Identification

1
Identification Remediation of Marginal Student
Clinicians

• Elissa Zylla-Jones, M.S. CCC/SLP
• Martha Wilder Wilson, AuD, CCC/A
• Auburn University
• Department of Communication Disorders
• Auburn, AL
• Zyllael_at_auburn.edu

2
Introduction

• Goal of university training programs
• Guide SLP and AuD students toward independence
  and autonomy
• Provide high quality and professional services
• Tasks of supervision (ASHA, 1985)

3
Tasks of supervision

• Assist supervisee in developing clinical goals
  and objectives
• Assist supervisee in developing and refining
  assessment skills
• Assist supervisee in developing and refining
  clinical management skills
• Assist supervisee in evaluation of clinical
  performance

4
ASHA standards

• ASHA Standards Council developed standards for
  quality services
• SLP standards effective January 2007
• AUD standards adopted in 1997 and implemented in
  2007

5
ASHA standards

• Up-dated certification standards require students
  to demonstrate both knowledge and skills in a
  variety of areas
• Candidates must demonstrate competencies in
• Prevention
• Identification
• Evaluation
• Treatment
• Patient interaction
• Documentation

6
Student at-risk protocol

• Identify students with marginal clinical skills
• Students-at-risk cannot perform independently in
  several areas
• Prevent inadequately prepared student clinicians
  from matriculating through the program

7
Students at-risk

• Do not recognize their weakness(es)
• May be unaware that their skills are lacking
• Have difficulty accepting responsibility for
  their actions (Dowling, 2001)
• May place blame on another individual (client or
  supervisor) or circumstance

8
Auburn UniversityStudent at-risk protocol

• Protocol developed in 1996
• Protocol revised in 2006 to incorporate criteria
  from KASA form
• of students involved in remediation process
  since 1996
• 5 SLP students
• 10 AUD students

9
Auburn UniversityStudent at-risk protocol

• _at_ mid-semester
• Student identified as at risk for inadequate
  clinical performance
• Student notification
• Student responsibilities
• Clinical faculty responsibilities
• Department chair responsibilities
• _at_ end of semester
• Pass
• Conditional Pass
• Fail

10
At mid-semester

• Student identified as at risk for inadequate
  clinical performance
• Student is notified in writing
• Faculty identifies KASA standards, which have not
  been met
• At risk for inadequate clinical performance is
  defined as performing at 79 or below

11
Responsibilities of student clinician

• Self-evaluation
• Clinical improvement plan
• Weekly progress meetings

12
Responsibilities of Clinical Faculty Member

• Completes a student evaluation tool
• Notifies Department Chair
• Notifies students academic advisor
• Develops clinical improvement plan
• Conducts weekly meetings
• Involves additional clinical faculty member

13
Responsibilities of Department Chair

• Written notification to student
• Written notification to academic advisor
• Written notification for students file

14
Remediation

• Student-supervisor conferences
• Cooperative planning
• Demonstration therapy
• Role playing
• Videotaping (Dowling, 2001)

15
Student-Supervisor Conferences

• Style of conference is directive (Anderson1988)
• Student clinician is passive
• Clinical instructor is directive
• Role of clinical instructor
• Develop specific goals and objectives
• Develop plans for student to achieve goals
• Faculty should document content and outcomes of
  meetings

16
Cooperative Planning

• Faculty and student work cooperatively to plan
  for diagnostic or treatment session
• Initially, clinical instructor develops detailed
  protocol for session
• Then, student and faculty develop plan together
• Eventually, student prepares diagnostic
  protocol/treatment plan independently

17
Demonstration Therapy

• Student observes successful implementation of
  treatment or diagnostic techniques
• Eventually, student will incorporate these
  techniques into her own repertoire of
  intervention strategies

18
Role-playing

• Student clinician and faculty member assume
  different roles
• Faculty and student interact in simulated
  clinical situation

19
Videotaping

• Diagnostic or treatment session is video-taped
• Video-tape viewed by student and instructor
• Student identifies own clinical strengths and
  weaknesses
• Faculty identifies students clinical strengths
  and weaknesses
• Data collected during video-taped session should
  be retained in students file

20
Advantages to videotaping

• Student is actively involved in tracking their
  performance
• Reduces disagreement there is visual proof

21
Documentation

• Documentation of remediation process is crucial
  (Dowling, 2001)
• Document content and outcomes of student
  conferences
• Retain written diagnostic and treatment reports
• Retain data collection from videotape observations

22
Documentation

• Student must take active role in process
• Data collection
• Documentation of improvement in clinical skills

23
Faculty involvement

• Advantages of assigning more than one faculty
  member to supervise student
• Student obtains information and input from more
  than one instructor
• Student less likely to blame her failures on
  supervision style of one instructor

24
Auburn UniversityStudent at-risk protocol

• _at_ end of semester
• PASS clinical practicum (final grade of 80 or
  better) ? continue clinical practicum next
  semester
• CONDITIONAL PASS clinical practicum (final grade
  of 79-70) ? not placed at off-campus site,
  continue clinical practicum at AUSHC
• FAIL clinical practicum (final grade of 69 or
  lower) ? enroll in directed study

25
Auburn UniversityStudent at-risk protocol

• FAIL clinical practicum ?
• Enroll in directed study next semester
• Can not enroll in clinical practicum when while
  enrolled in directed study
• Clinical practicum grade of D or lower will delay
  graduation
• Student may not count ASHA hours

26
Directed Study

• Committee
• Two or three faculty members (clinical and
  academic)
• Committee to oversee/supervise directed study
• Committee members and students identify areas of
  concern
• Plan is developed

27
Directed Study Plan

• Student observes diagnostic and/or treatment
  sessions
• Student completes appropriate documentation
• Documentation is reviewed by several faculty
  members
• Committee meets periodically with student to
  discuss progress
• Grade is derived from completion of all
  assignments

28
Outcomes of directed study

• PASS (final grade of 80 or better) ?
• Enroll in clinical practicum next semester
• May be placed at off-campus site
• UNSATISFACTORY (final grade of 79 or lower) ?
  repeat directed study next semester

29
Outcome of directed study

• UNSATISFACTORY
• May repeat Directed Study one time
• Can not enroll in clinical practicum while
  enrolled in directed study
• Repeating Directed Study will delay graduation

30
Challenges of Student at-risk Protocol

• Time consuming process
• Involvement of at least two faculty
• Weekly meetings
• Development of diagnostic and treatment plans
• Observation of clinical practicum
• Observation of videotapes
• Reading and editing students written
  documentation

31
Legal issues ofStudent at-risk protocol

• Risk of legal action if student is not successful
  in completing clinical practicum after
  participating in at-risk protocol
• At least two faculty members must be involved in
  process
• Detailed written documentation is vital

32
Conclusions

• Primary objective of university training program
  is to educate audiology and speech-language
  pathology students to become competent and
  independent practitioners
• Clinical faculty are responsible for and
  accountable to clinical growth and development of
  supervisees

33
References

• American Speech-Language-Hearing Association.
  (2005) Membership and certification handbook of
  the American Speech-Language-Hearing Association.
  Retrieved October 18, 2007 from
  www.asha.org/about/membership_certification/handbo
  ok/slp/slp_standards.htm
• American Speech-Language-Hearing Association.
  (2005) 2007 Audiology standards. Retrieved
  October 18, 2007 from www.asha.org/about/membershi
  p_certification/certification/aud_standards_new.ht
  m
• American Speech-Language Hearing Association.
  (1985, June). Committee on Supervision in
  Speech-Language Pathology and Audiology, Clinical
  supervision in speech-language pathology and
  audioloy A position statement. ASHA, 27, 57-60.
• Anderson JL. (1988) A Continuum of supervision.
  In Anderson JL. The Supervisory Process in
  Speech-Language Pathology and Audiology. Boston
  College-Hill Press, 49-62.
• Dowling S. (2001) Supervising Clinical Training.
  In Supervision Strategies for Successful
  Outcomes and Productivity. Boston Allyn and
  Bacon, 162-167.