Bringing virtual reality into speech and language therapy education

Speech and language therapist and senior teaching fellow, Carolyn Allen, reflects on using immersive virtual reality to create a new learning experience that helps build students’ confidence and communication skills before they enter professional practice.

For nearly 30 years, I have worked as a speech and language therapist across a range of clinical settings, from adult acute and rehab services to voice and stammering. My work in a multidisciplinary clinic for professional voice users led to myself and an ENT Consultant creating West End Voice, an independent practice, with the aim of providing group training to prevent the voice difficulties and diagnoses we were seeing in the voice clinic. I have also spent much of my career teaching part-time at the University of Strathclyde, enjoying a combination of teaching alongside clinical practice.  

Creating different learning experiences

Whilst learning theory is crucial, authentic human interaction is what allows clients and their families to feel heard, and so developing sophisticated therapeutic skills is firmly embedded in my teaching and assessment design.

An academic-clinical combination of work ensures I am abreast of the latest research for the benefit of my clients, and sharing examples of practice based evidence supports student learning in return.  

As a student it can be daunting to respond to tricky questions and heightened emotions in the moment on placement, and although in-class roleplay with peers can help a little it’s difficult to create conversations which truly reflect what clients and their families say.  I want all students to feel confident in what they bring to the workplace when they graduate. 

To help combat this problem, I had been wondering how to make in-class roleplay practice more realistic and dynamic and then saw a post on X by Gareth Walkom who developed the withTherapy VR app. I had heard of clinicians using this with clients who stammer and thought I might be able to turn the tables so the person wearing the headset wasn’t a client practising speaking to an avatar in a coffee shop, but a student practising speaking with an avatar client, parent or teacher. Funding from the university’s Digital Innovation Fund paid for app licences, a new VR headset and replacement headphone buds to help us pilot immersive virtual reality (IVR) sessions.

Stepping into virtual reality 

Working in pairs or small groups and supported by a clinical tutor or lecturer, students use the VR headsets to interact with avatars representing clients, parents, family members, teachers or other professionals. 

We integrate the practice into our suite of placement modules, typically within pre-placement workshops or counselling classes and use a variety of clinical scenarios so students can practise with different client groups.  

The virtual environments can be adapted to reflect different clinical contexts, from therapy rooms to hospital visitor spaces. Avatars are customised to represent a range of ages, appearances, and cultural backgrounds, helping create varied and realistic scenarios. 

Tutors control avatar responses using pre-prepared statements, but as we don’t know what students are going to say there is also the flexibility to type live responses which helps retain the flow and authenticity of the conversation.  

This brings a more authentic representation of therapeutic conversation whilst aiming to retain the relative safety of a classroom environment where uncertainty is supported, and experimentation is encouraged. There is positive student feedback regarding this novel learning experience, and facilitators have noted that students stay in the situation more consistently than if they were practising role-play which is easily halted by moments of hesitation around what to say next.

Recognition for innovation 

This innovative addition to our students’ learning was recognised with a Strathclyde Medal within the category of developing digital innovation for social impact.  

The award came as a surprise, as I was unaware that the project had been nominated, but I was delighted that an early stages project was being valued at university level, and this recognition is motivating to pursue this further.  

Whilst this is a resource heavy activity and needs financial investment, I can see opportunities to develop immersive virtual reality use in student training. funded research could explore which aspects of therapeutic practice IVR is most effective at developing and how activity design can be aligned to the different stages of student training. As someone who enjoys human connection, I’m aware of some personal and professional resistance around robots taking over the world but perhaps this is one useful tech development!