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Department of Communication Sciences & Disorders

Part 6: Evaluation of Clinic Performance

UMD Practicum Grading Protocol:

The clinic instructors in the CSD Program use the UMD Practicum Grading Protocol-3rd Edition (2013), a tool which includes the Clinic Competencies outlined in ASHA Standard IV and is adapted with permission from the Wisconsin Protocol for Assessment of Clinical Competence (W-PACC) and the Western Washington University CSD Clinic Practicum Grading Protocol. A link to the protocol is at the bottom of the Handbook Main Page.

Four Categories. The Grading Protocol divides skills into four categories.

  • Professional and Interpersonal Skills
  • Assessment
  • Teaching/Intervention
  • Reporting

A student' proficiency in clinical performance is determined in part by the average rating of performance in each of these categories. 

Basic Performance Expectations. In addition to the four performance categories, the grading protocol includes a section on basic performance expectations. These expectations include being punctual for appointments, following the clinic dress code, following safety and privacy protocols, and so on. Failure to meet these expectations results in an automatic reduction by one full grade.

Sliding-Scale system, depending on student experience. The UMD Practicum Grading Protocol uses a 10- scale rating system, which matches intern performance to numeric values. These values correspond to the level of collaborative competence versus the level of dependency the intern has for the clinic instructor to guide all clinical activity. The clinic competence level, based on ASHA ratings, is a comparison of intern performance to that of a new professional beginning their Clinical Fellowship. Early in their education, students may be expected to perform at level 5, Entry Level, to earn an A. By the time a student graduates, their ratings are expected to be at 8 or 9, the Proficient level for starting their Clinical Fellowship.

Nine is excellent, Ten is unusual. The grading scale is unique in that even the most experienced students are considered to achieve excellent ("A") work at a rating of 9 on the scale. The scale does go to 10, but a 10 is reserved for those occasions when a student performs above and beyond any expectation, given their level of experience. A score of 10 is a moving target, representing the level of competence professionals strive for throughout their careers.   A score of 10 indicates the individual is performing at a level of a mentor or a role model for others.

 

What does it mean to have increased proficiency in clinic? As a student intern gains experience, the expectation is they will increase their independent ability to collaborate and be proactive in case management. Sometimes students confuse the expectation of “independence and proficiency” with the definition of “isolation”. Interns who do not consult with their clinic supervisors are NOT demonstrating proficiency or independence; instead, they are isolating themselves and not using pro-active problem solving in seeking out the expert support in the program.

Instructors are here for the intern, to support the the intern's learning. Interns are NOT expected to manage their caseload in isolation and to the exclusion of their clinic instructor; rather, interns are to demonstrate increased proficiency, knowledge and skills in initiating collaboration and coordination of client care. 

As a student demonstrates increased independence and profiency, they are being pro-active in getting what they need to help their client; they are seeking out the resources and the professional support from their course instructor to provide the best service to their client.

 

Guidelines for Rating Performance:

 

Guidelines for Rating Performance
COMPETENCY LEVEL SCORE SCORE DEFINITION PERCENT INDEPENDENT INDEPENDENCE CATEGORY Performance Scale by Intern Level

Exceptional:

Demonstrates skill level sufficient for Clinical Fellowship

10

Operates independently

95-100% of the time.

Proficient, Independent:

95-100%

Proficient,

Independent:

Pro-active

collaboration and

case management

(“independence” does NOT mean the intern works in isolation and without direction from supervisor)

 

Exceptional
10

 

Proficient:

Demonstrates skill level sufficient for Clinical Fellowship

9

Operates independently 85%-94% of the time.

Via limited general direction, can problem solve.

Proficient, Independent:

85%+

General Direction:

15%

Level V
9

8

Operates Independently 70%-84% of the time.

Via limited general direction, can problem solve.

Proficient, Independent:

70%+

General Direction:

30%

Level IV
8

Developing:

Demonstrates positive growth toward skill level needed to enter Clinical Fellowship

7 advanced Via Limited general direction, can problem solve

Proficient, Independent:

60%+

General Direction:

40%

General Direction &/or Demonstration

 

Level III
7

6 Intermediate Needs general direction with no repetition or further clarification.

Proficient, Independent:

50%+

General Direction:

50%

Level II
6
5 entry Needs general direction consisting of direct discussion with repetition and further clarification of ideas immediately or in succeeding discussions.

Proficient, Independent:

40%+

General Direction:

60%

Level I
5

Emerging:

Demonstrates significant limits in skills needed to enter Clinical Fellowship

4 Needs specific direction but no demonstration.

General Direction:

50%+

Specific Direction:

50%

Specific Direction &/or Demonstration

4
3 Needs specific direction and role–played demonstration.

General Direction:

40%+

Specific Direction:

60%

3
Pre–Emergent 2 Needs specific direction and demonstration with the client.

General Direction:

30%+

Specific Direction:

70%

2

1

Despite specific direction, role-play, demonstration, and repetition, does not demonstrate satisfactory performance or ability to make change.

Specific Direction with absent or unsatisfactory performance or change:

70- 100%

Specific Direction from Instructor does not alter unsatisfactory performance & inability to make change

1

 

 

 

Step ONE: Determine the Intern's Experience Level. 

At the beginning of each semester, the intern and the clinic instructor will establish the intern’s experience level. The student will be assigned to one of four Experience Levels based on the following:

  • total number of clock hours the student has accrued;
  • total number of previous clients;
  • previous experience with a client of the same diagnosis/management approach;
  • academic coursework or equivalent related to the diagnosis

Intern Experience Levels

Level Requirements Experience # of previous
clients
Current practicum Academics
I Meets 2 or more criteria. No practicum experience. Minimum 25 observation hours. No previous clients. No practicum experience. Coursework complete OR currently taking coursework (limited client base assigned at this level)  
II Must meet or exceed all criteria; otherwise, drop back one level. Less than 20 clock hours accrued At least 1 previous client and/or equivalent of one semester of practicum experience

Minimal Experience:

no more than one prior practicum experience.

Coursework not complete OR currently taking coursework. 
III Must meet or exceed all criteria; otherwise, drop back one level. At least 30 clock hours of therapy

At least 2 previous clients and/or equivalent of one semester of practicum experience

General Experience:
First client with this communication diagnosis.
Coursework not complete OR currently taking coursework. 
IV Must meet or exceed all criteria; otherwise, drop back one level. At least 90 clock hours of therapy At least 6 clients and/or an off-campus practicum General Experience:
First client with this communication diagnosis or first experience with this specific management approach.
Coursework completed or currently is taking the academic coursework.
V Must meet or exceed all criteria; otherwise, drop back one level. At least 150 clock hours of therapy At least 10 clients and/or an off–campus practicum Specific Experience: Has worked with a client with this communicaiton diagnosis or used approximately the same management approach with at least one other client. Coursework complete.

 

 

Step TWO: Compare Intern Experience Level with Performance Expectations. 

After determining the student's experience level, it can help to compare their experience level with expectations for their assigned Competency Level and have a discussion about supervisor expectations and intern expectations for the semester.

 

 

Step THREE:  Review the suggested Grade Assignments at each level.

A score on the UMD Practicum Grading Protocol is determined by adding the averages of the four performance categories and dividing by four.  In addition, attention will be given to whether a student has met all Basic Performance Expectations, and will drop one full grade if these expectatations are not met.  These grade parameters are a starting point for discussion.

A student’s grades are based on performance as measured by the UMD Practicum Grading Protocol and the clinic instructor’s judgment. For example, an on-campus clinic instructor considers the student intern’s level of clinical experience and the difficulty of the client/caseload. The clinic instructor also considers the intern’s completion of intern clearances, professional conduct at all times in the clinic, and practicum class participation.  Suggested grade assignments are based on the score from the grading protocol, adjusted for the level at which the student is functioning.

 

Suggested Grade Assignments at Each Level
Letter Grade Level 1 Level 2
Level 3
Level 4
Level 5
A 4.65-5.00+ 6.05-6.50+ 6.98-7.50+ 7.91-8.50+ 8.37-9.00+
A- 4.50-4.64 5.85-6.04 6.75-6.97 7.65-7.90 8.10-8.36
B+ 4.35-4.49 5.70-5.84 6.53-6.74 7.40-7.64 7.83-8.09
B 4.15-4.34 5.40-5.69 6.23-6.52 7.01-7.39 7.39-7.82
*B– 4.00-4.14 5.20-5.39 6.00-6.22 6.80-7.00 7.20-7.38
C+ 3.85-3.99 5.01-5.19 5.78-5.99 6.55-6.79 6.93-7.19
C 3.65-3.84 4.75-5.00 5.48-5.77 6.21-6.54 6.57-6.92
C- 3.50-3.64 4.55-4.74 5.25-5.47 5.95-6.20 6.30-6.56
D+ 3.35-3.49 4.36-4.54 5.03-5.24 5.70-5.94 6.03-6.29
D 3.00-3.34 3.90-4.35 4.50-5.02 5.10-5.69 5.40-6/02
F <3.00 <3.90 <4.50 <5.10 <5.40

 

*A grade of B– or lower and/or instructor concern of intern performance will result in initiation of the Remediation Procedures.

The above are only suggested grading guidelines, and the clinic instructor has the ability to adjust the grade up or down based on the student’s performance in achieving practicum objectives.

Composite Grades for Muliple Clinical Assignments: If a student has more than one client, or does one or more diagnostic evaluations during the semester, each activity will receive a grade. The final composite grade will then be determined by weighing each grade, based on the amount of time involved in the activity. 

 

Step FOUR: Track Progress

Meetings: Student interns generally will meet with the clinic instructors once each week to discuss their client’s progress and to discuss their clinical growth and expectations.

Clinical Education Goals: As the semester progresses, students may be asked to complete self-critiques of their clinical knowledge and skills. Self-assessment is a critical skill for making effective decisions regarding professional need and clinical expertise. Using self-assessment and instructor input, student interns are encouraged to set personal performance goals with their clinic instructor. Progress toward personal goals is a way to mark progress and learn to self- critique performance. 

Mid-term review: Approximately half-way through the semester, the clinic instructor may begin evaluation conferences with student interns.  UMD clinic instructors will use the UMD Practicum Grading Protocol (Appendix D) as a part of this evaluation. Students also may be asked to rate their performance using the grading protocol, as a formative assessment exerice. Whether they are asked to do so or not, students may find this a helpful means of determining their strengths and areas for growth, or for stimulating discussions when meeting with their clinical instructors.

Final Performance Review: Near the end of the semester, another conference is scheduled for a re-evaluation. At this time or earlier in the semester, students also may be asked to self-rate their performance. The process is repeated each semester, and written evaluation comments are filed in the student’s department records.

Remediation: If specific concerns are raised about a student intern’s performance in practicum, the Remediation Procedure may be used. This is a process of looking at the difficulties, establishing behavioral objectives for the student intern, then evaluating progress. 

 

Step FIVE: Submit Grade to Clinic Director

The Clinic Director calculates composite grades and submits final grades for interns in the CSD Department. 

  • Students should receive and scan a copy of the grading protocol from the instructor and scan this into their ePortfolio. 
  • Instructors should submit the original document to the clinic director for grade processing and placement in the department records.

 

Variations to the Grading Protocol:

  • At the RFP Clinic, certain group therapy programs use grade protocols designed specifically to reflect the knowledge and skills in those situations. See a link to the Interact Grading Protocol at the bottom of the Handbook Main Page.
  • At off-campus placements, supervisors may choose to use a grading tool other than the UMD Practicum Grading Protocol. Student interns in off-site placements are encouraged to ask, at the beginning of the semester, which grading protocol the practicum instructor will use to judge the intern’s performance. 

 

Student Information Release Authorization for CSD Department Communication:

In compliance with the Federal Family Education Rights and Privacy Act (FERPA) of 1974 and the Regents´ Policy on Access to Student Records, the CSD Faculty and Staff are prohibited from accessing certain information from your student records, such as information on grades.

You may, at your discretion, grant the CSD Faculty and Supervisors permission to access information for the purpose of fair assessment of student performance. Your authorization release grants permission only to CSD Faculty and Staff, and will be released only if requested by a CSD Faculty or Staff Member.

In order to provide a fair and inclusive student evaluation and to maintain standards of accreditation, the CSD Department requests your authorization to access the following information and resources:

  • Input on performance from CSD clinic instructors
  • Input on performance from CSD faculty
  • Input from off-site supervisors related to completion of coursework in CSD

 

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Last modified on 08/30/13 11:13 AM
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