Clinical Education: Competencies and Conversations KSHA 2012

1. Clinical Education: Competencies and ConversationsKSHA 2012 KSHA 2012

2. 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

3. Standards for Accreditation – Clinical Education • Council on Academic Accreditation (CAA) in Audiology and Speech-Language Pathology of ASHA • Sets and implements standards • Awards accreditation

4. 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

5. 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 speech-language pathology.

6. 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

7. Standards for Accreditation – Clinical Education • The program must provide opportunities for students to acquire and demonstrate knowledge & skills in • Articulation • Fluency • Receptive/expressive language • Hearing • Swallowing • Cognitive aspects of communication • Social aspects of communication • Communication modalities

8. 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

9. 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.

10. 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.

11. 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

12. Standards for Accreditation – Student Assessment • Competency Based Outcomes • Formative Assessments • Summative Assessments

13. Clinical Supervision Competencies • http://www.asha.org/docs/html/PS1985-00220.html • Tasks of supervision • Competencies for effective clinical supervision • Preparation of clinical supervisors

14. 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

15. 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

16. 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/PS1985-00220.html

17. 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-prep-references.htm

18. Continuum of Support Supervisor and Supervisee Process

19. 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.

20. Anderson’s Model (1988)

21. 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.

22. 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.

23. 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.

24. Resource • ASHA - Clinical Education and the Professions http://www.asha.org/academic/teach-tools/supervision.htm

25. 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

26. Strategies • Create positive partnerships/learning environment • Provide encouragement, confidence • Engage in reflective practice

27. Strategies • Model best practices • Participate in collaborative problem solving • Case presentations • Assigned/directed reading with discussion & application to clients • Relate classroom knowledge to clinical experiences

28. Strategies • 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

29. Professional Growth and Development: Active Engagement on the Part of the Student

30. 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

31. Generic AbilitiesIs it important to discuss with students? • 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

32. 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

33. The Art of Feedback

34. What makes feedback effective? • Descriptive • Specific • Responsive • Directed to modifiable behavior • Solicited • Well timed • Validated

35. Types of Feedback • Written • Verbal • Scheduled / Spontaneous • Live / Recorded

36. Feedback on Writing • Formula writing • Editing • Electronic records • Volume

37. Role of the Supervisee • Responsibility • Reflection

38. Sounds So SimpleLet’s Talk • Time for Questions • Scenarios • Thank you for your interest