2021/2, стр. 172 - 184

PROMOTING THE INTERNATIONALIZATION OF SPEECH-LANGUAGE PATHOLOGY EDUCATION: THE BULGARIAN-AMERICAN COOPERATIVE EXPERIENCE

Резюме: Several collaborative projects between South-West University in Blagoevgrad, Bulgaria, and 8 universities in the USA have worked well to improve the overall competence of students in speech-language pathology programs and practicing clinicians to better meet the needs of individuals with fluency and voice disorders. The US Fulbright Senior Specialist and EU Erasmus+ exchange programs serve as effective instruments that provide systemic and long-term impact supporting innovation and fostering contemporary teaching methods. These international projects prepare students and faculty succeed in a global, multicultural society, and in doing so, advance speech-language pathology as an evidence-based allied health science discipline.

Ключови думи: speech-language pathology; internationalization; higher education; Erasmus, Fulbright

Introduction

Speech-language pathology (SLP), known as logopedics in certain countries (including Bulgaria), is a profession with practitioners who continuously work to improve outcomes for individuals with communication and (in some cases) swallowing disorders. The clinical and academic education of speech-language clinicians developed at different times, varying widely among countries. Based largely on 19th and early 20th century research, pedagogy, and medical practice in Germany and France, SLP training programs in the USA have had much time to establish and maintain high educational standards and to further increase its scientific base to promote accountable evidence-based practice1) (Duchan, 2002; Georgieva, 2010) while advocating for an ever-expanding scope of practice and greater interprofessional collaborative practice among allied health professionals.

In Bulgaria, speech therapists have been trained almost exclusively within the framework of special education (Georgieva, 2010). However, following positive accreditation in 2009, South-West University (SWU) established the first Bulgarian logopedics program (BA, MA, and PhD level) in the area of Public Health. The logopedics program at SWU has since received Bulgaria’s largest Erasmus+ K 107 grant (150 000 €), which supports cooperation with several well-established US universities, including Michigan State University (MSU), East Carolina University (ECU), and the University of Pittsburgh (Pitt). This work (Erasmus+ Grant, 2016 – 2020) is a direct continuation of 7 previous Fulbright projects (2004 – 2016)

within the SWU Stuttering Research Center and coordinated by Prof. Dobrinka Georgieva. SWU has thus established partner projects with eight US universities to establish collaborations that help promote research activities and evidence-based SLP practice in Bulgaria.

Aim of study: The main purpose of the present study is to conduct a theoretical review of selected Fulbright and Erasmus+ projects according to the main strategic documents shaping contemporary higher education.

The article describes the essential goals for international collaboration policy concentrated on:

1. Improvement of overall competence of students in SLP undergraduate, graduate, and doctoral programs as well as practicing clinicians by increasing knowledge and skills within the areas of fluency disorders and voice disorders; and

2. Development of projects utilizing the US Fulbright Senior Specialist and EU Erasmus+ programs.

Method: Using document and content analyses of the Fulbright and Erasmus+ projects in addition to the official strategic documents that shape international collaboration in university training, education and research, the authors outline positive outcomes and provide recommendations for further studies between the USA and Bulgaria.

Discussion of the main strategic documents shaping global perspectives in contemporary SLP education

The Fulbright Program is a US cultural exchange programs designed to improve intercultural relations and competence between US citizens and other countries through the exchange of individuals, knowledge, and skills. In 1992, the Bulgarian and US governments signed a 10-year agreement creating the BG-US Commission for Educational Exchange. Since becoming fully operational in 1993, more than a thousand individuals have completed Fulbright research and academic cultural exchanges. Over the past decade, SWU can report 9 Fulbright exchanges, 3 of which involved research projects, the other 6 (completed within the Fulbright Senior Specialist Program) involved educational exchange. Of note, 7 of the 9 exchanges were in the field of SLP within the area of public health (see Table 1).

Seeking to add coherence to higher-education systems across Europe, the Bologna Process established the European Higher Education Area (EHEA) in 1999 to facilitate student and staff mobility, to make higher education more inclusive and accessible, and to work toward making European higher education more competitive worldwide. With 48 European countries participating as part of the EHEA, they have agreed to: (i) introduce a three-cycle higher education system consisting of bachelor's, master's and doctoral studies; (ii) ensure mutual recognition of qualifications and learning periods abroad completed at other universities; and (iii) implement a system that ensures strong quality and relevance of learning and teaching (EHEA, 20202); European Commission, 20183); EUA, 2021). Bulgaria’s education minister was among the original 29 signatories of the Bologna declaration.

Developed in 2009, the Europe 2020 Strategy has served as the basic EHEA policy for the past decade (European Commission 20094)). This document reinforced the long-term prospects of the EHEA, emphasizing student-centered learning and mobility to “help students develop the competences they need in a changing labor market and will empower them to become active and responsible citizens.” In particular, it defines the two priorities of higher education as: (i) stimulation of the student mobility (i.e., at least 20% of graduated college students in Europe must have a study-abroad experience), and (ii) strengthening of international education and culture for European college students.

The Erasmus+ Program was developed by the EU to facilitate exchanges of students, faculty, and administrative staff with the purpose of improving educational training systems, while focusing on skills development, employability, institutional development, and the internationalization of European higher education. Between 2011 and 2017, SWU supported more than 260 exchanges to various countries, of which more than 70 focused on SLP. The validation of the modern university as a research and education center that prepares highly qualified specialists that support our current knowledge-based economy is the principle aim of The SWU Strategy for International Cooperation and Concept for structure and functional development according to the international standards and EU Strategy 2020 (Tcholakova, Georgieva & Ivanov 2012). The Erasmus+ Programme Guide (European Commission, 20205)), as well as SWU’s published rules for organization and management of Erasmus+ activities (SWU, 2020) were key in regulating the exchange projects undertaken.

The strategic documents of the following two US universities are presented as they engaged in the largest number of mobilities with SWU during the four years of Erasmus+ KA 107 projects. The main aim of the MSU Mission and Strategic Plan is to advance the university's international agenda. MSU's International Studies and Programs (ISP) works with the whole of the university to mobilize research capacity, enhance scholarship and educational programs, strengthen international experiences, support foreign language instruction and build partnerships around the world. ISP aligns international strategy with the university's strengths in thematic focus, regional expertise, and global partnerships. These efforts expand and deepen global research and create lasting impact (MSU, 2021).

The ECU Capture Your Horizon strategic plan for 2017 – 2022 defines the university’s responsibility to ensure the health and wellbeing of the citizens of the US state of North Carolina and its region. With the aim to be a national model for student success, public service and regional transformation, ECU (i) uses innovative learning strategies and delivery methods to maximize access; (ii) prepares students with the knowledge, skills and values to succeed in a global, multicultural society; (iii) develops tomorrow’s leaders to serve and inspire positive change; (iv) discovers new knowledge and innovations to support a thriving future for eastern North Carolina and beyond; (v) transforms health care, promotes wellness, and reduces health disparities; and (vi) improves quality of life through cultural enrichment, academics, the arts, and athletics (ECU, 2021). The mission of ECU’s Office of Global Affairs is “to amplify the global impact of ECU, its faculty, staff and students,” by preparing students to succeed in a global, multicultural society by maximizing access to international experiences; encouraging regional transformation by contributing to a globally aware, globally engaged, and globally competitive citizenry; and facilitating global, international and intercultural public service and community engagement (ECU Office of Global Affairs, 2021).

The other US universities involved in Fulbright projects, including Pitt, West Virginia University (WVU), Minnesota State University (MSU), Vanderbilt University (VU), and the University of Cincinnati (UC), all strongly support studyabroad opportunities for their students and stress international cooperation as an important part of their mission.

Discussion of the Fulbright and Erasmus+ KA 107 collaborations between SWU and US Universities

Eight US institutions have collaborated with SWU between 2004 and 2020. During this time, there were 7 Fulbright and 27 Erasmus+ exchanges, involving 34 individuals (23 faculty members, 5 students, and 6 administrative staff). These collaborations provided continuing education for students and clinicians with the intent of increasing their knowledge and skills in the areas of fluency and voice disorders while promoting cultural competence and awareness.

Table 1 outlines the chronology of SLP development in the USA and Bulgaria (Andreev 1897; Denev 1940; Ivanov 1973; Stoyanov 1999; Lubinski & Golper 2007; Georgieva 2009; Georgieva & Popova 2012a; 2012b). From the perspective of SWU, much of the success of the exchanges with the US university SLP programs has been tied to their historic development as a dynamic, systematic, and scientific applied health science – allied with, but independent from, medicine, social science, and special education.

Surveying SLP/logopedics programs in selected central and southeastern European countries, Georgieva (2010; 2014) highlighted the need to improve the quality of courses and guarantee the excellence of professional education by creating effective continuing-education programs, workshops, and seminars through research-informed teaching; extending the traditional role of SLPs through the development of new subspecialties; and engaging in basic and applied research to support accountable evidence-based practice.

In addition to providing unique experiences and academic courses for three MSU students who visited Bulgaria for a 3-month study abroad, SWU has sent two students to MSU to be trained in areas that are uncommon for SLPs in Bulgaria. Within the Erasmus+ program at MSU the Bulgarian students participated in courses covering such topics as swallowing disorders, audiology and hearing rehabilitation, neurogenic and motor-based speech disorders, cognitive communication disorders, and SLP research methods.

A total of six exchanges of administrative staff have occurred between MSU and SWU to support the development of further international exchange programs and a graduate (MA-level) curriculum for a possible SLP/Logopedics program to meet the educational and clinical needs of Bulgaria. The administrative exchanges have provided department chairs and program directors collaboration with SWU Erasmus experts, education specialists, and staff members who oversee international affairs. This has promoted the sharing of how different educational and clinical systems function, leading to discussions of how these systems may adapt to the current and future needs of students, patients, and speech-language clinicians in each country.

Essential to the development of a health-science-based SLP curriculum has been the delivery of courses in fluency and voice disorders. In lecture, both the Bulgarian and US academics emphasized the principles of education as reflective practice, collaborative practice, cultural competence, contexts of practice, holistic and evidencebased practice, creativity, mindfulness and care, as well as professional knowledge and practical skills. The special purpose of the Fulbright and Erasmus+ teaching was to (i) provide advanced knowledge in existing theories and scientific research through research-based teaching, and (ii) to evaluate critically research evidence regarding the prevention, diagnosis, treatment and management of communication disorders. All teaching activities during the Fulbright and Erasmus+ projects conformed to the accepted frame of research-informed teaching promoted by European universities.

Conclusions

The Erasmus+ and Fulbright programs serve as effective instruments for systemic and long-term impact by supporting innovation and contemporary teaching methods. During the past 15 years of collaboration between SWU’s Logopedics program and several US universities, these partnerships have influenced the way educational institutions disseminate research, create valuable international collaborations, and prepare students at the undergraduate, graduate and postgraduate level. Furthermore, visiting MSU students have had the opportunity to gain culturally and linguistically diverse perspectives as they relate to European culture and the field of SLP abroad. These students were exposed to different models of health care, billing, clinical populations, and scope of practice.

Students and clinicians in SWU received education and training from US faculty who provided important knowledge and evidence-based insight into the etiology, pathogenesis, and clinical symptoms of fluency and voice disorders. All described exchange activities have fostered international recognition of both the SWU Logopedics program and the Stuttering Research Center. Further, the activities were in accord with the Bulgarian National Strategy of Scientific Research with its emphasis on the internationalization of science and education. The internationalization of the scientific and educational achievements of SWU’s Logopedics program is essential to full participation as Faculty in Public Health as well as to structure and functional development outlined by EU Strategy 2020.

Relationships have been built between institutions in the USA and Bulgaria that continue to foster collaborations and consultations on various research projects, resulting in publications (St. Louis, Andrade, Georgieva, & Troudt 2005; St. Louis, Filatova, Coşkun, Topbaş, Özdemir, Georgieva, McCaffrey, & George 2010, 2011; Georgieva 2013a; Georgieva 2013b; Georgieva & Orlikoff 2020; Brosh, Yaruss & Georgieva, in press) as well as national and international professional conferences (Georgieva, Andrade, St. Louis, & Troudt 2004; St. Louis, Goranova, Georgieva, Coşkun, Filatova & McCaffrey 2007; Kuster, Georgieva, Felsenteld, St. Louis, Topbaş, & Shultz 2008; Georgieva, Spray, Yaruss, Orlikoff & Deliyski 2018). Although the US universities that participated in the Fulbright and Erasmus+ KA107 projects with SWU represented different structures and systems of higher education, all of them shared one essential strategic purpose: to offer high-quality student education that best prepares them for a successful career as a speech-language clinician. The Fulbright and Erasmus+ exchanges served as an effective instrument for gaining an international perspective regarding education and practice in the field of SLP.

Acknowledgments: The authors would like to thank the Fulbright Specialist Program for providing a unique opportunity for U.S. academics and established professionals to engage in exchange opportunities in Bulgaria, in addition to the Core Fulbright Visiting Scholar Program for providing the funds for an international researcher to visit Cincinnati Children’s Hospital. The authors would also like to thank the Erasmus+ Program for their dedication to supporting global study, training, experience, and volunteering abroad. Both Georgieva and Orlikoff have received travel funding to participate in the Erasmus+ Program through the following grant: Erasmus+ K107 project: 2017-1-BG01-KA107-035621, key action 107 “Learning mobility of individuals”, Mobility between program and partner countries, European Commission, Brussels, Belgium.

NOTES

1. Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association (2016). 2014 Standards for the Certificate of Clinical Competence in Speech-Language Pathology. http:// www.asha.org/Certification/2014-Speech-Language-Pathology-CertificationStandards/

2. European Higher Education Area and Bologna Process. https://ehea.info

3. The Bologna Process and the European Higher Education Area. https://ec.europa. eu/education/policies/higher-education/bologna-process-and-european-highereducation-area_en

4. Communiqué of the Conference of European Ministers Responsible for Higher Education, Leuven and Louvain-la-Neuve, 28 – 29 April 2009. https://ec.europa. eu/commission/presscorner/detail/en/IP_09_675

5. The Erasmus+ Programme Guide 2020. https://ec.europa.eu/programmes/ erasmus-plus/resources/documents/erasmus-programme-guide-2020_en

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