“The data comes more smoothly now”: a qualitative feasibility study of student experiences with intensity tracking in ICAPs

Background: Intensive Comprehensive Aphasia Programs (ICAPs), sometimes delivered by graduate student clinicians in speech-language pathology (SLP-GSCs), provide high-dose, multicomponent interventions to cohorts of people living with aphasia. Aims: This study evaluates the feasibility of session-level dose tracking in a student-led ICAP as measured by Treatment Dosage Log completion, and explores the acceptability of using Multidimensional Dose Articulation Framework (MDAF)-informed logs during individual (1:1) impairment-focused sessions from the perspectives of SLP-GSCs and research assistants (RAs). Methods & Procedures: The MDAF informed quantitative dose tracking during individual (1:1) sessions in an ICAP. SLP-GSCs and RAs were trained to complete Treatment Dosage Logs. Feasibility was assessed via log completion rates, and acceptability was explored through role-separated focus groups. A four-stage qualitative content analysis approach was used to organize and elicit meaning from transcribed interviews by four independent raters. Outcomes & Results: Feasibility was high; Treatment Dosage Logs were obtained for 100% of sessions across both SLP-GSCs and RAs, with two logs initially missing and later resolved (contemporaneous SLP-GSC submission rate = 186/188; 98.9%). In focus groups, SLP-GSCs (n = 8) and RAs (n = 4) reported a steep initial learning curve and desire for additional training, followed by increased confidence and perceived usability as the ICAP progressed. Themes reflected a trainee learning trajectory from early cognitive overload to later confidence and recognition of the perceived clinical value of systematic dose tracking. Subthemes included (1) the importance of hands-on training materials, mentorship, and supervisor support; (2) early challenges with confidence and consistency; and (3) later recognition of the clinical value of systematic data tracking. Participants expressed commitment to applying these procedures in future settings. Conclusions: Student perspectives suggest that MDAF-informed dose tracking is feasible (as measured by log completion), and acceptable when supported by scaffolded training and user-friendly tools. This study supports feasibility and perceived acceptability of dose tracking in this context; subsequent work should evaluate metric reliability/validity and examine links to fidelity and patient outcomes.