Clinical Education:
Competencies and Conversations
KSHA 2012
KSHA 2012
Outline
• Background Information
– Standards for Clinical Education – Competency Based Outcomes;
Knowledge and Skills Needed by SLPs Providing Clinical
Education– Debby Daniels, KUMC
• Strategies for Collaborative Teaching and Learning
– A Continuum of Support – Melanie Hilgers, KSU
– Clinical Educator: Strategies to Promote Learning – Jane Wegner, KU
– Active Engagement on the Part of the Student – Marla Staab, FHSU
– The Art of Giving Feedback – Laurie Hughey, WSU
• Discussion; scenarios
Standards for Accreditation – Clinical
Education
• Council on Academic Accreditation (CAA) in
Audiology and Speech-Language Pathology of
ASHA
– Sets and implements standards
– Awards accreditation
Standards for Accreditation – Clinical
Education
• Six necessary components for quality graduate
education
– Administrative structure and governance
– Faculty
– Curriculum (academic and clinical education)
– Students
– Assessment
– Program resources
Standards for Accreditation – Clinical
Education
• Standard 3.1B
– The curriculum (academic and clinical education)
is consistent with the mission and goals of the
program and prepares students in the full breadth
and depth in the scope of practice in speechlanguage pathology.
Standards for Accreditation – Clinical
Education
• Program curriculum must provide opportunity
for students to obtain
– A minimum of 400 supervised clinical education
hours, of which 325 must be attained at the
graduate level
– Provide sufficient breadth and depth of
opportunities to gain experiences with
• Different work settings
• Different populations
• Appropriate equipment and resources
Standards for Accreditation – Clinical
Education
• The program must provide opportunities for
students to acquire and demonstrate knowledge
& skills in
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Articulation
Fluency
Receptive/expressive language
Hearing
Swallowing
Cognitive aspects of communication
Social aspects of communication
Communication modalities
Standards for Accreditation – Clinical
Education
• The program must provide opportunities for students
to acquire and demonstrate knowledge & skills in
– Oral and written or other forms of communication
– Prevention, evaluation and intervention of communication
and swallowing disorders
– Interaction, including counseling and collaboration
– Effective interactions
– Delivery of services to culturally and linguistically diverse
populations
– Application of the principles of evidence-based practices
– Self-evaluation of effectiveness of clinical practice
Standards for Accreditation – Clinical
Education
• Clinical supervision is commensurate with the
clinical knowledge and skills of each student,
and clinical procedures ensure the welfare of
each person served by students is protected,
in accord with recognized standards of ethical
practice and relevant federal and state
regulations.
How Much Supervision?????
• Standard IV-E of SLP Certification Handbook
– Direct supervision must be in real time and never
be less than 25% of the student’s total contact
with each client/patient and must take place
periodically within the practicum. These are
minimum experiences that should be adjusted
upward if the student’s level of knowledge,
experience, and competence warrants.
Standards for Accreditation – Clinical
Education
• Written policies describing the manner and
amount of supervision
• Written procedures for client/patient safety,
confidentiality, and security of client/patient
records
Standards for Accreditation – Student
Assessment
• Competency Based Outcomes
– Formative Assessments
– Summative Assessments
Clinical Supervision Competencies
• http://www.asha.org/docs/html/PS198500220.html
– Tasks of supervision
– Competencies for effective clinical supervision
– Preparation of clinical supervisors
Tasks & Competencies of Supervision
• Establishing and maintaining effective working
relationship with supervisee
• Assisting supervisee in developing clinical skills and
objectives
• Assisting the supervisee in developing and refining
assessment skills
• Assisting the supervisee in developing and refining
clinical management skills
• Demonstrating for and participating with the
supervisee in the clinical process
• Assisting the supervisee in observing and analyzing
assessment and treatment sessions
Tasks & Competencies of Supervision
• Assisting the supervisee in development and maintenance
of clinical and supervisory records
• Interacting with the supervisee in planning, executing, and
analyzing supervisory conferences
• Assisting the supervisee in evaluation of clinical
performance
• Assisting the supervisee in developing verbal reporting,
writing and editing skills
• Sharing information regarding ethical, legal, regulatory and
reimbursement aspects of practice
• Modeling and facilitating professional conduct
• Demonstrating research skills in the clinical or supervisory
processes
Preparation for Clinical Supervision
• Specific curricular offerings from graduate
programs
• Continuing educational experiences
• Research-directed activities that provide
insight into the supervisory process
• Web resources for clinical supervision support
and education
– http://www.asha.org/docs/html/PS198500220.html
Web Resources
• Tips for first time clinical supervisors
http://www.asha.org/slp/supervisortips.htm
• Special Interest Group 11: Administration &
Supervision
http://www.asha.org/SLP/SupervisionArticles/
• Frequently asked questions
http://www.asha.org/slp/supervisionFAQs.htm
• Printed references for clinical supervision
http://www.asha.org/academic/teach-tools/phd-prepreferences.htm
Continuum of Support
Supervisor and Supervisee
Process
Anderson’s Model (1988)
Tool provides a framework for
Supervisor and Supervisee to Utilize
• Fluid model that supports the individual
student’s growth.
• The continuum is not time – bound.
• Designed to support the supervisee in the
development and self-recognition of
clinical and professionals strengths as well
as the development and self-recognition of
those areas requiring additional
development of skill.
Anderson’s Model (1988)
Evaluation-Feedback Stage
• Supervisor
– Directive in working with supervisee.
– Takes “the lead” in planning for the needs of clients
with whom the supervisee is serving.
• Supervisee
– Benefits from specific input and feedback for each
client assigned for intervention and/or diagnostic.
– Feedback is considered to be ‘direct-active’ in that the
supervisee follows supervisor directions.
Transitional Stage
• Supervisor
– Willing to relinquish control.
– Provides input and feedback’ however the tone of the
relationship becomes more of a joint project.
– Use of directive style when necessary.
• Supervisee
– Begin participating in the planning, implementing and
analyzing the course of treatment for clients.
– Increased responsibility and planning required for the
client.
– Increase independence.
– Increase client management skills.
Self-Supervision Stage
• Supervisor
– Serves in a collaborative role.
– Listens and supports in the problem solving process.
• Supervisee
– Grows in clinical independence
– Plan and implement therapy with less direct
supervisory input.
– Responsible for primary management of the
caseload.
Resource
• ASHA - Clinical Education and the
Professions
http://www.asha.org/academic/teachtools/supervision.htm
Strategies to Promote Learning
• Learner centered teaching/learning focus
– what the student is learning
– how the student is learning
– the conditions under which the student is learning
– whether the student is retaining and applying the
learning
– how current learning positions the student for
future learning
Strategies
• Create positive partnerships/learning
environment
• Provide encouragement, confidence
• Engage in reflective practice
Strategies
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Model best practices
Participate in collaborative problem solving
Case presentations
Assigned/directed reading with discussion &
application to clients
• Relate classroom knowledge to clinical
experiences
Strategies
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Share your clinical teaching “style”
Provide specific feedback that leads to change
Facilitate peer to peer learning
Ask questions that promote learning
Evaluate your clinical teaching practices
Professional Growth and Development:
Active Engagement on the Part of the Student
From the beginning, keep the end in mind.
• It is essential for the student to
– Embrace a long term commitment to their own
personal and professional development
– Specific strategies include:
• Self-analysis through taped observation of assessment
and/or treatment sessions
• Data collection
• Observation of others
• Peer interaction/discussion/feedback
• Asking and answering questions
• Independent goal setting
• Commitment to evidence based practice
Generic Abilities
Is it important to discuss with students?
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Commitment to learning
Interpersonal skills
Communication skills
Effective use of time and resources
Use of constructive feedback
Problem solving
Professionalism
Responsibility
Critical thinking
Stress management
• May et al., 1995
In addition to demonstration of core knowledge
and skills, mastery of generic abilities should
yield the following student outcomes:
• Generalize from one context to another
• Integrate information from different sources
• Successfully apply knowledge and skills in practice
settings
• Synthesize information across domains (cognitive,
communication, social, motor, etc.)
• Interact effectively with clients, families, the
community, and other professionals
• Whalen, 2001
The Art of Feedback
What makes feedback effective?
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Descriptive
Specific
Responsive
Directed to modifiable behavior
Solicited
Well timed
Validated
Types of Feedback
• Written
• Verbal
• Scheduled / Spontaneous
• Live / Recorded
Feedback on Writing
• Formula writing
• Editing
• Electronic records
• Volume
Role of the Supervisee
• Responsibility
• Reflection
Sounds So Simple
Let’s Talk
• Time for Questions
• Scenarios
• Thank you for your interest