What’s in a name?
Preceptor, Mentor,
Coach, Supervisor
in Clinical
Education
Susan M Moore, Clinical Professor
University of Colorado, Boulder
Goals for Session
Participants will increase knowledge of and
discuss:
• Current ASHA & CAPSD issues and initiatives
impacting clinical educators
• Design and content of current models of
clinical education in personnel preparation
Participants will have an opportunity to share
perspectives regarding their roles and
responsibilities as clinical educators at each level
of personnel preparation in SLP Perspectives
Clinical Education is a
process…
• Goal: “… guide and support the learner
through hands-on clinical training with the
goal of developing clinical and professional
knowledge and skills.” (Newman, 2005)
What’s New?
• Knowledge, Skills and Training Consideration
for Individuals Serving as Supervisors ~ ASHA
2013…Ad Hoc Committee on Supervision
• White Paper: CAPCSD ~ Preparation of Clinical
Educators …”to develop a white paper on
evidence-based guidelines for individual's to
acquire the knowledge and skills necessary
for effective clinical supervision and
education” 2012
Questions to guide our
Discussion
• What is the emerging content addressing the increasing
roles and responsibilities of clinical educators preparing the
future professionals in our disciplines serving individuals
with communication challenges?
• What are issues and questions that guide our review,
including:
• what knowledge is needed specific to each level of personnel
preparation?
• What are the necessary skills and competencies of clinical
educators?
• What amount and type of preparation is necessary to achieve
competence as a clinical educator
• Why would you want to do this?
ASHA Ad-Hoc Committee&
CAPCSD White Paper
• We used to think if you were an effective
master clinician, you could easily fulfill the
role of preparing future professionals.
• We now know a wider knowledge base and
refined skill set, specific to each level of
personnel preparation, is necessary to fulfill a
role as clinical educator.
Consider the Knowledge Base
• Supervisory Process and Clinical Education—
Supervisor will possess:
• Knowledge of collaborative models of supervision
• Knowledge of adult learning styles
• Knowledge of teaching techniques (e.g., reflective
practice, questioning techniques)
• Ability to define supervisor/supervisee roles and
responsibilities appropriate to the setting
What specific skills are needed?
• Relationship Development—Supervisor will:
• Develop supportive and trusting relationship with
supervisee
• Create an environment that fosters learning and
exploration of personal strengths and needs
• Work within the relationship to transfer decision
making and social power to the supervisee, as
appropriate
• Educate supervisee about the supervisory process
Communication Skills
• Communication Skills—Supervisor will
define/demonstrate:
• Expectations, goal setting, and requirements of the
supervisor/supervisee relationship
• Expectations for interpersonal and modes of
communication, including written/oral messages with
supervisor, families, clients, referral sources, or
colleagues
• Appropriate responses to differences in
communication styles and evidence of cultural
competence
Other considerations
• Recognition of and access to appropriate
accommodations for supervisees with
disabilities
• Engagement in difficult conversations, when
appropriate, regarding supervisee
performance
• Access to and use of technology, when
appropriate, for remote supervision
Guiding and modeling the Way
• Establishing and Implementing Goals—Supervisor
will:
• Develop goals/objectives—collaboratively with
the supervisee—that allow for the supervisee’s
clinical and professional growth in critical thinking,
problem solving, etc.
• Set personal goals to enhance supervisory skills
• Observe sessions, collect and interpret data, and
share data with the supervisee
Feedback
• Give the supervisee objective feedback designed
to motivate and improve performance…Side
point on type and method…
• Understand the levels and use of questions to
facilitate clinical learning
• Adjust supervisory style based on level and needs
of the supervisee
• Review relevant paperwork and documentation
Analytical Skills and Function
• Analysis—Supervisor will:
• Examine collected data and observation notes
to identify patterns of behavior and target
areas for improvement
• Assist the supervisee in conducting selfreflections until independence is achieved
• Reflective practice is key towards independence and
autonomy of future professionals
Clinical Decisions
• Clinical Decisions—Supervisor will model and
guide supervisee to:
• Respond appropriately to ethical dilemmas
• Apply regulatory guidance in service delivery
• Access payment/reimbursement for services
rendered
Evaluation as a Function
• Evaluation—Supervisor will collaborate with
the supervisee and continually:
• Assess performance of the supervisee
• Determine if progress is being made toward
achieving the supervisee’s goals
• Modify current goals or establish new goals if
needed
Performance Decisions
• Performance Decisions—Supervisor will:
• Guide supervisee in using reflective practice
techniques to modify his/her own performance
• Assess supervisee performance and provide
guidance regarding both effective and
ineffective performance
• Determine if progress is being made toward
achieving the supervisee’s goals
What happens when its not
working?
• Performance Decisions—Supervisor will:
• Identify issues of concern in regard to
supervisee performance
• Create and implement plans for improvement
that encourage supervisee engagement
• Assess response to plans for improvement and
determine next steps, including possibility of
failure, remediation, or dismissal
Research/EB Practice
• Supervisor will adhere to principles of evidencebased practice and effectively convey applicable
research information/analysis to the supervisee
and will:
• Refer to research and outcomes data and their
application in clinical practice
• Encourage the supervisee to seek applicable
research and outcomes data
• Utilize methods for measuring treatment
outcomes
Look Around…What works?
• Clinical education literature across all allied health
fields should be employed for the development of
training materials—notably the information
related to the scholarship of teaching and
learning, adult learning, and successful models for
training clinical educators in related disciplines.
• Inter-professional… Team-Based…
Additional Considerations
• Clarifying Expectations : A Sample Teaching Technique
Definition and discussion of terms…variations on a
theme and parallel process
• “Giving Back” to the professions: The why…
• Career Ladder: Framework for Roles and
Responsibilities at Each Level of Professional
Preparation
• Models to guide your development and practice
• Strategies for Learning
Expectations
• Think about your expectations for your time
here in this presentation today…
• What do you expect of me as a presenter and
what do you expect of yourself in terms of:
• Content
• Participation
• See a handout
Sample Strategy
• Clarifying Expectations: This strategy is
appropriate at any level of professional
development…
• Saves time as can avoids misunderstandings
and/or miscommunication down the line
• Opens doors to discussion and resolution of
discrepancies that can interfere with
relationship building and satisfaction
Clarifying Expectations
• “as the relationship begins, it is critically important
to “set the stage” for participation by resolving
expectation discrepancies. This will prove
beneficial in the long run as communication about
expectations “up front” alleviate the problems of
backtracking later with “but I thought…” and also
documents what is expected reciprocally . This
exercise is critical to the establishment of realistic
expectations for both the prospective employee/
student and the mentor and clarifies goals and
objectives for a mentoring process.” Moore et al,
1998
Terms Can Be Confusing…
• What do we mean by… Preceptor
Working Definitions
Do you do all of the these…mentor, supervise,
coach, complete performance-based
assessments, promote and evaluate competency
development etc…?
Focus of each may pull in another perspective
that facilitates meeting the individual personal
preparation needs or career goals of a student at
any given point in time …
Supervision & Supervisory
Process
• Purposes: Sergionanni (1991)
• Quality control through monitoring of
performance
• Competency development in a particular skill
set
• Promoting commitment to the position or
work focus…alignment of goals
Supervision is a process…
• “Supervision is a process that consists of a variety
of patterns of behavior, the appropriateness of
which depends upon the needs, competencies,
expectations and philosophies of the supervisor
and the supervisee and the specifics of the
situation (task, client, setting, and other
variables).”
--McCrea, Elizabeth S. and
Brasseur, Judith A., The Supervisory Process in
Speech-Language Pathology and Audiology, Allyn
& Bacon, 2003, p. 8
Key Components of Supervisory
process
• Defining and communicating the position activities
and scope of responsibilities
• Coaching for improved performance
• Provision of job-related instruction
• Providing formative feedback
• Evaluating performance
• Providing consequences for poor performance
Additional Aspects
• “ Organizational acculturation” Dowling (2001) :
Includes introduction to workplace culture and
people; orientation to roles & responsibilities of others
etc.
• Determination of training and supervisory needs
including pathways to competence with appropriate
levels of supervision
• “Guidance of development” modeling of professional
behavior, confidentiality, appearance, ethics, quality
services
• Documentation of performance with feedback (
journals, portfolio development, written evaluations, formal
Is Mentorship part of the role?
• Mentorship is a term that implies more than
supervisory management and evaluation of
assigned tasks and responsibilities. It is often
described as a “caring and supportive
relationship between an experienced more
knowledgeable practitioner (mentor) and less
experienced, less knowledgeable practitioner
(mentee) in which the mentee receives careerrelated and personal benefits” (Henry,
Stockdale, Hall, & Deniston, 1994).
Reciprocal Relationship
• Mentorship relationships are relationship based and
not entirely one-sided, with only the mentor providing
time, advice, expertise and support of the mentee.
More recent descriptions of the relationship point out
benefits for both the mentee and the mentor (Moore
& Pearson, 2003).
• “Mentoring is a tool that organizations can use to
nurture and grow their people. It can be an informal
practice or a formal program. Protégés observe,
question, self-reflect and explore. Mentors
demonstrate, explain, model and use inquiry to
promote self awareness and problem solving.
The act of mentoring…
• “Deliberate learning is the cornerstone of
mentorship. The mentor's job is to promote
intentional learning, which includes capacity
building through methods such as instructing,
coaching, providing experiences, modeling and
advising.
• “Benefits may include career satisfaction, job
retention, opportunities to actualize and optimize
skill development and abilities, expansion of
knowledge base, opportunity to grow and learn
and working effectively with others.”
A Matter of Focus ?
• The terms mentoring and supervision are not
synonymous but are often used interchangeably
(Urish, 2004). Mentoring is typically defined as a
relationship between two people in which one person
(the mentor) is dedicated to the personal and
professional growth of the other (the mentee)
(Robertson, 1992). While this definition may sound
similar to the relationship of the supervisor and the
supervisee, the primary focus of supervision is
accountability for the supervisee's performance (e.g.,
providing grades or conducting performance
evaluations; documenting professional behavior and
clinical performance).
In contrast…
• In contrast, mentoring focuses on creating
effective ways to build skills, influence attitudes,
and cultivate aspirations. Mentors advise, tutor,
sponsor, and instill a professional identity in
mentees.
• Mentoring is an intense interaction between two
people, where the mentor has authority and
power based on experience. To highlight the
importance of the mentoring role, the 2005 ASHA
Standards for Clinical Certification references
mentoring.
Coaching
• Crane, T., (2002) The art of assisting people
enhance their effectiveness, in a way they feel
helped”
• Current research from business, education,
etc. indicates training alone is necessary but
not sufficient to promote sustained
performance changes…without coaching old
behaviors quickly resurface, sustained
performance improvements do not materialize
Coaching Process
• “Coaching is a comprehensive communication process
in which the coach provides performance feedback to
coachee in all work-related dimensions…the coach
acts as a guide by challenging and supporting
individuals as they strive to achieve their personal and
organizational objectives”
• “An adult learning strategy in which the coach promotes
the learner’s ability to reflect on his or her actions as a
means to determine the effectiveness of an action or
practice and develop a plan for refinement and use of
the action in immediate and future situations. Rush &
Shelden, 2005
Coaching vs. Training
6
5
Coaching
Training
4
3
2
1
0
Category 1
Category 2
Category 3
Category 4
Consultation
• Intention is to share vital information about
policies, procedures, content and effective
practices…Lipton & Wellman, 2003
• Buysse & Wesley ,2005 …it is an indirect
method…triadic in nature, ..a joint , systematic
problem solving process
Consultant
Consultee
Client
Collaboration
• “Involving two or more professionals
providing direct service to the client” Buyesse
& Wesley, 2005
• Often difficult to distinguish …especially when
consultant is internal… is a valuable goal in
consultation to foster collaboration to
optimize resources, commitment and
satisfaction in the process.
How do these constructs fit
together?
Key Components to Consider in
your role as a clinical educator
•Relationship-Based
•Competency & Performance
Based
•Involves Reflective Practice
Relationship-Based
• “The supervisory relationship should be based
on a foundation of mutual respect and
effective interpersonal communication”.
ASHA, 2008
• Development of trust… “a sense of
investment in the other person, earned
confidence and trust, use of empathy to
understand the other person’s emotional
reality and mutually developed goals”” (p. 26).
Competency/ Performance-Based
Assessments
• Competency and/or performance based assessments
are integral to the process
• Tools utilized may be informal or formal, based upon
standards of practice, and provide data to promote
improvement in practices specific to a setting or role
or discipline.
• Internal … Self –administered checklists, inventories,
use of video tape to promote reflection.
• External… PRAXIS, CLASS, Annual Performance
Review etc.
Reflective Practice
• Reflective practice is defined by Schon (1996)
as “thoughtful consideration of one’s own
experiences in applying knowledge to practice
while being coached by professionals in the
discipline.” The ability to learn from one’s
actions is necessary for continuous learning
and crucial to quality clinical education.
Self-Reflection is Key!
• Effective supervisors are able to foster, model,
and facilitate reflective activities that teach
self- awareness and the ability to assess one’s
strengths and weaknesses leading to changes
in practice.
• Goal: “Simultaneously enhance clinician
performance and develop a relationship that
supports the clinicians’ ability to effectively
convey concerns, strengths, and new ideas to
the supervisor.”
Reflective Practice involves…
Reflective Practice - a process by which
educators actively engage in thinking critically
about our own:
• Reactions…
• Judgments…
• Behaviors…
• Emotions… and Intentions
Models & Process
• Anderson, 1988 A continuum…
A Developmental Continuum
Variables
• Novice ………………………… Proficient
• Direct ……….………………… Indirect
• Inexperience…………………..Experienced
• Intensive………………………..Less Intensive
• Active Support…Collaborative…Consultative
Expanded Definition
• ASHA's position statement (1985b) noted that
“effective clinical teaching” involves the
development of self-analysis, self-evaluation,
and problem-solving skills on the part of the
individual being supervised. Self-analysis and
self-evaluation are important activities for the
supervisor as well.”
• the shared core principles of supervision
regardless of the discipline and/or service
delivery setting (Dowling, 2001).
Mentorship Model
• Mentoring Matters ( Lipton & Wellman, 2003
• “Learning focused mentoring relationships
frame the learning journey from novice to
expert…” Mentees are more likely to…
• Increase efficacy as problem-solvers and decisionmakers
• Engage in collaborative professional exchanges
• Remain in the profession
What mentors do…
• Mentors offer support, create challenges and
facilitates professional vision through
maintaining a learning focus within the
relationship Daloz, 1998
Model for Learning Focused
Interactions
• Lipton & Wellman
CONSULT
Information and analysis
COLLABORATE
COACH
Information and analysis
A Continuum of Interaction
• Consulting …share information, advice and
technical assistance about policies and
procedures, content, learning competencies,
effective practices to establish standards for
professional practice
• Collaborating ….to co-develop information, ideas,
and approaches to challenges. Model a collegial
relationship as a standard of practice
• Coaching…skilled coaches provide guidance in
accessing internal resources and developing
capacities for self-directed learning
Moving Back & Forth Across the
Continuum
• Consultation Strategies : Sharing Information Think
Aloud…Offer a Menu…Idea Bank …Model…Review
Video tape
• Collaboration Strategies: Co-develop or Co-construct
the information pool through brainstorming, coplanning, co-teaching, conduct action research,
explore research and case studies
• Coach: Support thinking, problem solving and goal
through nonjudgmental inquiry …probing ,
paraphrasing, or inquire about successes, concerns,
self- reflection is key
Coaching Model by Crane
This transformational model is built upon…
• 1. Foundations (Connect, Set Expectations,
Observe and Prepare)
• 2. The Learning Loop (“Asking the L earning
Questions” with permission and positive
intention, share perceptions, and explore through
listening
• 3. Forwarding the Action (Identify options and
specific changes, clarify commitment with support
and follow-up)
Transformational Coaching
Activity… Characteristics
• Think about your favorite advisor, mentor,
supervisor when you were in training…
• Pair & Share with the person sitting in front or
behind you…
• What about the relationship worked for you?
• How did this professional support your
professional development and career?
• Think of an “opposite” person if one in your
life…what did not work?
Consultation Framework
• Buyesse & Wesley, 2005
• Stage 1: Gaining Entry ~ Establish purpose and assess
disposition
• Stage 2: Building the Relationship~ Open and trusting
relationship with parameters and roles and goals
• Stage 3: Gathering Information / Assessment ~Identify
factors for change
• Stage 4: Setting Goals~ Agree on concrete goals for
change
Buyesse & Wesley, 2005
• Stage 5: Selecting Strategies ~ Develop agreed
upon plan for change
• Stage 6: Implementing the Plan ~ Support and
assistance from consultant
• Stage 7: Evaluating the Plan ~ What is match
between desired goals and outcomes? Document
• Stage 8 Summary Conference~ Transfer of
responsibility for maintenance and consider new
goals
Career Ladder
• All professions ( OT, PT, SLP, Education, Other)
have a career ladder of personnel preparation
• Mentorship, supervision, coaching and
consultation must be seated in context of level
of personnel being prepared and scope of
practice at each level
Comparison of Levels of Preparation
•
SLP
PhD
Research
+ Teaching
SLPP
24 credits
In SLHS
BA
MA-SLP
400 + hrs
CCC
SLPA
CDE-SLP
0-100 hrs
Authorization Clinical Felloe
CDE
Specialty
Recognition
How do models address each level of personnel
preparation across disciplines?
• Supervision ?
• Mentorship ?
• Coaching ?
• Collaboration ?
Standards : Consider standards at each level
Time to talk…
• Think Pair Share…Complete survey…
• Do you need more information? Knowledge and
skill development? Are recommendations from
ASHA and CAPSCD applicable?
• How do these models inform your practice as a
mentor, supervisor, coach, consultant or
collaborator in your present role?
• How does context of level of personnel
preparation impact your practice as a mentor,
supervisor, coach, consultant or collaborator?
Refining your Skills
A “5” step program ( A proposed framework for
your engagement in online learning class)
1. Develop skills to support learning and
competency development at each level of
preparation
2. Develop skills as a mentor: relationship -based
3. Develop skills and tools as a supervisor
4. Learn skills and strategies that facilitate adult
learning and reflective practice
5. Use the level of support appropriate to level of
preparation
Step 1
Step 1…Develop skills to support learning and
competency development at each level
 Know level of preparation as this dictates specific
roles, responsibilities, and limitations as well as
supervisory requirements for performance.
 e.g.. Can an SLPA take your place on a team-based
assessment? No!!!
 SLPAs are not prepared, nor qualified to plan,
implement, or interpret diagnostic assessments
Step 2
Step 2 …Develop skills as a mentor
• Mentor: “Deliberate learning is the
cornerstone”
• The mentor's job is to promote intentional
learning at each level of expected
performance, which includes capacity building
through methods such as instructing,
coaching, providing experiences, modeling
and advising.
Step 3
Step 3…Develop skills as a supervisor
• The terms mentoring and supervision are not
synonymous but are often used
interchangeably (Urish, 2004).
• Mentoring is typically defined as a relationship
between two people in which one person (the
mentor) is dedicated to the personal and
professional growth of the other (the mentee)
(Robertson, 1992).
Mentorship…Supervision or Both
• While this definition may sound similar to the
relationship of the supervisor and the supervisee,
the primary focus of supervision is accountability
for the supervisee's performance (e.g.., providing
grades or conducting performance evaluations;
documenting professional behavior and clinical
performance)
• In contrast, mentoring focuses on creating
effective ways to build skills, influence attitudes,
and cultivate aspirations. Mentors advise, tutor,
sponsor, and instill a professional identity in
mentees. Mentoring is an intense interaction
between two people, where the mentor has
authority and power based on experience.
Step 4
Step 4… Learn skills and strategies that facilitate
adult learning and self –reflection
Examine how you learn…ask how others learn…
Reflect on how you reactions, judgments/biases,
behaviors, feelings and intentions impact what
you do.
“Adult learning refers to a collection of theories and
methods for describing the conditions under
which the process of learning is optimized”
Trivette et al, 2009
Adult Learner characteristics…
• Readiness to learn
• Self-directedness
• Active learner participation
• Solution-centered
Knowles ,1995
Research about Adult Learners
 New material and information is more easily
learned when it relates to existing learner
knowledge and it’s relevant to the learner
 Mastery of new material and information
requires application in contextual framework
 Ongoing monitoring of learning and selfassessment of progress facilitates deeper
understanding and continued application of
new knowledge
Adult learners benefit from…
 Planning
Introduce/preview new information
Illustrate or demonstrate applicability
 Application
Practice
Evaluate
 Deeper Understanding
Reflection
Mastery
Research… Trivette et al, 2009
 A review of 79 research studies evaluating
learner outcomes showed all 6 characteristics
listed above were associated with more
positive learner outcomes
 Adult learning methods that more actively
involved learners in using, processing, and
evaluating their knowledge and skills were
most effective
Implications
 Engage learners in a process of self-assessment
through a relationship-based building of trust
 Use instructor “guided” learning and feedback in
reference to competencies
 Active learner participation throughout all three
phases of planning, application and deeper
understanding promotes sustained learning
 Multiple learner opportunities and practice are
necessary
Step 5
Step 5…Use the level of support appropriate to
the level of preparation
 Development matures over time. Mentoring -when it works -- taps into continuous learning
that is not an event, or even a string of
discrete events. Rather, it is the synthesis of
ongoing event, experiences, observation,
studies, and thoughtful analyses.
Tools
• Pre- post learner surveys
• Expectation Clarification exercise
• Professional Growth Planning … written and
discussed…based upon data
• Self Reflection within scope of practice… tools (
check lists, videotape, inventories or objective
measures such as CLASS etc.) must be adapted to
context of practice
• Performance –based assessments
Strategies that work …
• Focus on the learning conversation… respect
boundaries
• Tap into conflict resolution strategies as
needed when having the “difficult
conversation”.
• Use inquiry respectfully but frequently to
promote self reflection and independent
problem solving …ask the learning questions.
Selected References
• American Speech-Language-Hearing Association.
(2008). Clinical Supervision in Speech-Language
Pathology [Technical Report]. Available from
www.asha.org/policy.
• Anderson, J. L. (1988). The supervisory process in
speech language pathology and audiology. Austin, TX:
Pro-Ed.
• Buyesse & Wesley, (2005) Consultation in Early
childhood Settings, Baltimore: Paul H. Brookes
References
• Crane, T.G., (2002) The Heart of Coaching: Using Transformational
Coaching to Create a High-Performance Culture .San Diego, CA: FTA
Press.
• Fenichel, E., (1992) Learning through Supervision and Mentorship.
Washington, DC: Zero to Three Press
• Lipton , L., & Wellman, (2003) Mentoring Matters, Sherman CT:
MiraVia Publications
• Moore, S. & Pearson, L (2003). Competencies and Strategies for
the Speech, Language Pathology Assistant. Delmar Learning
Solutions. Delmarlearning.com
• Urish, C. (2004). Ongoing competence through mentoring.
Bethesda, MD: American Occupational Therapy Association.
Thank You
• It was a pleasure to be here…Thank you for
your participation and engagement
Human Resource ~
• Susan M. Moore, JD MA CCC-SLP, Clinical
Professor Emeritus
• Susan.moore@colorado.edu
• University of Colorado, Boulder