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Department of Communication Sciences & Disorders

Part 8: Student/Clinic Instructor Relationship

 

 

Clinic Instruction is Different

Professionals who provide clinic instruction, or clinical supervision, are interested in your progress toward becoming a competent and confident professional. The student-instructor relationship is intended to foster student growth.  To grow, you need the opportunity to figure things out for yourself-- to develop knowledge and skills, to include critical thinking as a clinician. 

This is not to say that you should "go it alone" in your practicum.  Quite the contrary!  You should be participating in an active and ongoing dialogue with your instructor about your client's progress and your own progress as an intern.

Your instructor is looking for signs that you are analyzing your client's progress and assessing your own performance; that you are being proactive in finding answers and forming ideas; and that you are bringing this information and these ideas to your conversations with them.

Your instructor is not only an educator but a support person for you as an intern. We encourage you to open and honest with your instructor; you instructor cares about you as a student in the program and as a future professional.

Your instructor will use several methods to guide your learning. These usually include individual student-instructor conferences, reviews of recorded sessions, group meetings, demonstration therapy and evaluation. Through these processes, the instructor intends to help you develop greater independence in problem solving, decision-making, and evaluating your clinical skills.

 

Style of Supervision

Instructional styles vary across supervisors, and a given instructor's style may vary across students.

Instructional styles vary across  supervisors for numerous reasons, to include:

  • Professional backgrounds: The years of experience and the settings in which professionals have worked will influence their style and expectations of student interns.
  • Prior experiences with interns: Professionals have varying levels of experience with clinic instruction.  At the university, clinic instructors typically have extensive experience in working with numerous interns and in using methods to guide student learning.  Off-campus supervisors have varying levels of experience working with interns.
  • Previous experiences as interns:   Supervisors' instructional styles also are influenced by the experiences they had as student interns.  They may seek to emulate styles of supervisors they enjoyed, and avoid the stylings of supervisors with whom they had less positive experiences.

A supervisor may change instructional styles between students for numerous reasons, to include:

  • The experience and clinical prowess of the student: Students have different degrees of clinical experience.  Students learn and master clinical knowledge and skills at different rates under different circumstances.  A supervisor will provide the support based on the student's level.
  • The complexity of the client: Clients vary in the complexity of their communication disorder and other health or social needs, and a supervisor may determine the student needs additional support to work with the client.

 

Amount of Supervision

The CSD Department follows CAA Accreditation Standards and ASHA Certification Standards when providing clinical supervision to student interns.  As an accredited program, the CAA Standard 3.5A states that clinical supervision "must be commensurate with the clinical knowledge and skills of each student, and clinical procedures ensure that the welfare of each person served by students is protected, in accord with recognized standards of ethical practice and relevant federal and state regulations."

 

The department anticipates that each student will be on a continuum of supervision throughout her/his program.  Determination of amount of supervision is based on numerous factors to include coursework completed, past clinical education experience and proficiency, number of earned clock hours, complexity of the client’s communication disorder, and the student’s experience with clients who have similar disorders.  Superivisors assess students' abilities based on their knowledge and skills relative to ASHA 2014 Certification Standards.

Students completing internships at the RFP Clinic are at the beginning stages of developing clinical skills.  These students are at an "emerging" skill level on their student evaluations and typically require 100 percent supervision.  “Emerging” skill level describes students taking CSD 4097, 4197, 8397, 8497, and at least some students in 8597, 8697, 8797, 8897, and 8997.

“Emerging” also describes the graduate student in off-campus internships, at least in the first half of the off-campus clinical placement.  In their second year of graduate school, students complete off-campus internships after completing on-campus internships.  Second-year graduate students typically require 100% supervision, even after completing on-campus internships.  Those students  who have "present" skills may require less supervision toward the latter part of their off-campus internship. Ethical "patient-first" treatment is expected at all times. At least 25% of the total clock hours must be directly supervised, though supervisors are to use their clinical judgment to provide as much supervision they believe the student needs, for the welfare of the student and the client. A reduced amount of supervision is appropriate only for the most advanced interns, and typically this is only the case for second year graduate students in off-campus internships.

Students should be able to contact supervisors at all times when needed. It is anticipated that an ASHA Certified clinician will be available for student consult whenever the student is engaged in practicum.

During their internships, students earn clock hours required for their own eventual certification.  These clock hours must be earned as part of completion of their degree in an accredited program. Only countable time may be put toward the required 375 clock hours and 25 observation hours needed as the minimum certfication requirement.  "ASHA countable time" is defined in the following way: any time that a supervised student engages in what a speech-language pathologist or an audiologist would be doing in a given clinical setting, with specific exceptions as noted below, is considered "ASHA countable time." 1. Only direct client contact time may be counted as clinical practicum hours. Time spent in writing lesson plans, scoring tests, transcribing language samples, preparing activities, in-service training, and writing reports may not be counted. 2. Prevention is countable time that refers to activities designed to engage a client/family in knowledge of the prevention of communication disorders (e.g. discussing/educating the client on noise exposure, smokeless tobacco, alcohol-related birth defects, and work-related risks). 3. Evaluation refers to those hours in assessment and diagnosis which are accomplished prior to the initiation of a treatment program. Hours to be counted in the evaluation category may also include re-evaluation including non-standardized treatment probes and informal functional assessments. 4. Time spent with either the client or a family member engaging in information seeking, information giving, counseling, or training for a home program may be counted as clinical clock hours (provided the activity is directly related to evaluation and/or treatment). 5. Time spent in a multidisciplinary staffing, educational appraisal and review or in meetings with professional persons regarding diagnosis and treatment of a given client may be counted if the client/family is present. 

In additon to direct supervision of sessions, clinical supervisors are the guides for helping interns navigate their internship.  To this end, clinical supervisors spend additional time conferencing with students, working with students on documentation,  approving clock hours, and submitting grades at the end of the internship. The purpose of weekly meetings is to help students develop their own clinical skills as well as help students plan for their upcoming client sessions. Supervisors also make themselves available at other times during the week, to assist students as questions or issues arise. Clinical supervisors also assist students with writing clinical documents required for the course. These documents include diagnostic reports, treatment plans, encounter notes, professional correspondence, and treatment summaries, as well as charting in the client's record.  Supervisors also review progress with students and submit grades for their performance in the course at the end of the semester.

*Based on CAA and ASHA CFCC Standards, and adapted with permission from UMTC SLHS

ASHA Resources on Supervision

The American-Speech-Language-Hearing Association has helpful resources on Student Supervision

 

 

 

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Last modified on 10/29/14 10:56 AM
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