Communication Sciences & Disorders
221 Bohannon Hall, 1207 Ordean Court, Duluth, MN 55812
Phone:(218) 726–7974; Fax: (218) 726–8693
Email: cd@d.umn.edu
Student Practicum Handbook
Handbook Parts 1 - 10
- Part 1: Welcome!
- Part 2: Introduction to CSD Department
- Part 3: UMD
CSD Program and ASHA
- About ASHA
- ASHA Code of Ethics
- ASHA Membership and Certification Handbook
- Certificate of Clinical Competence
- Part 4: State Licensing Regulations
- Part 5: Clinical Education Mission Statement
- Part 6: Undergraduate
Clinical Education: Observation Requirements
- Purpose
- Prerequisites
- Rules for Participation
- Procedures for Arranging Observations at RFP Clinic
- Suggestions of Arranging Off-Site Observations
- Documentation of Observation Hours
- Transition to Practicum
- Part 7: Undergraduate
Clinical Education: Practicum Requirements
- Purpose
- Prerequisites
- Documentation of Clock Hours
- Course Objectives for CSD 4097, CSD 4197, CSD 4297
- Part 8: Graduate
Clinical Education: Practicum Requirements
- Prerequisites
- Department Experience Requirements for Grad Students
- Typical Clinical Education Sequence
- Documentation of Clock Hours
- Course Objectives for CSD 8097
- Course Requirements/Expectations for CSD 8197
- Off-Campus Internships and Externship
- Part 9: Evaluation
of Clinic Performance
- UMD Practicum Grading Protocol
- Performance Standards
- Tracking Progress
- Part 10: Counsel Out Procedure
- Part 11: The
Robert F. Pierce Speech-Language-Hearing Clinic
- Introduction and History
- Mission Statement of the RFP Clinic
- Services Offered
- Student-Instructor Relationship
- Part 12: RFP
Clinic Policies and Procedures
- Referral and Admission
- Discharge Policy
- Clinic Access Fees
- Client Records
- Diagnostic Assessment Teams
- Personal Appearance of Student Interns
- Scheduling Procedures
- Therapy Procedures for the Semester
- Responsibilities toward Colleagues, Faculty and Staff
- Infection Control
- Fire Safety
- Medical Emergencies and Incidence Reports
- Vulnerable Adult Documentation
- Mandated Reporter Policies/Procedures
- Responding to Seizures
- Recording Therapy Sessions
- HIPAA and Confidentiality
- Part 13: RFP
Clinic Materials and Equipment
- Location of Materials
- Procedures for Check-Out
- Materials/Equipment Return Policy
- Part 14: University
of Minnesota Policies
- Sexual Harassment
- Nepotism and Consensual Relationships
- Part 15: CSD Department Policy: Letters of Reference
- Part 16: Professional
Resources
- ASHA
- NSSLHA
- MSHA
Appendices
Appendix A: Documenting Clinical Clock Hours
Documentation of Observation Hours
- Student Daily Observation Record (Word Document)
- Student Semester Observation Form (Word Document)
- Student Clock Hours Summary Form (Excel Document)
Documentation of Clinic Clock Hours
- Student Daily Clock Hours Record (Word Document)
- Student Semester Clock Hours Form (Word Document)
- Student Clock Hours Summary Form (Excel Document)
- Tracking Your Clock Hours (instructions)
- End of Semester Clock Hours Submission Form (Word Document)
Appendix B: General Clinical Education Forms
Objectives of Clinic Practicum
- CSD 4097
- CSD 4197
- CSD 4297
- CSD 8097: RFP Clinic
- CSD 8097: Off-Site Internship
- CSD 8197: Off-Site Externship
- Sample Practicum Itinerary (Word Document)
- Infection Control Procedure: Therapy Rooms (Word Document)
Student Intern Forms
- ASHA Code of Ethics Agreement (Word Document)
- Background Study Form
- Counsel Out Form (Word Document)
- FERPA Release Form (Word Document)
- HIPPA Privacy Rules
- HIPAA Agreement for PHI (Word Document)
- Internship/Externship Planning Worksheet (Word Document)
Observation Forms
- Observation Sign-Up Sheet
- Observation Notes: Critique
- Observation Notes: Diagnostic (Word Document)
- Observation Notes: Treatment (Word Document)
- Observation Notes: Child WNL (Word Document)
Practicum Survey Forms
- Student Evaluation of Clinical Practicum: Off-Campus (Word Document)
- Clinic Instructor Evaluation Forms (Word Document)
- UG Clinic Education Evaluation Form (Word Document)
- Graduate Clinic Education Evaluation Form (Word Document)
Appendix C: RFP Clinic Forms and Letters
- Journal Article Review Format (Word Document)
- Practicum Client Observation Notes (Interns) (Word Document)
- Daily Lesson Plan (Word Document)
- Guidelines for Videotape/DVD analysis (Word Document)
- Hepatitis B Waiver (Word Document)
Client Documents
- Client Forms Checklist
- Client Assignment Form (Word Document)
- Client Initial Intake Form (Word Document)
- Client Enrollment Information (Word Document)
- Client Service Agreement (Word Document)
- Client Notice of Notice of Privacy Practices Form (Word Document)
- Payment Agreement (Word Document)
- Notice of Fee Support Program
- Application for Fee Support (Word Document)
- Policies and Terms of Service (Word Document)
- Semester Treatment Plan
- Semester Treatment Summary (Word Document)
- Diagnostic Assessment Report (Word Document)
- Interact Report (Word Document)
- Socialize Report (Word Document)
- Consent to Release Private Data
- Clinic Fee Schedule (Word Document)
- Client Services Questionnaire (Word Document)
- Hearing Screening Form (Word Document)
- Service Summary Sheet (Word Document)
Sample Letters
- Semester Welcome Letter: Therapy Clients (Word Document)
- Diagnostic Assessment
- Audiologic Assessment (Word Document)
- Auditory Processing Assessment
- Welcome: Summer Phonology Groups
- Welcome: Project Interact
- Welcome: Socialize!
- Welcome: Adolescent Social Group
- Welcome: Aphasia Group
Appendix D: University of Minnesota Duluth Practicum Grading Protocol
- Grading Protocol (Word Document)
- Intern Clearances and Workplace Skills (Word Document)
- Practicum Class Rubric (Word Document)
- Diagnostic Assessment Clinic: Evaluation of Student Participation (Word Document)
- Project Interact: Evaluation of Student Participation (Word Document)