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We are discussing the biggest challenges that are currently holding back the field of speech-language pathology. We present the issues with facts and invite you to be a part of joining our movement to make things better, one conversation at a time. Let's fix SLP!
Hosted by Jeanette Benigas, PhD, SLP
Megan Berg 0:00
Hi, everyone. I'm Megan Berg
Jeanette Benigas 0:02
and I'm Dr. Jeanette Benigas.
Megan Berg 0:04
And we are here to fix SLP.
Jeanette Benigas 0:06
We are discussing the biggest challenges that are currently holding back the field of speech language pathology.
Megan Berg 0:12
We present the issues with facts and invite you to be part of joining our movement to make things better one conversation at a time.
Jeanette Benigas 0:19
Let's fix SLP
Hey, Megan, welcome back, everybody. Um, before we begin, I just have to say that something happened yesterday that a fearless fixer picked or pointed out to us. I wasn't in fact, in SLP crying in my car yesterday, and I recorded it and put it on Instagram. So if you missed it, go find the real. I was just so overwhelmed with gratitude. I didn't even realize I was at SLP crying in my car. But I was overwhelmed with gratitude for something that was announced yesterday by the informed SLP. And and this was not planned. This was a happy accident. We knew we were moving in to see us and the informed SLP just does it so well that we asked Meredith Herald to join us today. And again, like we did not plan we didn't plan this to coincide with what she's going to talk about here in a second. It just happened. So hi, Meredith. Thanks for joining us.
Meredith Harold 1:29
Yeah, thanks for having me.
Jeanette Benigas 1:31
This is Dr. Meredith Harold, she is the founder of the informed SLP amongst many other really great things that she does for the field. But Meredith, why don't you tell us what the informed SLP is, and tell us what you guys announced yesterday, on social
Meredith Harold 1:46
horse. Yeah. Um, so yesterday on social media, we announced that each year we do a fundraising sale where we give a discount to SLPs to join the informed SLP membership. So it's 15% off all memberships right now. And for every person who uses that discount code, which is right now fixed SLP, we're giving $5 for each joiner back to fix SLP. And then we also for our current members have a donate button sharing fix SLPs just you know, pure donation location. And this was actually a team decision. So there's over 60 of us who work at the informed SLP. And we all kind of got together and we're like, you know, which organization or group of people or individual in our field right now is doing really solid work that's important for the future health of our field, but doesn't have a revenue source. And we together identified the fix that fix SLP. So you too, as doing really critical work for our field right now that we wanted to get behind. And so we basically selected fix SLP for the annual fundraising sale. And so that's going to go for the next several days. And you know what, because this podcast is going to be live for quite a while. If anyone listens to this like a month from now or two months from now and still wants to use the coupon code, we can continue honoring it. So we'll just keep that fixed SLP coupon code live. And so if you hear about it here, just email us and we can manually apply it to your account for 15% off and informed SLP membership.
Jeanette Benigas 3:18
Now I'm gonna be using everywhere, don't
Meredith Harold 3:24
try again. And then we'll just keep contacting Megan and Jeanette every, like several months or so to update them with any like new, you know, people who've used that coupon. But aside from the sale that we have going on right now, in order to try to help raise funds for fix SLP. The reason that you all invited me on the podcast today actually was to talk about CPUs, not the sale. And the reason they invited me like Jeanette said is because the informed SLP is an actual CEU provider. And we have been for several years. But also, I used to be the president of the Kansas State Association, and would have been on the board for quite a few years. And Kansas is an ASHA CEU provider as well. So I've seen how the process works not from only my own company, but also from the state association side. So lots of experience with the whole Asha CEU process, which is basically what we're here to talk about today.
Megan Berg 4:17
Yeah. And yeah, thanks
for being here. Thank you for supporting fix SLP we're really grateful. Yeah,
Jeanette Benigas 4:23
well for you. And I am I have I just I want to say this too, as I wasn't asked to say this, but I have a really hard time finding CPUs that are advanced enough for me with a little bit of an advanced skill set because I have a PhD and have researched and I find the informed SLP to be a great way to just really keep up with the research without having to dig and read and it's so digestible, and it's it doesn't I don't leave it thinking I already knew that I'm learning something every time so it's advanced enough for me but it's also simple enough I think that anyone can Do it. So it's just wonderful. So thank you, thank you for that code. And everybody should check it out, at least for a short time. You won't, you'll check it out, and you'll never leave. So.
Meredith Harold 5:12
And that's another piece of context, which also lends itself to like part of why I'm here today to talk with you all is the informed SLP reads all of the research in our field that's published each month. And that's kind of like our unique niche, like we've committed to every single month pulling all the newly published journal articles within our scope of practice, reading them all, and then telling practicing clinicians what they need to know. So basically, we offer like a monthly digest of all the updates and our fields research. And I know that that's one of the topics we're going to talk about today, too, is like, research backed, continuing education course. So
Jeanette Benigas 5:48
you recently dropped a number I don't I'm checking our script to make sure I'm not like jumping ahead. I don't think it's there. But you recently dropped a number in a social media conversation about like, how much it would cost to access all the research. It was right. Am I remembering the right? Yeah, yeah.
Meredith Harold 6:06
What was that number again, $300,000 a year to have full access to our fields research, okay. And which I think is critical for people to understand for a million different reasons. But, but accessing research, research is really, really frickin expensive. If you aren't at a university, people who work at universities tend to forget this because they just get quote, unquote, free access without realizing that it's actually their university paying that bill to all the top publishers. So Elsevier Taylor, and Francis Wiley, you know, but there's another organization called CS disseminate, that I helped found as well, that teaches our field scientists how to put their research online for free legally, because hypothetically, if 100% of our fields researchers would do that would just upload PDFs to the internet, once they publish something, then that $300,000 a year, paywall wouldn't be there. But I think that's really important to understand. Because when all of us are talking about oh, everything needs to be research backed, everything needs to be researched, backed and you need to do like, you know, deep dives into the research, in order to get the information, you need to know that that Paintball is real, you know, so
Megan Berg 7:18
I need that and completely unrealistic in
Jeanette Benigas 7:21
my research is old. But I often think I should do that. And then I forget, so I'll add it.
Megan Berg 7:30
So I think, can we start with the listener questions, because we've been posting on social media and asking people what questions they have. And I think that's just a good basic place to start. Because as we talk through all of this, we're gonna get deeper and deeper into the layers and just see kind of the complexity of this whole situation, which I think has a simple solution, but it does take SLP understanding all the different layers and how we fit into the puzzle. So we're probably going to answer these questions again, as we get deeper into the conversation, but I think we'll just start with like a quick q&a. So the first question that was asked was, can you talk about how Asha CEUs are not required? Are they required for the CCC but not for membership without the CS? And I think the simple answer to this question is the ASHA CPUs are not required for anything. In order to understand the answer to that question, we have to understand that there's Asha CPUs, which you can only get by purchasing the CEE registry through Asha. And then there's Asha approved CPUs and Asha approved CPUs are those courses that are offered by people who are Asha CD providers. But Asha CPUs themselves, those are a product of Asha. Again, they're only available if you pay for the registry. And those are not required for anything, nobody will ever ask you for a record of your Asha CE use other than Asha, when they're giving out their ace Awards, which as we've talked about before, is a silly award because it's basically like the analogy we gave on social media was like, it's like a book store giving an award for the people who bought at least 70 books in a cycle of three years or whatever. Like, it's not that the ACE award doesn't count anything other than Ashesi use. So if you take something that isn't approved for Ashesi use, then it doesn't count for the ACE award. So the other important thing here is that the CCC maintenance requirements, they only require professional development hours and these can be anything like if somebody comes into your facility and trains you on how to use a device, or a certain therapy modality like that is considered a pro National Development hour. If you take a course by a reputable company or organization, that is not Asha approved, that still counts as a professional development hour. And so that is you only need 30 professional development hours every three years to renew your CCC. Asha does not require Asha CEUs or Asha approved the use? Did I miss any things that you want to touch on?
Meredith Harold 10:28
No, I mean, I can clarify to like so like the informed SLP is an ASHA approved provider. And basically what that means is we pay $1,000 to them every single year. And we go through a paperwork heavy application process that doesn't at all vet the quality of content we're producing and instead, purely teaches us how to report the courses that people have taken in our system to Asha. So it's just reporting training, like when you have 75 people take this course how do you then show Asha that those 75 people took the course and make sure that there's not like to Mary Smith's that get confused? You know, so like that I think that's a really common misconception that courses that are quote unquote, Asha approved are higher quality in some way, when in reality, it's just like us purchasing a brand stamp for our courses. And I do think that a lot of people would then be like, Well, why do businesses keep doing this while businesses keep doing this, because our customers keep demanding it. So we weren't Asha approved providers. When the informed SLP first started, we became Asha approved providers, because of all the things people would ask us for of all the things they could dream that we would offer them, that consistently is the number one thing like, you know, we don't want to take your courses unless they're Asha approved. And even though we knew that that was kind of mean and meaningless, we made the choice to be like, Well, okay, if everybody's demanding that we have it, and if they're telling us, they're not going to buy our product, unless we do this, then we may as well just do it. Right. And I honestly struggle with that a lot. Because I think that as a business, especially, you know, as we've grown over the years that it starts to become my responsibility to if we're going to carry that brand stamp to simultaneously educate people that like, it doesn't really mean anything. Like if you like that our courses can carry that brand stamp, because you want it then we've got it but like it's also it doesn't mean anything. So that's one of my kind of goals going forward as I feel like because otherwise, like our fields, businesses, like my own, are just perpetuating problem. And again, they all do it because they want to be able to secure customers and advertise against other businesses to say like, Oh, our courses are Asha approved. Maybe other things you find out there aren't but ours are. Because SLPs all believe that that means something.
Jeanette Benigas 12:54
My hope is that as part of this movement, that we change that mindset, because I don't think I think all of us have been around for a while. I've said something like this before, I don't think we've ever seen an impact like this on the field before when it comes to educating about the CCC and educating about what Asha is and what they do and do not do and, and see us what are CPUs? What is it PDH what matters and what doesn't. It there are definitely great, small con, content creators out there who have said this kind of stuff before like I don't offer CPUs, I only are Asha approved CPUs I only offer PDH is so we're definitely not the first people to say this. So I'm not taking credit for this. But I think for whatever reason, we have been the ones where it has just stuck. And I hope that it changes the mindset in the field. So leaders like your company can say, You know what, we're not going to do it anymore. And and just like you have the option to get the CCC, our company isn't going to offer that because it's a choice. And it doesn't mean anything. But until people really fully understand it. We won't be in a place where people Yeah, where you can do it. It's not a good business decision at the moment to just stop offering it but you know it a year maybe it would be right,
Meredith Harold 14:19
exactly.
Megan Berg 14:20
Yeah. And just to piggyback off what Meredith said, like, it's, I think it's like an 80 page application to become an SSC provider. I've gone through this process, and then once you're approved, at that point, there's 10 hours of training that happens over zoom. And personally, I found this to be like the most condescending waste of my time ever. Like if you can imagine sitting with someone over zoom for 10 hours, like painstakingly being told how to use a spreadsheet and how to log into something and how to report numbers and how to make sure the spreadsheet matches and how to upload a file on a website. ain't like, that's all that the ASHA CEU approval process is it's just that a paperwork management thing, like there's literally a checkbox that you have to click when you are adding a course that says I, I something like I pledge that this has like good content basically. And you just check that box, nobody at ASHA is is looking at the content of your course to approve it. And I think that's one of the largest misconceptions we want to clear up here is the ASHA CEUs or Asha approved CEUs does not mean that anyone and Asha is spending any amount of time looking at the quality or the evidence base of that course. Yeah, and I'm going to skip ahead a little bit here. Because Meredith, you and I talked about this a little bit, we went into the finance report, the 2022 Asha financial report. And they report that there, there are operating costs for continuing education, which includes this is how they get money. Is the registry fees, provider application fees provider reaccreditation fee, you have to get reaccredited every five years, cooperative offering.
Jeanette Benigas 16:13
Okay, I think we lost Megan.
Megan Berg 16:15
Okay, I'm okay. Like all these different fees that come together, that brings in $4.8 million. And that is Asha, continuing education, operating costs. So my question for you, Meredith, is at at four point, if they're bringing in $4.8 million, from all these different fees? Is that enough money for them to have a program in place to vet content? Like if if their goal is really to, you know, make their brand like Ashesi? Ease are the best CPUs because they're vetted? Could they do that with $4.8 million a year?
Meredith Harold 16:56
Maybe, but I think that we need to, like talk through what it would take to achieve that so that we can see like the pros and cons. So like, first of all, I think that it's it would be really helpful for people to understand what Asha is receiving from course providers, right? So like when, when we saw like, when the informed SLP, or when the Kansas State Association submits a new course to them and says, Hey, we're ready for this to be Asha approved, what we're submitting as an outline, okay. And I think that people don't think this through. So basically imagine, like one or two sheets of paper with just like bullet points that are like, first we're going to talk about this, then we're going to talk about this, then we're going to talk about this right. And then at the end, like Megan said, you essentially just click a checkbox that says, yes, we've considered the evidence, the research evidence thoroughly and considered evidence based practice when we put together this course. But
Megan Berg 17:48
it's not even two pages. It's literally attacking borders, just like the five ones. Yeah. Like
Meredith Harold 17:54
you couldn't make it two pages, if you're really working really frickin wordy, but basically just an outline. So all they really no is the topic and of what you're about to speak about, right. And so first of all, in the current system, Asha, Asha isn't given enough content in the first place to be able even able to vet the content of your course. But then, so that's thing number one that would have to completely change. And then think number two, just think through what it would take for all the live and recorded courses. Like if we wanted Asha, hypothetically, to spend a whole bunch more time and labor and effort, making sure the quality of courses is really good. What would that mean for live courses? Like, how would they do that? What would that mean, for recorded courses, like, for example, medbridge, with that does a lot of video courses, they would have to record the entire thing, then once they've spent all the production money on recording the entire thing, then they'd have to send it to Asha. And Asha would have to decide if they wanted the new changes, right? This would be astronomically expensive for both the companies and Asha. And I looked the other day on their website, there's over 140,000 Asha approved courses currently offered. So if you just take that number, and then think to yourself, Okay, it would take an expert at least two hours to basically quality check every single course even if we were to put that in place. So imagine that the experts are paid, you know, $60 per hour, multiply that times two, multiply that times 140. And that's the bare minimum, like we do really intense quality control at the informed SLP. And like, two hours would be like, just enough to catch some of the true junk but not enough to actually truly VET courses. That would be astronomically expensive. And so that's thing number one, like could they could they try it? Sure, but it'd be really, really friggin expensive. But the other things we have to keep in mind is if Ash is also a CE provider, selling you know, the access paths and selling their own courses, it's a conflict of interest for them to be the one vetting all the other companies so that COI just won't work. means Asher needs to stop selling courses or Asha can't be the one to like quality check everybody else. And then the other thing to keep in mind too is like it opens them up to significant lawsuit risk and major labor on their end. Here's why. You know, like I gave the example of like, medbridge, or whatever, but I'm not calling out medbridge members of the fantastic company, right? But imagine a company will just do this, we'll say, imagine a company like medbridge, where they record you know, video courses, spend, you know, $3,000, putting together the video course send it to Asha. And then Asha says, No, you need to fix this. What if this company disagrees with Asha. And it's like, actually, you're not looking at this, right? You didn't look at these research articles. I disagree for this reason, then it ends up becoming this back and forth and back and forth thing where Asha puts themselves in the position of having to deal with pushback from relatively large companies who absolutely will push back well threatened to sue Asha, like the whole shebang, you know. And so imagining that each course would only take two hours of time to vet is in the cleanest case where the business doesn't come back and say, No, you're wrong because of this. And then they have all this back and forth. Like, it would just be out rageous ly expensive for Asha to even attempt to do. And so that's, you know, my assumption of why it continues to just be an honor system thing, where a business basically pays to be able to have an OSHA approved course. And they essentially like pinky swear, I hereby pinky swear I'm considering the evidence when I put this together, and then you know, goes up, because that's the cheapest, most efficient way to do it.
Jeanette Benigas 21:40
Yeah, I'll give up, I want to give my own just to like frame the mindset to of what people think about that type of labor. This was before fix, SLP started, and I wish I would have had the language less than a year ago, to defend myself a little better. But I gave a course at my state convention called about consumerism, and speech language pathology. And I made this statement, Asha is not protecting us. That's all I said, I was talking about CPUs, and this whole idea of them not being vetted, and how we have to be good consumers about the product, you know, with the products that we're buying. And I said, we have to be good consumers because Asha is not protecting us. And the room was a guest. There were audible gasps from the small handful of older SLPs, who were in the room, it was meant more for students and newer clinicians. So that was my target audience. But there was definitely a small group of older clinicians in the room. And they, they when when the talk was over, during the question and answer session, they very much challenged me about that statement. And some of them were personally offended because they have dedicated their life to approving courses for conventions like Asha. And I, in my head. I'm like, but are you really like, what are you doing to approve a course you're really just reading the description and all of the things that you said, you're not actually betting these things? Yeah, like, and then I was further challenged. While I don't. Another gentleman said, I don't even know why your university isn't an ASHA provider, which had nothing to do with what I was talking about. But the reason that we're not is for all of the reasons that you and Megan gave already, is the pure cost to do that to offer CEUs we'd either have to charge more, or raise tuition. And you know, we're not CEU providers. So to do these couple one off things a couple times a year just isn't a It's not affordable. And yeah, I was very much challenged. I was not well received. I ended up in the Dean's office. It turned out fine. It turned out fine. But yeah, I mean, I and now I, I I wish I would have had this language. So you know, now I have the argument if I'm ever challenged again. But the the mindset very much is that Asha is protecting us, and that people are reading these courses and the SLPs who do the approving think that they're vetting? when really they're not? Yeah,
Meredith Harold 24:21
I mean, they're doing things like keeping out, you know, a talk on Facilitated Communication, because that they see that facilitated communication is the topic they might be like it not evidence based, like just block it. But together, it's just a few sentences of a description, like the only thing they're keeping out is things that are like blatantly obviously, you know, for topic reasons, we could exclude it otherwise. Frankly, a lot of the things that are kept out of places like the ASHA convention, are clinicians who want to present about their like real world clinical experience, but because they don't know how to write that application in a way that sounds like an academic or Audit, they tend to end up just getting like pushed out. So I mean, you can hardly see anything from those applications for, you know, conventions and stuff. And the same thing goes with state associations like all of us are in that position. And like I, you know, what you mentioned, mentioned, Jeanette about people being like, I can't believe you're saying that Asher doesn't protect us. Like, I think it's really important that we all start to get a lot more comfortable with criticism. And recognizing that it's not just like black and white, it's not for and against, like SLPs need to be able to like state things factually and state, you know, factually, like our state associations, Asha, like they're not in the position to protect us from like, junk courses. And a lot of companies in this field are putting out junk courses. And that sort of feedback doesn't mean that, you know, state associations are junk or ashes, or Asha is junk, or even that a lot of these cee cee providers that have like about, you know, five to 10% of their content, that it's like, Oh, my God, I cannot believe they have that in their database. But that doesn't mean that the all the other things that they do are junk, like, we need to be able to get comfortable with criticism, not like, meaning that we're trying to like blackball a group, you know, like, as a business owner, I expect to receive criticism regularly. And I, I see it as my role to take all criticism seriously, and look at it carefully, and then make internal or external adjustments as needed, because that's the only other way that we can move toward quality. Right.
Jeanette Benigas 26:39
I wondered what they were all passing around in the red cup after they gasped, and I now have the language to say they were passing around the red Kool Aid. Yeah, I mean, that, you know, they, they, they've dedicated their life to an organization and have some what what are we calling it? Pagan organizational identity syndrome? Right? There's, there's just a little bit of that, but that didn't mean I was criticizing them directly. You know? Yeah.
Megan Berg 27:12
Ultimately, it's a free market. I mean, that's what I would argue for is free market continuing education. Because at the end of the day, what we all really want, and what this platform is about is critical thinking. And like, we're not SLPs just because we pay $199 a year, we are SLPs. Because we critically examine things and we question things, and we come to our own conclusions. And we work every day, to try to do better and learn more and expand our clinical practice in ways that are person centered and actually ensure progress in a way that's meaningful for the people that we're working with. And so, when we're thinking about continuing education is, is it a good continuing education course? Because Asha says it is, which, as we've said, Isn't they don't have a good process to even do that? Or is it a good continuing education course, because multiple SLPs, who have the capacity to think critically have said, you know, I really learned a lot, I was able to examine the research that they included in the course and examine the perspectives and experience that all the presenters brought to the table. And I learned something and it made a difference in an impact for myself as a practitioner and for my clients. And I think the only way that we can have a free market continuing education world is if like, right now all we really have is like social media, and Reddit. But, you know, Meredith, you and I were talking about this, like, there needs to be a way for people to publicly review and provide feedback and have that that positive critical analysis exchange where SLPs can learn from other SOPs, what they thought about, of course, unfortunately, what we have right now is a world where, you know, business owners are sending cease and desist letters to people who speak poorly about their courses or their certification programs, and trying to silence people. And I think that all gets back to just the culture that we're in with SLP. And when we we elevate a national organization and have this patriarchal system, where we just like, wait for them to tell us what to do and wait for them to tell us what to think and what's okay and what's not. Okay, then it's no wonder that we have this situation where cease and desist letters are sent out in the silencing effect on SLPs. Yeah,
Meredith Harold 29:48
yeah. You know, I was thinking about this earlier when you talked about this. Just the whole concept of what we really want is for SLPs to feel comfortable talking about The quality of various courses websites, just openly and fearlessly online. And I think for the most part that we can do that, but I also think we have to think about, like, why people feel scared. And you know, in what circumstances because like, are you all scared to like write a restaurant review online, like if you go out to eat, and you know, get a meal, and it's disgusting, or like, the chicken isn't cooked or something, like most people are pretty frickin comfy getting online. And putting a Google review, that's like, you know, I complained about this, and the manager didn't address it. And this was really awful food. And I really hope they get this under control, otherwise, I won't be back to their restaurant, blah, blah, blah. You know, and think about all the places or like an Amazon review, you buy a product off of Amazon and say it breaks and you know, you decide that you do want to go in and like warn other people like, Hey, this is a piece of junk, I did not have a good experience with this. Like, that's normal. First of all, like, it's the norm to be submitting reviews, and you know, feedback about things online. It's perfectly legal, as long as you're not lying, it's perfectly legal. So for, you know, companies to think that they can use cease and desist to like threaten people is hilarious, because as long as what you're saying is just an accurate, like review of your experience of a product. It's not illegal, first of all, but then I started to think about, like, in what context, might you feel uncomfortable doing this? Like, what sorts of like businesses or people would you be like, I don't know, if I want to get online, and like, blast them for this. Like, I feel like maybe I should reach out to them personally. And I feel like the context in which that that's the case is when you see a brand as an individual, you know, so like, if it's like Joe's hair shop, and she's the only one who works there. And it's like all about Joe and Joe's haircuts and stuff like that, like I probably wouldn't get directly on Google and be like, Joe gave me the worst frickin haircut ever. Like, I would probably try it try to deal with her individually. And I just got me thinking, I almost wonder if there's because our field is so small, and because such we have such a culture of like influencers and things like that. I wonder if part of it just feels personal for people. And I've noticed this too, when SLPs will criticize brands, like, they're really comfy criticizing brands that don't have a face. But when the brand has an individual face, they feel less comfortable getting online and being like, you know, Stacy Jones, this course was frickin awful, you know. And I just think that that, like, it's maybe something that we should like, as a field, sort of, think about if like, brands with individuals, as the face of the brand, makes us respond differently to the context in which we feel like criticism is appropriate, and how we approach it, and just all that stuff. You know, this
Jeanette Benigas 32:52
really ties into the organizational identity rabbit hole that we went down the other night. And there's actual science to this that we read about. So if anyone's interested, it is called organizational identity, hit Google Scholar and just start reading. But yeah, people feel a deeper sense of connection to organizations, which makes it harder to criticize, and then they feel like there'll be Outcast if they speak against it. And there's just there's just all of these reasons that people feel that way. It's very interesting. Yeah,
Megan Berg 33:30
on Meredith, you're saying it's the individually people feel less safe. Criticizing an individual, though, you're saying, Yeah,
Meredith Harold 33:37
I feel like both are the case. Like, I feel like what you're saying, like is, if everybody says, like this brand, this group, this organization, we love them, then it's really hard to get online and be like, actually, that you messed up here, because you feel like everybody is gonna like Outcast you. But I think another layer to that is perceiving something as an organization or a brand, versus as an individual can add an additional layer of, oh, but everybody loves Joe. And so I don't like if I come after Joe, they're gonna call me a bully. Even though I have a legitimate criticism of something Joe did in her business, you know what I mean?
Megan Berg 34:10
Yeah, yeah. And that speaks to just as a profession, like evolving to a place where we can disagree. Professionally, we can hold multiple truths at once we can allow, you know, one SLP to think something and we can think a different thing. And that's okay. Yeah,
Meredith Harold 34:29
we're there like that. behavior should be just expected and we should welcome it with open arms as part of like, the quality appraisal process.
Jeanette Benigas 34:41
It's a process to learn how to do though, Megan, and I go through this exercise. Every week. I feel like, you know, we often we have the same goals in mind. And we have this platform that we both care very much about, but sometimes we don't see eye to eye and it's a it's a process so Sometimes for me to be like, You know what, it's okay for her to feel like that. And I, I can't speak for her. But I'm sure she's like, it's okay for genetics feels like that. Jeanette doesn't want a credit card, it's okay. And I'm like, Megan wants a credit card. That's fine. You know, but, and we just, you know, it's and then we move on. And we're great. But it's, it's it's kind of an exercise to strengthen that muscle.
Megan Berg 35:23
And I think it starts in at the grad school level, like, I've always been fascinated, my dad's an architect, and I've always asked him all these questions about his training, and how architects learn how to be architects, and so much of their training is literally sitting in a room with other students and critiquing each other. And just like, you know, picking apart thing after thing like, like a little, microscopic piece of a design versus, you know, in the overall concept of something. And we don't do that as SLPs. In grad school, we have, we have the right answer that we're trying to get. And like, we have to give that right answer. And then if we don't, we fail. And there's just not a lot of comfort level right now in the training programs with learning how to critique and how to sit with different ideas and look at the evidence and realize that, like, yes, there are some black and white issues in SLP. But it's also an art and it's how you approach the science and the art and the blend of it and the balance of it that I think like we still have yet to like get into that strive as a profession. And I think if we can get there, like there'll be no stopping us, because we won't be arguing about, you know, what, what is an ASHA CEU. And like, if we have to pay for a certification, like these are all just such silly issues that if we can get over them and be autonomous and think critically, we can address the real issues of our field. And there are many. Yeah, agreed. So we've answered one question in however many minutes.
Jeanette Benigas 37:03
Marathon, this is a marathon episode.
Megan Berg 37:08
The next question is what makes a CEU acceptable for CCC maintenance, and I'm just gonna say there's, there's a page on the ASHA website. We referenced it on social media. I'm sure you can get to it if you search acceptable activities for professional development, Asha, and I'm just going to quickly list off what they have included. So continuing education activities, such as courses offered by organizations, state association workshops, seminars, university symposia, formal online noncredit courses, employer sponsored in service activities, such as grand grand rounds, special education workshops, formal training sessions, business management content that helps you manage your private practice more effectively, teacher oriented content that is not related to the professions but enhances your ability to better serve your clients, and college or university coursework at any level, undergraduate graduate doctoral, offered by any accredited program, the activities that are not accepted. So basically anything but volunteer work, work experiences, business meetings, clinical work experience, and association membership. Those are the only things not allowed. So it's a very broad list. And I got another question over Instagram that was like, Oh, crap, like, I haven't paid for the CEE registry. Does that mean that it negates all of the CEUs that I've completed? And the answer is, no, like ASHA has no control over anything. Like you can just keep track of the courses that you take and the time that you spend learning, like just document how you're learning and how you're growing. And that will count for professional development hours to maintain your certification if you choose to do that with Asha. And then as far as state legislation that's all over the map. And Jeanette wants to say something.
Jeanette Benigas 39:13
Yeah, I want to jump in and say if you're not sure, and I think this would apply for the CCC or the state, which Megan was starting to say is all over the place. Just contact them someone asked us another question about does it have to be pre approved? And it looks like it doesn't have to be preapproved? At least not with ASHA, but it may used to have been, again, one of those may be Asha, let legends that we don't know but a bunch of years ago, I wrote a book. And when I was coming back from Pennsylvania to Ohio, I had to show proof of 40 CPUs, even though I had only been gone for two years they were making me show two cycles worth of CPUs, which was insane and a discussion for another day. But I had written a book during that time. So I sent it to the state and I asked them, if they would count it. And they said, well, we'll probably give you a few hours, but don't don't count on a lot. And I sent them the PDF, I got permission from my publisher to forward it to them. And they awarded me the entire 40 hours. So and in the meantime, because they said, Well, don't count on it. I started getting courses and taking them and like scrambling to get to my 40s. I had way over 40 that year for the state for the reinstatement. But if you're not sure, then just ask and wait and see before you start doing what I did and paying and taking other courses, see what they say. You can just all you have to do is that yeah,
Megan Berg 40:42
and yeah, like when we think about why do we have this requirement to begin with, it's not just so that, like, we can check a box, it's literally because, you know, we went to grad school in whatever year and things change, like the knowledge base evolves. And we have to keep up with that. And that's an ethical commitment that we have made. And so when you're looking at continuing education, don't just think of it of like, I took an hour long course and got a certificate, like what are you doing to ensure that you are keeping up with the changes in the field, and understanding the current evidence base. And if you can make a case for that, you can go to the board at anytime, and just strongly and confidently make the case that you are committed to lifelong learning and continuing education in a way that, you know, maybe is a little bit outside of the box, but that's okay, all like all these regulatory bodies, they just want to make sure that any professional is doing due diligence to not, you know, do what we were doing in 1985. And like staying up with the times and providing ethical treatment.
Jeanette Benigas 41:54
On that note, too, if you are a content provider who is writing a course, you can also take the credit hours for that. So what I write and give a talk, say for medbridge. My my colleague just asked me that about when we were reviewing the course we were watching the final product make getting ready to sign off on it. And she's like, do we get CEU hours for this? And I said absolutely, that you now we don't take 400 cu hours, it feels like that's how much time we spent putting it together. But we can take the five, or whatever it turned out to be. What unfortunately you cannot do as a professor is take hours for the development of a course. And I think that's something that needs to change. But for the development of a CEU course you can take those hours. Yeah. You want to do it another question?
Megan Berg 42:49
So yeah, sorry. And the next question is Why can't see used taken during the CFI account for CCC maintenance? I have no idea.
Jeanette Benigas 42:58
Because you don't have the CCC yet. What are you meant you're not maintaining? You haven't? You haven't been accepted into the club yet? You can't maintain your membership, not in
Megan Berg 43:09
the club. And then the clock starts? Yeah,
Jeanette Benigas 43:12
they haven't they haven't accepted you into the club yet.
Megan Berg 43:16
Here you go. But then ask why. Oh, go ahead.
Jeanette Benigas 43:20
That brings up I've seen this a little bit too is should we able be able to roll over hours. And I don't think there's necessarily a bad thing. And Meredith you can jump in here too with like rolling over a certain number like five or 10. Like we would be allowed with like paid time off or something so that way, if a CF is doing a couple of things during their CF year, you know, maybe they could rollover five or 10 into their maintenance. Or maybe I go to a couple big conventions this year. And my my next cycle starts next year and I'm not going to have the money then. Sure it would be nice to count a couple extra from this year for next year that it's probably makes tracking harder but for work ethic. Yeah, yeah. But I it's i People figure it out with paid time off all the time. It's not a new concept to carry things from one place to another. Right? Yeah, I
Meredith Harold 44:15
think it's really goofy that nothing during your CF counts. But I mean, to a certain extent, I don't care. Like if I'm gonna spend my time advocating for something, it's certainly not going to be that because it's like advocating for like something that's kind of goofy in the first place. Yeah, no, I mean, like, all we really want for our field is for clinicians to continue learning every single year for their license, their state license, and that's it.
Megan Berg 44:44
You know, um, and as far as state regulations, they're like we said they're all over the map. And it's, it's a whole range from like, only accepting Ashesi EU up, Asha approves the US and or or, like State Association approved courses to really like anything goes kind of like ashes required or ashes. Yeah, requirements. But I would say that would be another great place to start if you have joined the free humble platform to connect with other SLPs in your state. And that's just another piece of regulation to hit. So if you're seeing that they have really stringent kind of closed requirements that are very limiting, as far as what see use will count. You can look at other states that have a more free market type setup, or even like reference ashes requirements as a model. But I think that states need to move away from these really stringent or closed requirements, because basically, they there's a lot of regulation out there, and then they're not enforcing it. And I think that speaks to, like most SLPs don't even know what their state CEU requirements are. Because even if they get audited, they're probably not enforcing the rules that they have in place. So that's just another piece of regulation for SLPs to hit together with your state association. Yeah. And
Meredith Harold 46:13
Go ahead, Janette.
Jeanette Benigas 46:13
I was just gonna say, if you are advocating for these kinds of changes, Megan said, use the ASHA, use the ASHA verbiage, but I would encourage, as you're advocating for these changes to get Asha and the CCC out of all verbiage in state licensure, including CCC or CEU requirements, but the verbiage itself on the actual website does lay it out very nicely. And they don't even reference themselves, right. Because it's kind
Megan Berg 46:42
of a conflict of just say, like, we're going to model it after the professional development or you can use
Jeanette Benigas 46:47
what they have. And it doesn't have to say Asha or Asha, approve CPUs at all, and it shouldn't. And I think that, again, that's, that gives us a little bit more power in the ability to make choice and to take the power away from Asha. And I think that's really important as we keep advocating for change.
Meredith Harold 47:07
And across states to I think it's important to recognize, like if your state has like, a list, if that list means that you can only take courses from providers off their list, or if it's just a recommended list, and also how those recommendations or how that recommended list is put together in the first place. So like, as a case example, we got an email from a customer about six months ago saying, Hey, I'm a California based SLP. And I really want to join the informed SLP. But I noticed that you're not on their approved providers list. And we didn't even know this. We're like, what California has an approved providers list. And so I was like, oh, you know, we didn't know about this, we'll get ourselves on the list. Thank you for letting us know. So I contacted California, and I was like, so how do I get on your list? And they're like, pay it pay us? $200. And I was like, okay, cool. $100. So, so put your bracket website. Yeah, I got on the website, paid the $200. And then I let go through this waiting process or whatever. And like six weeks later, somebody contacted me back and was like, Oh, by the way, actually, we're getting a way we're doing away with our approved providers list. And I was like, oh, okay, fantastic. So I already paid the $200, though. So can you refund it to me, I actually had to go through my credit card company in order to get a refund back for that. But the whole point of the story is the fact that a lot of times these approved provider lists are just a revenue source for the state association, which is fine. Like, I don't mind that. But I think it's important for SLPs, when they're looking at like an approved provider list, ask how that list is being put together? Like is it that the state association actually went through the labor to vet quality of who's on that list? Or is it a revenue state stream for the for the state, whether it's the state association, or you know, like licensing board, or whatever, where somebody just has to jump through another hoop in order to get their name on the list. But I have a feeling that if SLPs were to push on some of those lists a little bit, that we could, at minimum, require disclosure for how the list is put together? Like this list does not represent a comprehensive summary of you know, quality providers pay a fee in order to be on this list and whether or not you are allowed to take things on or off the list. Because Megan, do you remember off the top of your head with your research? Like how many states actually have a list where like, you're required to only use what's on the list
Megan Berg 49:31
or like five or something like five states, maybe less?
Meredith Harold 49:34
Yeah, and I think it would be nice for SLPs in those states to find out like what on earth do those lists mean? And how are they put together?
Megan Berg 49:44
I mean, it really does just come down to money and that's what I keep reiterating this I'll feel like this is just a money making scheme all around and it's I'm not trying to sound like a conspiracy theorist, but like, I've gotten courses approved for physical therapy courses, occupational therapy. courses, speech therapy courses, and it's all just money, you're just paying money, checking boxes, nobody's really checking to see the quality of anything all around. Like, it's not like speech pathology is unique here. This is pretty much every profession has this issue. And like, companies are smart enough to realize that they can make money by like making it seem like courses have more value by putting their logo stamp on it, or approval stamp on it, but it is just about money. And interestingly, the American Physical Therapy Association, they stopped being a CTE provider approver. And they were very clear about that when they did it. They said it was a conflict of interest for them to provide continuing education courses, and approve their own courses and approve other people's courses. So they just stopped doing it. And they get all of their courses approved through different boards. And yeah, the PT world is a whole other ball of wax, because basically all these boards approved them in different states. And they all have it's a nightmare over there, too. So
Jeanette Benigas 51:10
on our list, or on our map, I'm looking at our map, we have seven states in purple, which is must be approved by the state or the National Association. So that is either they went through the ASHA process to be an ASHA approved provider or they went through the state process to be a state approved provider. Correct. There's no list involvement there.
Megan Berg 51:33
Right. So if the state the state association, or the state board will either have a process where you can become an approved provider, or they will approve courses on a one off basis. Yeah, but either way, it's just a revenue source for the board or the association.
Jeanette Benigas 51:52
There's also three states in dark green where the board runs its own provider approval program. So that's another three.
Megan Berg 51:59
Yeah. That's like Florida, Illinois, in Florida,
Jeanette Benigas 52:02
Illinois, and South Carolina, and then West Virginia.
Megan Berg 52:06
That's smart. That's where those are. The board so that's how they're getting revenue. Yeah, for the board. Yeah.
Jeanette Benigas 52:14
West Virginia is one but they also allow Asha or AAA for Audiology. But the lists the lists the board has a list of approved providers that is California, North Dakota with Wisconsin Kentucky, Louisiana, Mississippi, DC and Missouri eight Pink's
Megan Berg 52:43
Yeah, what a headache what it just it's like a paperwork. Um, okay, so one question I was a little confused with is is Asher, the one requiring providers to be Asha approved to provide the 30 hours needed to keep the CCC so I'm just gonna go back to what Meredith said at the beginning. Like the only reason that companies become Asha CE, like approved see providers is because SLPs are asking for it. And I I assume the only reason that SLPs are asking for that is because they're assuming the Ashesi ease are required for anything. And they're not required for anything. So it's just like this silly cycle where we are all buying into this illusion that the ASHA CEE providers and means anything to anybody. Yeah, it just doesn't know nobody's Yeah,
Meredith Harold 53:41
yeah, like if you can convince people that having this one brand attached to the product that you're buying or that being approved by that brand, is a means something and if you can get that, you know, feeling to spread far enough, it's really difficult to undo that myth and undo that feeling. I'm sure there's really good examples. I wish I would have thought of one before we came here where there's like, people will only buy a certain brand because they think it's higher quality, but in reality that brand has just done an excellent job of marketing. And it just Yeah, Stanley Cups
Megan Berg 54:19
holding up my stand like but I was thinking yeah, but we need like anything on Instagram that's advertised. They do those really good viral marketing videos.
Meredith Harold 54:30
Right? Right. Where people can
Jeanette Benigas 54:32
you know what is another one which is we all fall prey to this is, you know, children's Tylenol namebrand Tylenol versus the drugstore brand, right. I have fallen victim to picking up the name brand, just because it's the name and have judged hard the name of the drugstore brand on the shelf, which if you turn the box around, a lot of times they are essentially the same ingredients in the same dose. Ah, right the exact same thing. Yeah,
Meredith Harold 55:02
I'll buy the drugstore brand. If it's cheaper, like I look at the price between the two. But like, if the when the price is equal and one is on sale, I will always choose the name brand of things right? Like, I'll always choose like the name brand Cheerios instead of the like oat circles if they're the exact same price because like, even though I know it's crazy, like, it's just really hard to undo that thinking. And it's really hard for CEE providers in our field to undo the thinking that something if it's Asha approved is better or vetted in some way. Big Daddy Asha is not better. He's just bigger. Correct? Correct.
Megan Berg 55:43
Okay, somebody asked a lot about the numerous.
Meredith Harold 55:45
Yeah, not better at approving or vetting courses, that's for sure. Go ahead.
Megan Berg 55:53
What about the numerous hours I spend listening to SLP podcasts? Can I count those? Also, if I attend a free online Summit, or course, but they want me to pay in order to get a certificate? Is that necessary? Or can I document my attendance another way? So the first part of this question, I feel like we cannot give a black and white answer to because it depends on if you're trying to get that approved, or submit that for professional development hours, or if you're trying to submit that to your state licensing board. And like, because we don't know what state you're in, we can't really speak to that. Um, and I'm just gonna, I'm gonna throw something out there. And I wanted to hear what you have to say. But like, I think it ultimately comes down to just acting with integrity. Like, I would say that the fix SLP podcast is probably not advancing your knowledge base for clinical practice. It's giving you you know, tools and ideas about professional identity. But I wouldn't say that I would count fix SLP podcast hours as advancing as CEOs. But there are other podcasts that really do dive deep into clinical practice. And I would definitely count those. And the way that I would personally do that is just document that like the different titles of the episodes I listened to you maybe jot down like a bullet list of things that you learned, just kind of keep notes that way. And that's what I would try to submit to Asha. But I'm not here to give anybody advice, whether that would work or not. But I think if it comes down to like, if we're doing anything to advance our knowledge, then we have to think critically about what we're listening to what we're watching. Is that evidence based? Is it meaningful? Is it having an impact? And yes, I would count that. But I want to hear what you have to say. I
Jeanette Benigas 57:48
was gonna say the same thing that certainly fix SLP does not count. But we could come up with a listener award for how many hours listen, you achieve every 70 hours, every 70 hours, we're gonna charge you $35 and send you a certificate, we could do that. But I think you just what you just said, Megan, you have to be careful because podcasts aren't vetted either. There's Megan, and I do a little prep, but we kind of just jump into it. And so people can be recording podcasts where they're just talking. But there are also times where researchers are coming on to talk about a specific article that they've published or some methodology that they use or engage in, I think those are really important. And those bring value to your knowledge base. But if it Yeah, if it's just someone talking, and you have to, is there evidence, are they citing articles? Are they talking about the research and the literature, one that comes to mind is Alicia voce and Tim Stockdale just recorded one where she was talking about evidence and some of her own research and literature about SLP decision making when it comes to diagnostics for dysphasia, I learned some things there from her talking about her research. So that was valuable to me. So I think you have to make sure that it is an actual expert talking about something valuable not just Jeanette coming on and giving her opinions. And there are there are one or two podcasts out there that do allow you to register for CEE use. They have quizzes that go along with them that you can submit and you do have to pay for those. They're not free. But those do exist.
Meredith Harold 59:36
Yeah, like SLP Nerdcast, as well. And like speech therapy PD is an example they have, you know, I think a really important way to like think about this whole like do I need to pay for like a certificate of completion from a company in order for something to count is like think of those things as like receipts. Okay? And unfortunately If you have to prove that you did a thing to your state board, you know, or state licensing board, like legally, they're the ones in control, right. And legally, they can come back and say, Oh, we're not going to let this count or Oh, we will let this count. So when you pin $20, to get like a certificate of completion, from accompany, basically, what you're getting is a receipt, that base that essentially bolsters your case to the state association, because it's not just us saying, Hey, I did this thing. But it's them also saying yes, we also sign on the dotted line that this person did, in fact, take this and it's got like a date on it. And it's got the title, and it's got, you know, signatures from people and stuff. So it's complicated, because on the one hand, I would love to be able to say to SLPs, you don't need certificates of completion for anything, you can just write down on a spreadsheet, when you did a thing, submit it to your state board, and you'll be good to go. Because I don't know that you always will be good to go. Like, it's usually better to show up with something that looks a little bit more like a receipt. But that being said, I also think that it can turn into a racket if companies are like, actually, we're going to start charging $45 for each Certificate of Completion, because then you get yourself in a situation where SL bleep peas believe that they have to pay for this receipt in order to be like, maximally safe in order to ensure that they pass on it for their license, right. And it just becomes like another like money racket situation. So I in a way, I don't know what to say. Because I think in some ways, it's irresponsible to tell SLPs Oh, you'll be good to go. Just write things down. You never need a receipt. Because I know that that's not actually true. Like the like, the receipt system does kind of help. Just like if you're audited for taxes, if you're audited for taxes, they expect to see some sort of documentation that you really paid this money for this thing and this money for this thing, if I showed up to like a tax audit, and was like, wrote down on like, a piece of notebook paper, oh, I paid cash for all these things. Like the 70 Grand that I spent this year, it was it was just all cash, there was no receipts, you know, like it would never fly, which is why it doesn't fly like the state association board.
Jeanette Benigas 1:02:05
It's kind of ties into the next question.
Megan Berg 1:02:09
I just can I just say one more thing. If you if you want to count something like a podcast, you just need to email your state licensing board and ask get it in writing, like, how do you want me to document this? And then you know, yeah, but I wouldn't Yeah, I agree that you shouldn't just do it, you'll be fine. And then see what happens. Just get, it will take five seconds to write the email and just ask what they need to
Jeanette Benigas 1:02:32
see. Yeah. The next part of this question says, If I attend a free online summit or a free course, but they want me to pay in order to get a certificate, is that necessary, or it can I document my attendance in another way. And so everything that Meredith said, you really should have the receipt. And I just want to point out that even though that course was free to you, it was not free for everyone, the organizers of those courses who give those things for free, spend a lot of time hopefully, planning quality content, they're paying for zoom fees, if you're doing it on Zoom, or whatever platform they're hosting it on there. That's not free. When we did one through the university, we did have to subscribe to zoom, so I could get enough people in the room for registration. So free, free, as in free, you know, we had to pay for that. There are to create those certificates, there's software or somebody physically putting time and energy into typing the names and the information into those certificates. So you're paying for that product. And it's, you know, very much a small price if all you're paying for is the certificate. Now if the certificate is $100, then you've you've no longer had a free course, right? They're charging you through the course through the certificate. But if they're asking you to pay 20 bucks, I mean, just think about what it's going to take for them to produce that and all of the tech fees behind that. It's not free for them. And then it's not their chair and other
Megan Berg 1:04:06
sizes, but it's like think think about like are they selling a product? Are they trying to give free access to something to get your attention to sell a product? And maybe that's not the best continuing education course to pursue even if it is approved for Ashesi us or anybody else? Right? Yeah. Does that all over but those were all the questions? I don't know if we want to wrap it up there or if there's anything else that we wanted to address, I do know that I mean, we're gonna talk more about the US and in future episodes so for people listening like continue to send us your questions you can email us at Team te am at fix slp.com You can DM us on Instagram or Facebook. You can send us a voicemail if you go to fix slp.com and click on Quick Links will continue to address your questions. And the only other thing I would say is we're starting to understand that SLPs feel like they're being regulated by three different entities. So you have Asha, you have the state licensing board. And then you also for some reason, they have Departments of Education trying to regulate school SLPs. So keep in mind that if you work in the schools, and you're required to have a Department of Education Certification, they're gonna have their own CEU requirements. And so you're trying to manage three different regulating entities, the with three different sets of rules and three different interval periods. And, and that's, again, why we're saying that like, first of all, the degree should be enough. And then state licensing is the gold standard for every other profession. And so if we're going to regulate, we should be using state licensing. And that should just be one regulatory body. That's telling us how many CPUs to get. And I will also say that Hawaii, if you're listening, you're the only state standing that does not have continuing education requirements for your state license. So if you could do the entire profession of favor and get continuing education required for your state license, then we can officially say that all state licensing boards meet or exceed the CCC standards. But right now, we can't say that because Hawaii does not require continuing education.
Jeanette Benigas 1:06:29
We're gonna tag you Hawaii, I know your handles.
Meredith Harold 1:06:34
I can think of some Hawaiian SLPs
Jeanette Benigas 1:06:38
before we go, I just wanted to read one of our podcasts reviews. Normally we start with that, but we got a nice one. So this is little flower to to to your articulating so many of the thoughts I've been having in my five years as an SLP. So disillusioned with the field in general, but this podcast gives me hope. It's okay for us to not to I'm sorry, it's okay for us to not do this thing we were doing in 1985. I hope we do evolve. Yes, we should evolve from 1985. So thank you little flower 222. So give us a five star review. Write us a nice little note on Apple podcasts if you listen there. Otherwise, just five stars all across the board on every other platform. We'll take that.
Megan Berg 1:07:24
I love it. And thank you so much for being here. Really appreciate your perspective on all the continuing education and for people listening head to the informed slp.com and use code fix SLP for 15% off your membership, and $5 will go towards the fix SLP cause is there anything else that we want to add before we officially wrap up?
Jeanette Benigas 1:07:49
I think that's it just keep sharing our content. The more people who see our stuff, the more people we have supporting the movement and the louder we are. I love it bakes in it, everybody.
Meredith Harold 1:08:02
Cheers everyone.
Jeanette Benigas 1:08:03
Bye