tools in therapy planning.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/61207ce2a3b9c2f73568f02f.png"},{"id":107868760,"identity":"063cb8f0-0b9d-46bb-aaad-78936494f8a7","added_by":"auto","created_at":"2026-04-27 07:33:25","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":35387,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eQuestion 3, “Do you think applying technology in your future clinical practice will help you deliver better service?”\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/a876edab1dd7007d8991001b.png"},{"id":107702271,"identity":"2b23d098-bc86-4a80-8ca4-4a7a6bb7eb0c","added_by":"auto","created_at":"2026-04-24 08:22:58","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":34908,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eQuestion 4 “Do you think a formal module or elective course focused on tech-based service delivery methods is essential?”\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"9.png","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/c1734c4cc2afa7c51931c674.png"},{"id":107871670,"identity":"63e00212-2c2b-4bd2-b6e5-4fd1b683adfd","added_by":"auto","created_at":"2026-04-27 07:53:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":427911,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9218802/v1/af1925a8-35c8-4edd-ba82-522df3059a26.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of technology based intervention training on knowledge attitude and practice among speech language pathology students Running head: Technology Based Training in SLP students","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTechnology based behavioural Health Care intervention involving the delivery of evidence-based practices through computers, mobile applications, web-based applications, or any other technological platform are being rapidly developed. The rapid advancement in technology have effectively positioned the technology-based intervention in the fore front of behavioural Healthcare intervention. From mobile apps to teletherapy platforms and simulation-based environments, digital tools now offer opportunities for students to engage with clinical content in ways that are interactive, scalable, and increasingly reflective of real-world practice [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Despite these advancements, many SLP students enter clinical settings with limited exposure to technology-based interventions.\u003c/p\u003e \u003cp\u003eIn health profession education, the emphasis on clinical practice readiness primarily revolves around students' ability to exhibit knowledge, comprehension, and synthesis of concepts and abilities essential for client-centred care and practice [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The necessity for organised and experienced education in this field is thoroughly documented. Recent studies [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] highlight the significance of practical experience, structured simulations, and educational modules that specifically address the use of digital tools in clinical reasoning, therapy planning, and client interaction. Furthermore, as the profession transitions to technology-enhanced service models \u0026mdash; such as tele practice, mobile health, and AI-assisted therapies \u0026mdash; student readiness must align to guarantee high-quality, client-centred care [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe scarcity of comprehensive instruments for monitoring student outcomes in tele practice education significantly restricts research on the application of outcome measures in this domain. Recently, McGill \u0026amp; Dennard [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] published findings from a survey administered to various speech-language pathology graduate schools, which assessed students' assessments of their knowledge and clinical competencies concerning tele practice. In their study, hardly 20% of respondents indicated having experience in delivering tele practice services. Students with greater experience in providing tele practice services and those farther advanced in their graduate degrees had stronger confidence in their knowledge and skills compared to their less experienced counterparts [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThus, there is a critical need to address the gap between the rapid expansion of technology-based service delivery and the limited formal training provided to SLP students. The current study aims to create, administer, and assess a structured training program to enhance SLP students' Knowledge, Attitudes, and Practices (KAP) about technology-based service delivery. This study will enhance the existing evidence for technology integration in allied health education by offering practical insights for curriculum improvement.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eThe current study employed a quasi-experimental, pre-post intervention strategy and followed a purposive sampling method. Ethical clearance was obtained from the Institutional Ethics Committee prior to the initiation of the study.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe survey form was filled in by a total number of thirty-seven students that included twenty-seven under graduate and ten post graduate students from the department of Audiology and Speech Language Pathology. All the participants were recruited based on the following inclusion and exclusion criteria.\u003c/p\u003e \u003cp\u003eInclusion Criteria\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eFinal-year undergraduate or graduate SLP students.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCurrently in or scheduled for supervised clinical practicum.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eBasic proficiency in using computers/tablets/smartphones.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eExclusion Criteria\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eOver 6 months of prior telepractice/tech-based intervention experience.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eUncorrected visual, hearing, cognitive or motor impairments affecting participation.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eUnwilling or unable to follow the study schedule.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedure\u003c/h3\u003e\n\u003cp\u003eThe study was carried out in four phases. Phase I was the development and validation of the survey questionnaire. Phase II was the data collection from the students on the survey form prior to the intervention strategy. Phase III was the training program which revolves around medical education, focusing on the use of technology to enhance student learning \u0026amp; education. Phase IV was again the data collection on the survey form following the training program given to the students.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePhase I\u003c/strong\u003e \u003cp\u003eThe survey questionnaire was framed by the authors of the study. The questions were framed in such a way that they targeted the areas of Knowledge, Attitude and Practice of an SLP student\u0026rsquo;s clinical practice readiness in delivering the rehabilitation services using any type of technology-based methods. The survey questions were then validated by three SLPs with a minimum of five working years of experience in the field. Also, it was ensured that the validators had a minimum of one year experience in handling speech language therapy via tele practice methods or any other technology-based methods. They rated each item of the questionnaire on a four-point Likert scale of highly appropriate (score 4), appropriate (score 3), somewhat appropriate (score 2), not appropriate (score 1). Content validity index of 0.94 was obtained indicating an excellent level of content validity for the framed survey questionnaire. The comments and suggestions given by the validators were incorporated in the survey form that mainly included the rephrasing of the questions included in the survey. The final survey form included a total of 21 questions that contained 3 under demographic section, 5 related to the Knowledge, 5 related to the Attitude, 5 related to the Practice and 3 under Feedback section. The responses for each of the item were collected through open ended questions, Likert rating scale (strongly agree, agree, neutral, disagree, strongly disagree), yes-no-somewhat format, and multiple-choice format. The final questionnaire was converted to a google survey form and the responder link was generated for circulation among the students.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePhase II\u003c/strong\u003e \u003cp\u003eThe responder link for the google survey form was circulated among the UG and PG students who were enrolled for the voluntary participation in the current study. All the participants were informally assessed for any difficulty that affect the study participation. The students were explained about the research gaps that led to the purpose and objective of the present study prior to the collection of their responses on the survey form. In the initial section of the survey form itself, a brief description was given about the study followed by the informed consent from the participants. The responses were collected only from those students who gave voluntary participation for the survey and training programme that focussed on augmentation of SLP Student's clinical practice readiness in Service Delivery Using Technology-Based Intervention Method. It took approximately 7 to 10 minutes for an SLP student to complete the survey and the responses were saved automatically for the analysis.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e\u003cb\u003ePhase III\u003c/b\u003e: The training sessions were basically instructor-led with guidance provided by the principal investigator over two separate days for UG and PG students respectively. Each session lasted approximately 90\u0026ndash;120 minutes and was conducted in a classroom equipped with digital resources. Following were the topics of the training programme: 1. Technology-based intervention methods available, 2. Guidelines to select the appropriate intervention application, 3. Exploration of the apps available, 4. Student training using simulation therapy, 5. Tele practice guidelines [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. With the aid of PowerPoint slides, and demonstration videos, the author introduced students to various available technology platforms, therapy applications, technology specifications required to use such apps, benefits and challenges that were commonly encountered when using any such technology-based intervention methods for service delivery in the field of SLP. The session was quite interactive and students participated actively in the discussion during the training programme. Positive comments were received from the respondents after the completion of the training programme as it enhanced their learning skills for service delivery.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePhase IV\u003c/strong\u003e \u003cp\u003eThe same survey questionnaire link was generated in a different name- \u0026ldquo;post lecture\u0026rdquo; to collect their responses after the training programme. Students who responded to the baseline survey and attended the programme were reassessed using the same survey upon completion of the programme. There was no attrition of the students throughout the study period. The data were systematically collected, organized, and analysed using appropriate statistical procedures in SPSS software.\u003c/p\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the descriptive statistics (mean and standard deviation) of the participants\u0026rsquo; responses across the Knowledge, Attitude, and Practice (KAP) domains before and after the training program. An overall improvement in post-intervention scores was observed across all items, suggesting positive changes in the participants' knowledge, attitudes, and practices related to the topic following the training.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePre- and Post-Intervention Mean (SD) Scores of KAP Items (N\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" 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char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.51 (0.90)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.97 (1.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.38 (1.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.49 (0.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.54 (0.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.03 (0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.08 (0.28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.03 (1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.59 (0.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.86 (1.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.41 (1.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.43 (0.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.11 (0.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eKnowledge section\u003c/strong\u003e \u003cp\u003eWhen the pre and post responses were compared, there was an evident shift in student\u0026rsquo;s awareness about the available digital tools in therapy. For Question 1 - \u0026ldquo;Are you aware of technology-based intervention applications used in SLP service delivery?\u0026rdquo; (K1), the proportion of students answering \"Yes\" increased from 45.9% pre-training to 91.9% post-training. Those responding \"No\" dropped from 16.2% to 2.7%, and \"Somewhat\" from 37.8% to 5.4%, indicating a significant improvement in awareness (see Fig.\u0026nbsp;1 \u0026ndash; Question 1 under Knowledge domain).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 1\u003c/b\u003e \u003c/p\u003e\n\u003ch3\u003eQuestion 1 “Are you aware of technology-based intervention applications used in SLP service delivery?”\u003c/h3\u003e\n\u003cp\u003e \u003c/p\u003e \u003cp\u003eAfter attending the lecture, for the Question 2 and 4 under Knowledge domain, they were able to name some therapy apps and technology platforms used for speech and language therapy other than AAC that was commonly accessed by them in their clinic. For Question 3 under the Knowledge domain, participants demonstrated a clearer understanding of the benefits of using technology-based aids in therapy following the training program.\u003c/p\u003e \u003cp\u003eFor Question 5 \u0026ndash; \u0026ldquo;Do you know the optimum specifications (RAM, processor speed, etc.) a device should have to use a therapy application effectively?\u0026rdquo; \u0026ndash; the percentage of students answering \"Yes\" rose from 73% pre-training to 94.6% post-training, while \"No\" responses declined from 27% to 5.4%, demonstrating improved understanding of the technical requirements (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e \u0026ndash; Question 5 under Knowledge domain).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAttitude section\u003c/strong\u003e \u003cp\u003eIn this section, their post lecture responses indicated a dramatic increase in their confidence and understanding towards the use of digital tools for speech and language therapy. The findings of this section are represented in the Fig.\u0026nbsp;3, \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e4\u003c/span\u003e, \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e5\u003c/span\u003e, \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e6\u003c/span\u003e, \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e7\u003c/span\u003e respectively.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 3\u003c/b\u003e \u003c/p\u003e\n\u003ch3\u003eQuestion 1: I believe technology-based methods enhance my understanding of real-life clinical service delivery\u003c/h3\u003e\n\u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eQuestion 2: I am confident in my ability to provide rehabilitation services using technology-based methods\u003c/h2\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eOverall, the results under the section \u0026ldquo;Attitude\u0026rsquo; advocate that the targeted training programme certainly enhanced students\u0026rsquo; attitudes, accentuating the value of structured exposure to technology-based clinical tools in SLP education.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePractice section\u003c/strong\u003e \u003cp\u003eThere was a prominent positive trend in students' willingness to integrate technology into future service delivery, as well as improved understanding of its practical applications in adult neurogenic communication disorders.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eFor the Question 1 exploring the clinical readiness among the SLP students revealed that only 43.2% of the respondents had ever designed or planned a therapy session using technology-based tools, while the remaining 56.8% had not engaged in such practices prior to the intervention. This gap indicates limited pre-training exposure to real-world tech-based clinical application.\u003c/p\u003e \u003cp\u003eQuestion 2 identifying challenges associated with incorporating technology into clinical training, participants were allowed to select multiple options. The most frequently reported challenge was \u0026ldquo;Lack of training/exposure\u0026rdquo;, cited by 91.9% of students, followed by \u0026ldquo;Limited access to tools or software\u0026rdquo; (78.4%), \u0026ldquo;Time constraints in curriculum\u0026rdquo; (70.3%), and \u0026ldquo;Not confident with technology\u0026rdquo; (56.8%). Only three participants (8.1%) reported experiencing no challenges, highlighting the prevalent barriers to implementing technology in academic and clinical settings.\u003c/p\u003e \u003cp\u003eFor the Question 3, \u0026ldquo;Do you think applying technology in your future clinical practice will help you deliver better service?\u0026rdquo;, strong agreement increased from 43.2% pre-training to 78.4% post-training. Responses marked \u0026ldquo;Agree\u0026rdquo; dropped from 29.7% to 13.5%, and \u0026ldquo;Neutral\u0026rdquo; responses decreased significantly from 16.2% to 2.7%, suggesting that students became more decisive and positive about the role of technology post-intervention.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSimilarly, in response to the Question 4 \u0026ldquo;Do you think a formal module or elective course focused on tech-based service delivery methods is essential?\u0026rdquo;, strong agreement rose from 29.7% to 67.6%, reinforcing students\u0026rsquo; demand for structured academic exposure to technology in clinical training. This was accompanied by a decline in \u0026ldquo;Agree\u0026rdquo; from 37.8% to 16.2% and \u0026ldquo;Neutral\u0026rdquo; responses from 24.3% to 10.8%.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eQuestion 5, When asked about prior exposure to formal training in technology use for speech and language therapy, 59.5% (n\u0026thinsp;=\u0026thinsp;22) reported having received such training, while 37.8% (n\u0026thinsp;=\u0026thinsp;14) had not. One participant (2.7%) was self-taught. These findings highlight the need for structured training modules to ensure consistent competence in tech-based clinical approaches.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFeedback section\u003c/strong\u003e \u003cp\u003eMajority of the participants who took part in the study recommended for such training to be introduced into standard SLP curriculum to prepare students for evolving clinical demands. They found the lecture and the demonstration videos very helpful in building their insights about the technological options available and that they are welcoming more such training programmes in future, as part of their curriculum.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eThe Shapiro-Wilk test indicated a deviation from normality (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) for the study variables, denoting non-normal distribution. Hence, non-parametric tests like Wilcoxon Signed Rank Test was carried out.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eWilcoxon Signed-Rank Test Results:\u003c/h3\u003e\n\u003cp\u003eThe Wilcoxon Signed-Rank Test revealed statistically significant improvements across multiple domains (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In the Knowledge domain, all items (K1, K3, K4, K5) demonstrated significant increases in post-test scores compared to pre-test scores (p \u0026lt; .05), with Z-values ranging from \u0026minus;\u0026thinsp;2.530 to -3.674. Similarly, in the Attitude domain, four of the five items (A1 to A4) showed significant positive changes (p \u0026lt; .01). However, item A5 did not exhibit a statistically significant difference (Z = -1.436, p = .151). In the Practice domain, items P3, P4, and P5 displayed significant improvements (p \u0026lt; .05), whereas P1 and P2 did not show meaningful changes (p \u0026gt; .05), possibly indicating limited hands-on exposure or practical application opportunities during the intervention period. These results suggest that the intervention had a statistically measurable impact across most domains, particularly in knowledge and parts of attitude and practice.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe current study attempted to study the effect of a training program on the Knowledge, Attitudes, and Practices of Undergraduate and Postgraduate SLP students concerning about the usage of technology-based intervention methods; for an improved clinical practice readiness. The overall results revealed that there is an augmentation of student\u0026rsquo;s clinical practice readiness skills supporting the necessity of integrating the technology-based treatment options in SLP academic curriculum.\u003c/p\u003e \u003cp\u003eIn the knowledge section, significant shift in the awareness about the technology platforms, specifications for using any such therapy application suggested the future benefit of such academic programs for the SLP students in increasing their clinical capabilities. These were further supported by another study done by Bhattarai et al. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] where the most essential clinical skill for an SLP providing tele service was the knowledge on how to select an appropriate tele material for rehabilitation. Participants showed increased competence and awareness of various clinical apps suitable for therapy. Further Hansen et al. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] highlights the need for academic programs to incorporate technology training to prepare students for modern clinical practices.\u003c/p\u003e \u003cp\u003eAdditionally, works done by Hill and Miller [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and Bajaj and Karuppali [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] stressed the importance of education of technology and relevant training among the SLPs, asserting that an effective service delivery in the modern era requires clinicians to be aware of the technological advancements in their respective fields. Supporting results were obtained from the current study signifying that focussed education has evidently raised the student\u0026rsquo;s practice readiness levels for service delivery.\u003c/p\u003e \u003cp\u003eOn questions pertaining to their attitude towards incorporating such educational methods for enhancing their clinical skills also revealed positive shift on the post-survey responses. Their confidence in using technology and understanding about technology-based aids has increased after the program. In this section the respondents scoring was high for the inclusion of such technology tools in SLP curriculum and hands on training as well for the skill transfer to actual clinical settings. Similar study carried out by Grogan-Johnson et al., [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] mentioned the importance behind inclusion of tele practice applications in the curriculum for SLP students. Another experiment by Mohan et al., [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] also stressed upon the need for a short-term training course in tele practice for professionals. This training enhances understanding and reduces resistance to digital tools.\u003c/p\u003e \u003cp\u003eMytsyk et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] explored student SLPs' perceptions of digital technologies and found that their intention to adopt these tools was strongly influenced by performance and effort expectancy, social influence, and available support. The study emphasised the importance of institutional training, digital skill development, and resource accessibility in shaping student confidence and readiness to integrate technology into future clinical practice. Dudding and Justice [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] also demonstrates that embedding tele practice into academic programs significantly enhances students' preparedness and confidence in using digital tools.\u003c/p\u003e \u003cp\u003eIn the practice section, their responses showed a greater willingness to adopt these technology aids into their clinical practice in future. According to Worek A et al., [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] there existed a positive correlation between the hands-on experience in delivering tele practices and their confidence levels in handling such therapy services. Howell et al. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] found that integrating simulation-based modules into SLP education significantly improved students\u0026rsquo; confidence, clinical reasoning, and readiness for real-world practice. These results are supportive of the notion of our current study for encouraging more exploration of such technology platforms, applications, and aids to gain confidence in providing tele rehabilitation services. There is a dearth of such applications being developed in this technology era. Each SLP student must put effort in bombarding themselves with such tele practice applications and explore them for their clinical practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003e The current study was aimed to address the gap between the rising use of technology in speech-language pathology practice and the limited structured training provided to students. Results demonstrated that the usage of a targeted, technology-based intervention significantly improved SLP students' clinical practice readiness. This study highlights the importance of structured, hands-on training and sustained institutional and curricular support to effectively integrate technology into speech-language service delivery across diverse contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge the Pro- Vice Chancellor, Dean-Medical, Dean-AHS and HoD ENT and HoD ASLP, support in accomplishing this study. We are also extent gratitude to Department of Science and Technology (DST), SEED/TIDE scheme for supporting to conduct the study. We are grateful to the Faculty of Medicine and Health Sciences, SRM MCH\u0026amp; RC, SRMIST, Kattankulathur for bearing the defrayed costs of publishing this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe first and second authors conceptualized the study. The first author collected and analysed the data. The manuscript was drafted and revised by both the first and second authors. The supervising author provided clinical oversight, contributed to the study design and interpretation of the findings, and critically reviewed the manuscript. All authors approved the final version of the manuscript for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Conflicting Interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement of Informed Consent and Ethical Approval\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVerbal Informed Consent was taken from all the participants. The study was carried out in accordance with the principles as enunciated in the Declaration of Helsinki.\u0026nbsp;The study was accorded Ethical Committee Approval vide Institutional Ethics Committee SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, with the reference No. 1836/IEC/2019 dated on 12.12.2019.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBoyd C. Technology-based interventions: exploring new models of care and navigating new ethical dilemmas [Internet]. University of Kansas School of Social Welfare; Hope and Wellness Resources; [cited 2026 Mar 24].\u003c/li\u003e\n \u003cli\u003eWorek A, Sabo KK, Eddy EZ, Plummer L, Baldwin J, Reidy PA, et al. Students TeLE-AlL: self-efficacy and self-reflection as measures of student success in telepractice training. \u003cem\u003eEduc Sci\u003c/em\u003e. 2022;12(5):302. doi:10.3390/educsci12050302.\u003c/li\u003e\n \u003cli\u003eRao PS, Yashaswini R. Telepractice in speech-language pathology and audiology: prospects and challenges. \u003cem\u003eJ Indian Speech Lang Hear Assoc\u003c/em\u003e. 2018;32(2):67. doi:10.4103/jisha.jisha_39_17.\u003c/li\u003e\n \u003cli\u003eHowells S, Cardell EA, Waite MC, Bialocerkowski A, Tuttle N. A simulation-based learning experience in augmentative and alternative communication using telepractice: speech pathology students\u0026rsquo; confidence and perceptions. \u003cem\u003eAdv Simul\u003c/em\u003e. 2019;4(S1). doi:10.1186/s41077-019-0113-x.\u003c/li\u003e\n \u003cli\u003eMcGill M, Dennard Q. Graduate students\u0026rsquo; perspectives toward telepractice at the COVID-19 global pandemic onset. \u003cem\u003ePerspect ASHA Spec Interest Groups\u003c/em\u003e. 2021;6(4):841\u0026ndash;854. doi:10.1044/2021_persp-20-00231.\u003c/li\u003e\n \u003cli\u003eChatterjee I, Banik A, Ravi SK, Yuvaraj P, Kumar P, Kumar S, et al. Telepractice guidelines for audiology and speech-language pathology services in India [Internet]. Indian Speech-Language and Hearing Association; 2020 [cited 2026 Mar 24]. Available from:\u0026nbsp;\u003ca href=\"https://www.ishaindia.org.in/downloads/TELEPRACTICE-GUIDELINES.pdf\" target=\"_new\"\u003ehttps://www.ishaindia.org.in/downloads/TELEPRACTICE-GUIDELINES.pdf\u003c/a\u003e\u003c/li\u003e\n \u003cli\u003eBhattarai B, Sanghavi T, Panchakshari AB. Experience delivering telepractice services among upcoming and working professionals of speech language pathology. \u003cem\u003eJ Health Allied Sci NU\u003c/em\u003e. 2021;12(4):441\u0026ndash;447. doi:10.1055/s-0042-1743550.\u003c/li\u003e\n \u003cli\u003eHansen TN, Bjornsen AL, DeVeney SL. Use of tablet technology: a pilot program for graduate students in speech-language pathology. \u003cem\u003eTeach Learn Commun Sci Disord\u003c/em\u003e. 2017;1(1). doi:10.30707/tlcsd1.1hansen.\u003c/li\u003e\n \u003cli\u003eHill AJ, Miller LE. A survey of the clinical use of telehealth in speech-language pathology across Australia [Internet]. \u003cem\u003eInt J Speech Lang Pathol\u003c/em\u003e. 2012;14(3):110\u0026ndash;117. Available from:\u0026nbsp;\u003ca href=\"https://espace.library.uq.edu.au/view/UQ:289481\" target=\"_new\"\u003ehttps://espace.library.uq.edu.au/view/UQ:289481\u003c/a\u003e\u003c/li\u003e\n \u003cli\u003eBajaj G, Karuppali S. Knowledge, attitudes, and practices of speech language pathologists in India about telerehabilitation services during the COVID-19 pandemic. \u003cem\u003eCoDAS\u003c/em\u003e. 2022;34(6). doi:10.1590/2317-1782/20212021193.\u003c/li\u003e\n \u003cli\u003eGrogan-Johnson S, Meehan R, McCormick K, Miller N. Results of a national survey of preservice telepractice training in graduate speech-language pathology and audiology programs. \u003cem\u003eContemp Issues Commun Sci Disord\u003c/em\u003e. 2015;42(Spring):122\u0026ndash;137. doi:10.1044/cicsd_42_s_122.\u003c/li\u003e\n \u003cli\u003eMohan HS, Anjum A, Rao PK. A survey of telepractice in speech-language pathology and audiology in India. \u003cem\u003eInt J Telerehabil\u003c/em\u003e. 2017;9(2):69\u0026ndash;80. doi:10.5195/ijt.2017.6233.\u003c/li\u003e\n \u003cli\u003eMytsyk H, Kovachov S, Suchikova Y. From acceptance to implementation: student speech-language pathologists\u0026rsquo; perspectives on using digital technologies in practice. \u003cem\u003eDisabil Rehabil Assist Technol\u003c/em\u003e. 2025:1\u0026ndash;15. doi:10.1080/17483107.2025.2472262.\u003c/li\u003e\n \u003cli\u003eDudding CC, Justice LM. An e-supervision model. \u003cem\u003eCommun Disord Q\u003c/em\u003e. 2004;25(3):145\u0026ndash;151. doi:10.1177/15257401040250030501. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Clinical practice, service delivery, technology-based, SLP, intervention, tele practice","lastPublishedDoi":"10.21203/rs.3.rs-9218802/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9218802/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eWith the increasing role of technology in clinical practice, digital tools have become integral to the training of Speech-Language Pathology (SLP) students. However, many students still lack adequate exposure and training in applying technology-based interventions in clinical settings. This study aimed to evaluate the impact of such interventions on enhancing the clinical practice readiness skills of SLP students. A quasi-experimental, pre-post design was employed, conducted in four phases: Phase 1: Development and validation of the survey questionnaire, Phase 2: Pre-training survey, Phase 3: Technology-based training program, Phase 4: Post-training survey. A total of thirty-seven final-year undergraduate and postgraduate students from the Department of Audiology and Speech-Language Pathology participated in a KAP survey before a structured training program. The program covered technology-based intervention methods, app selection guidelines, and app exploration. The survey evaluated students\u0026rsquo; knowledge of technology-based rehabilitation tools, confidence in their use, perceived benefits of tech-focused training, and awareness of digital aids that enhance learning. There was a clear increase in agreement regarding the integration of technology into clinical training, with improved confidence and perceived usefulness of digital tools in therapy delivery. Overall, the study demonstrated a notable impact of technology-based interventions in enhancing the clinical practice readiness skills of SLP students.\u003c/p\u003e","manuscriptTitle":"Impact of technology based intervention training on knowledge attitude and practice among speech language pathology students Running head: Technology Based Training in SLP students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-24 08:22:53","doi":"10.21203/rs.3.rs-9218802/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"272784402628021011386680408224641468432","date":"2026-05-11T06:26:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"105647450886930883591276881682405911743","date":"2026-05-08T13:11:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209236115176233851430683204497900639813","date":"2026-04-16T10:35:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-16T10:25:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-30T08:34:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-28T08:33:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Psychology","date":"2026-03-28T08:27:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d1fc937e-96a7-4d3b-9cc5-3a4a48b401bf","owner":[],"postedDate":"April 24th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"272784402628021011386680408224641468432","date":"2026-05-11T06:26:10+00:00","index":53,"fulltext":""},{"type":"reviewerAgreed","content":"105647450886930883591276881682405911743","date":"2026-05-08T13:11:06+00:00","index":52,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-24T08:22:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-24 08:22:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9218802","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9218802","identity":"rs-9218802","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}