Clinical Education Handbook August 2007

8/8/2019 Clinical Education Handbook August 2007

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CLINICAL EDUCATION HANDBOOK

for the Professional Degree Programs:

M.A./M.S. Speech-Language Pathology

Au.D. Audiology

Communication Science & Disorders Department

School of Health and Rehabilitation Sciences

University of Pittsburgh

4033 Forbes Tower

Pittsburgh, PA 15260

Department Phone: (412) 383-6540

Fall 2007 (08-1)

Modified Aug 2007


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CLINICAL PRACTICUM MANUAL

For Graduate Student Clinical Education

Speech-Language Pathology and Audiology

Table of Contents

INTRODUCTION TO CLINICAL PRACTICUM MANUAL ..................................................... 5

Self-Study Guide For Initial Review Of Practicum Manual ....................................................... 7

PART I: BACKGROUND TO CLINICAL EDUCATION .......................................................... 8

Philosophy of Clinical Training .................................................................................................. 8

ASHA Standards ......................................................................................................................... 8

Sequence of Clinical Education Experiences ........................................................................ 9

Development & Measurement of Clinical Skills ....................................................................... 10

Feedback on Clinical Performance ............................................................................................ 10

Documentation of Clinical Training .......................................................................................... 11

Clinical Skills Scoring System.................................................................................................. 16

PART II: CLINICAL TRAINING GUIDELINES AND EXPECTATIONS ............................. 17

Prerequisites to Clinical Education ........................................................................................... 17Practicum Registration/Enrollment ............................................................................. 17Observation Requirements .......................................................................................... 17Academic Background ................................................................................................ 18Equipment (Speech/Language Pathology) .................................................................. 18Medical Clearance ...................................................................................................... 19

Act 33/34 Clearance .................................................................................................... 19Student Clinical Laboratory Fee ................................................................................. 19HIPAA Training.......................................................................................................... 20

General Guidelines for Practicum Training..21Clinical Coordinators .................................................................................................. 21Clinic Committee ........................................................................................................ 21Determination of Practicum Assignments .................................................................. 21Enrollment in Clinical Practicum................................................................................ 22Practicum for the AuD (Clinical Doctorate in Audiology) ......................................... 23Practicum for the CScD (Clinical Doctorate in Speech Language Pathology) .......... 21PA Educational Certification for School-Based SLP ................................................. 24

Professional Expectations ........................................................................................... 25Learning Modules ....................................................................................................... 25Clinical Grading Procedures ....................................................................................... 26Clinic Probation and Remediation (Clinic Remediation Plan) ................................... 27Student-Clinical Instructor Problem Solving Procedures ........................................... 28Evaluation of Clinical Teaching ................................................................................. 29Documentation of Contact Hours ............................................................................... 30Tracking of Clinical Performance ............................................................................... 31Clinical Requirements ................................................................................................. 31


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Clinical Procedures, General .34Clinical Instruction/Supervision ........................................................................... 34Confidentiality ...................................................................................................... 34General Clinical Documentation Guidelines ........................................................ 36Appearance Policy ................................................................................................ 36

Name/Identification Badge ................................................................................... 37Attendance ............................................................................................................ 37Clinic Environment ............................................................................................... 38Inclement Weather Conditions...33

Health & Safety Procedures........................................................................................... 38Universal Precautions. .......................................................................................... 38Routine Hand Washing. ........................................................................................ 38Use of Disposable Gloves. .................................................................................... 38Protective Eye Wear. ............................................................................................ 39Disinfection. .......................................................................................................... 39

PART III: NETWORK CLINICAL TRAINING.39

Background Regarding the CSD Clinical Network...39Training Sites in the CSD Network (2008-06 Year) ........................................................ 39Approach to Clinical Teaching ......................................................................................... 40

Network Clinical Training Activities & Requirements.40Basic Clinical Competencies ..................................................................................... 40Core Clinical Skills .................................................................................................... 41Clinical Documentation Activities ............................................................................. 42Diagnostic Writing Components................................................................................ 43Treatment/Intervention Settings Writing Components .............................................. 43Reflective Journals ..................................................................................................... 43

SLP Clinic Practicum Review (SLP CPR) ................................................................ 43AuD Clinic Practicum Review (AuD CPR)............................................................... 45Clinical Portfolio ........................................................................................................ 46

Network Clinical Faculty/Instructors.47

PART IV: OUTPLACEMENT & EXTERNSHIP TRAINING49Requirements for Enrollment in Outplacement Practicum ............................................... 49Outplacement Practicum Placements (2 year SLP & Audiology) ................................. 49nd

APPENDIX A: Clinical Education Action Plan

APPENDIX B: SUPPLEMENTAL MATERIALS SECTION

Clinical Education Forms1. Formative Assessment of Clinical Competency: Audiology2. Formative Assessment of Network Clinical Competency: SLP3. Formative Assessment of Outplacement Clinical Competency: SLP


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4. Formative Assessment Form for SLP School Practicum (SLP)5. Evaluation of Clinical Teaching6. Audiology Practicum Hours Log Form7. Sample SLP Hours Log FormProfessional Information and Materials8. Standards & Implementation for the Certificate of Clinical Competence in Audiology9. Standards & Implementation for the Certificate of Clinical Competence in Speech-Language Pathology10. ASHA Code of Ethics11. ASHA Scope of Practice in Audiology12. ASHA Scope of Practice in SLP

APPENDIX C: Outplacement Handbook

APPENDIX D: School Practicum Handbook


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INTRODUCTION TO CLINICAL PRACTICUM MANUAL

This manual has been prepared to provide incoming Speech-Language Pathology and Audiologyprofessional degree students (M.A.SLP, & AuD) with information about the clinical educationpolicies and expectations of the Communication Science and Disorders (CSD) Department. The

manual is intended to be used in conjunction with the KASA tracking form, the ASHA Membershipand Certification CD, the University of Pittsburgh graduate handbook, the Department ofCommunication Science and Disorders Academic Handbook, and policy/procedure handbooks atindividual clinic sites. For your first review of the Clinical Practicum Manual it is recommendedthat you focus initially on the sections marked with the star icon :

All information marked with the star (including the section on the CSD Clinic Network) should bereviewed by students before they begin their first day of practicum experiences. A study guideappears on the next page to help you summarize the star icon information. After completing thestudy guide check with your fellow students and/or Clinical Instructor to be sure that your answersare correct.

Please note that the remainder of the information in the Practicum Manual should be read by the endof the first two weeks of clinic. Please complete the sign off sheetand turn it in to the CSD ClinicAdministrator for your student file indicating that you have read theAcademic Handbookand ClinicPracticum Manual in its entirety.

In addition to requirements for the Masters degree in Speech/Language Pathology and the AuDdegree in Audiology, the CSD clinical degree programs provide the opportunity for students to meetclinical education requirements for:

ASHA Certification Pennsylvania State Licensure

Pennsylvania Educational Certification in Speech and Language Impaired (SLP only)

Since each of the above has separate requirements, students need to continually monitor theirprogress toward completion of the requirements. In addition, specific issues regarding ASHA may beaddressed to ASHA at (301) 897-5700 or via the web at www.asha.org. Details related to PAEducational Certification may be found at the Pennsylvania Department of Education web site atwww.pde.state.pa.us.

Note that all policies, guidelines and forms appearing in this manual are subject to modification

during your enrollment in the program. Students will be informed in the event of any suchmodifications. If you have any questions or concerns about the information contained in this manual,please contact the appropriate Clinic Coordinator or the Director of Clinical Education.

Cheryl Messick, Ph.D., CCC-SLP Elaine Mormer, M.A., CCC-ADirector of Clinical Education and Coordinator of Audiology Practicum

Coordinator of SLP Practicum [email protected] Officer Speech Lang Imp

[email protected]

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http://www.asha.org/http://www.pde.pa.us/http://www.pde.pa.us/mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://www.pde.pa.us/http://www.asha.org/


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Revised August 2008


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Self-Study Guide For Initial Review Of Practicum Manual

This Clinical Practicum Manual contains a wealth of information to guide you through the clinical training steps ofyour graduate training program. We recognize the challenge of sifting through it all during your first weeks here, sothe following set of questions were designed to help you learn the up-front information that you need to know for

your first week of Network practicum. If you cant answer a question, ask a fellow student! (Clue: the answers canbe found in the sections labeled with the star icon)

1. What does the term CSD Network Practicumrefer to?

2. How/when are graduate student clinical competencies measured?

3. a. Professional Responsibilities include:

b. How is performance onProfessional Responsibilities measured?

4. What medical & background clearances are needed before participating in practicum, and

how often are they obtained?

5. What is the purpose of HIPAA training and what does it focus on?

6. What areBasic Clinical Competencies and how are they focused on in Network Practicum?

7. What are Core Clinical Skills? When should they be mastered?

8. What are the required learning activities in all network practicum?

9. a. What are examples of appropriate dress/appearance in clinical education settings?

b. List examples of characteristics that would be considered inappropriate in clinical education

settings.

10. Who should I contact if I have questions about clinical education for SLP? For Audiology?

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PART I: BACKGROUND TO CLINICAL EDUCATION

Philosophy of Clinical Education

The CSD Departments objective is to help students acquire the knowledge and skills of their discipline

through in-depth academic content, structured & sequential clinical education experiences, and learningassignments. The clinical education component is viewed as a dynamic process where students participateactively in learning to apply academic information to clinical practice while working with clients whohave varied types of communication disorders. The goal is to prepare clinicians who demonstratestrengths in the following:

The ability to analyze and synthesize information from a broad-based fund of knowledge incommunication science and disorders

A problem-solving attitude of inquiry and decision-making utilizing evidence-based practice A high level of clinical competency in prevention, screening, evaluation, diagnosis, and

treatment of patients with varied communication disorders

The ability to communicate effectively and professionally

Self-evaluation skills resulting in active steps to develop/refine clinical competencies &extend their knowledge base

Ethical and responsible professional conductThe long term result of clinical education is to provide students with a solid foundation to enable them tosucceed in diverse educational, healthcare and rehabilitation environments.

ASHA Standards

The class entering graduate study in the Fall of 2008 will be following the requirements of current ASHA

standards. Copies of the current ASHA standards for Audiology and Speech-Language Pathology areavailable on the ASHA website www.asha.org . It is recommended that students becomehighlyfamiliar with these standards during their first term of study, and review the standards periodicallyduring their graduate program. Under current ASHA standards, the CSD department and the studentsgraduating from the program gather formative and summative evidence to demonstrate that the graduatesof the program have achieved all standards of knowledge and skill needed for entry level professionalwork.Entry level work refers to your first professional year of work (CF position for SLP students).

Across the program it will be important for each student to track their progress towards meeting thestandards. In practicum experiences, students work with their Clinical Instructors to develop clinicalcompetencies, improve and refine competencies, and maintain them. Formative assessment of progress isformally conducted at least two times per term in each practicum experience. Electronic files (to be

provided) will be used by students to track their progress meeting clinical hour requirements anddemonstrating required clinical competencies. Students will develop Clinic Portfolio artifacts each termfrom their practicum experiences to document acquisition of clinical competencies. The Clinic Portfoliowill serve as additional evidence of clinical competencies across the graduate program.

Students will need to work closely with their clinic coordinators, clinical instructors, and academicadviser to help develop ample opportunities to achieve all of the standards. It is each studentsresponsibility to monitor their progress and initiate plans and communication with CSD faculty to

facilitate their progress and achievement of ASHA requirements.

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Sequence of Clinical Education Experiences

The CSD Department has developed a clinical education program that includes a collection of sequencedlearning experiences to facilitate acquisition of clinical competencies and independence across thegraduate program (see Figure 1). Students have opportunities to participate in practicum in a wide varietyof clinical settings and sites. Throughout the process, students are supervised by licensed/certified

professionals who have ASHA or ABA certification.

Figure 1. Sequence & Levels of Clinical Experience

Externship Practicum (AuD, CScD)

Clinical Fellowship (SLP M.A.) (post graduation)

Outplacement Practicum

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BridgeNetwork Practicum Experience (when recommended byCoordinator)

Network Practicum

Initial practicum experiences take place in the CSD Clinical Network working with faculty membersfrom the CSD Department to acquire an understanding of the clinical process and to master Basic ClinicalCompetencies. Students typically remain in the Network for at least two semesters, withthe length of

time in Network training determined by a students individual rate of progress meeting Networkrequirements (see section on Network Education beginning pp.34).While in the Network, studentsreceive 1.5-2 hours per week of teaching time with their assigned Network Clinical Instructor, in additionto two hours of client-contact time. Students work with their Clinical Instructor 1-2x per week for .5-1.0day blocks of time. Assignment schedules vary based on the Clinical Instructors caseload and schedule.

In the Network the Clinical Instructors work closely with each student providing direct instruction,modeling clinical behaviors, suggesting resources, and developing learning activities. Teaching focuseson helping students develop and masterBasic Clinical Competencies and Core Clinical Skills (detailedexplained pp.35). In the Network, clinical education focuses on teaching the student the underlyingstructure of the clinical processes involved in prevention, screening, evaluation and treatment.Understanding of the foundations for clinical decision making is also taught. Students in the Network

participate in a series of required activities (see details in Network Training section) in order to developthe competency level necessary for moving to community based Outplacement assignments.

Students typically participate in Network Education for 2-3 terms. However, students vary in the rate atwhich they acquire and meet Network requirements and the number of terms they participate in Networkclinical education activities. Occasionally a student is able to meet many of the Network requirements,but continues to show difficulties in certain aspects of clinical performance which hampers their ability tosuccessfully transition to Outplacement education. Students who do not meet expectations inOutplacement practicum may also benefit from returning to Network Clinical Education. In thosesituations a student may be recommended to participate in a Bridge Practicum experience.


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TheBridge experience was designed to provide an interim level of clinical education between Networkand Outplacement levels. It provides a level of training for students who still may need the support ofstructured teaching time that is not available in Outplacement settings. In a Bridge practicum studentsregister for Network practicum and are assigned for a Network level experience. As they demonstrate asolid level of competency and require less structured teaching time, the instructor increases the patient

contact time while decreasing the teaching time. Increases in level of independence must bedemonstrated by the student before this change can be made. The recommendation for a student to beconsidered for a Bridge experience can be initiated by the student, the current clinical instructor, or theClinic Coordinator. Approval for the Bridge experience will be made by the Coordinator of thePracticum to the Director of Clinical Education with input from the current Clinical Instructor andstudent. Students recommended to participate in a Network Bridge practicum, are required tosuccessfully complete that practicum experience before being considered for further practicumexperiences (i.e., Outplacement).

After students have met the requirements and competencies (detailed later) of the CSD Network, theyparticipate in Outplacement Practicum. Outplacement clinic typically occurs during the 2nd year ofgraduate training. When students move to Outplacement practicum, direct teaching time decreases while

time spent in patient services increases. In Outplacement practicum teaching time is significantly reducedand direct teaching is not provided in as intensive of a manner as done in the Network. Outplacementassignments occur 1-5 days/week, with placements changing each term so that students experience avariety of different settings and services. All students are required to complete at least one adult and onepediatric outplacement minimally during their graduate program. In Outplacement practicum students areexpected to demonstrate knowledge of clinical processes and to apply information learned in academiccoursework. Clinical Instructors help students better understand the intricacies of efficient servicedelivery with a range of different patients. The CSD Department has clinical affiliations with an extensivecollection of agencies throughout the region (western Pennsylvania, West Virginia, & Ohio), providingstudents with a vast range of options for SLP & Aud Outplacement and AuD Externships. Setting typesinclude public schools, early intervention sites, private practices, not-for-profit agencies, acute carehospitals, rehabilitation centers, community hospitals and skilled nursing facilities.

AuD students clinical education will culminate in an externship placement in the 4th year where theywork independently with the collaborative oversight of a Clinical Preceptor. SLP masters studentsgraduate and then complete a 9-month Clinical Fellowship (CF) experience as their first professionalposition. Options for AuD 4th Year Externships in other geographic areas of the country are also available(see AuD Externship handbook).

Development & Measurement of Clinical Skills

The basic areas of clinical education focus on facilitating the acquisition of knowledge, skills, andprofessional attributes needed for professional practice. While participating in clinic practicum thefollowing broad competency areas are targeted:

1. Professional Responsibilities2. Interpersonal Skills

3. Communication Proficiencies: Verbal, nonverbal, & written

4. Interviewing & Counseling Competencies

5. Prevention and Screening Skills (SLP and audiology)

6. Self Evaluation Skills

7. Assessment Competencies (planning, implementing, post-session)

8. Treatment Competencies (planning, implementing, post-session)

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Within each of the above areas a collection of sub-skills are defined on the clinical evaluation formsallowing students to target the acquisition of sub-components of each competency area. Both SLPstudents and Audiology students focus on Skills 1-6 (above), while the evaluation and treatmentcompetencies are discipline specific. The list of competencies focused on in the CSD Clinical Educationprogram was developed for each discipline based on the current ASHA standards and Scope of Practiceguidelines. Copies of the current Network, Outplacement, and School Practicum Formative Assessment

forms for SLP and Audiology practicum are contained in the Supplemental Materials section of thismanual. Clinical evaluation forms &/or grading systems may be modified or changed by the ClinicCommittee during the duration of your enrollment in the program. Students will be informed of anychanges made.

Measurement of student performance on clinical competencies is determined using a 1-7 scoring system.This scoring system was created so that it considers the students level of independence, as well as theClinical Instructors level of support and guidance. The scoring system (see Table 3) was developed toprovide a method of formative assessment for describing and tracking acquisition of clinicalcompetencies from the first term of clinical education through the end of graduate education. In Networktraining experiences the first five levels of scores (1-5) are used, while Outplacement settings use 1-6point scores. Fourth year AuD externship students use the 1-7 point system in its entirety.

Feedback on Clinical Performance

The purpose of clinical feedback is to monitor progress towards attainment of clinical competencies.Clinical grades provide a continuous record of student performance across the graduate program andallow students to track their progress on meeting ASHA & CSD department clinical competencies.Students will at least be formally evaluated (in writing and in an oral conference) twice per term: at mid-term and at the end of each semester. Mid-term grading provides a mechanism for identifying studentstrengths and areas to improve. A students actual grade for the term is based on performance at the endof the semester as measured across the last 3-4 weeks of the grading period.

According to academic guidelines set forth by the University & the CSD department successful

completion of a practicum requires a letter grade ofCor better. Grades ofC- and below are failing gradesin the CSD graduate program. Neither the credit, nor the contact hours obtained from a failing practicumexperience may be counted toward degree or ASHA requirements. A student receiving a grade ofC orlower may be required to successfully complete a Network/Bridge placement before participating inoutplacement training. A Clinic Remediation plan may also be written to help the student work towardsimproving areas of concern. A failing grade may also be assigned if required paperwork is notcompleted, or if there is a serious breach in professionalism. Students who receive a failing grade inmore than one practicum experience (Network, Outplacement or Externship practicum) will no longerbe permitted to participate in practicum education. (See Academic Handbook regarding options forcompleting a non-clinical degree).

Documentation of Clinical Education

While participating in practicum a variety of methods will be used to document performance and to helpstudents track their progress on meeting Clinical Education requirements. We currently use a systemwhere both hard copies and electronic data base systems are used. For example, students track theircontact time with patients using hard copy paper log forms on site (with supervisor confirmation), andthen transfer that information onto their individual electronic Hours Log. Student acquisition of clinicalcompetencies in Network and Outplacement education is tracked using the Formative Assessment ofClinical Competency forms each term.


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Initially the steps used to document hours and performance may seem complicated, however withfamiliarity the systems provide an efficient and effective way for you and the ClinicCoordinators/Director to be able to monitor your progress across the graduate program. Please note thatthe documentation procedures were also developed to ensure that all ASHA and department requirementsof clinical education can be monitored and documented for each individual student.

Hours Logs. Students are required to log their patient contact time DAILY and obtain theirClinical Instructors initials to confirm the time at least WEEKLY. When an hours log page has beencompleted, the supervisor should provide their signature & ASHA number on the bottom of each page.Hours Log Forms have been developed by the department in order to help students and clinic coordinatorstrack student progress towards ASHA and department clinical education requirements. SLP students usedifferent forms to document pediatric (gold sheets) vs adult (grey sheets) hours. Both SLP and Audstudents should code the characteristics of each patient experience as described in Table 1 below. Thesecodes are used to ensure that patient confidentiality and HIPAA standards are adhered to.

Table 1. Hours Log Codes to document practicum experiences

ASPECT SPECIFICS EXAMPLES

CODES USED FOR AUDIOLOGY & SP/LANG HOURS DOCUMENTATION

Date of Service Month/day/year 9-17-05

Cultural/ Linguistic

Diversity

L = patient from a linguistically diverse background (e.g.,second language user; dialectical variation) compared toStandard English

C = patient from culturally diverse background (e.g., emigrantfrom another country; patient from Amish community; childborn in US to family from Somalia)

L, C, or LC (both). It is rec. that studecreate artifacts for their Clinic Portfoliothat describe experiences with culturally&/or linguistically diverse clients.Specific descriptions of how they modifwhat they did in relation to the clientsdiversity should be defined

Patient Age

Pediatric Age Categories

IT = Infant Toddler 0-35 monthsPK = PreSchool 3-5 yearsSA = School Age 6-18 years

Adult Age Categories

EA = Early Adult 19-29 yearsMA = Middle Age 30-64 yearsGR = Geriatric 65+ years

SA

MA

GR

Contact Time

with Patient

Contact time: must be recorded in units of time asfollows: .1 = 6 min; .2 = 12 min; .25 = 15 min; .3 = 18min; .4 = 24 min. .5 = 30 min; .6 = 36 min; .75 = 45 min;.8 = 48 min; .9 = 54 min; 1 = 60 min

Contact time includes time spent

with patients or programming

devices for individual patient need

not total time at site. Discuss withsupervisor how much contact time tbe credited, especially in Networktraining.

SLP Service Categories: Screening (SLP or Aud);Prevention; Assessment; Treatment Screening: contacttime earned in formal or informal screenings. Prevention:focuses on information provided to patients/families orprofessionals that include specific strategies to prevent thedevelopment of a communication/swallowing disorder, or

SLP: Screening also includesinformal observations during a dx thare not assessed directly (e.g., voicewas judged to be normal; fluency w

not an area of concern). Bedsideswallow exams also fall under this


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Service Type

to reduce the severity level of an identifiedcommunication/swallowing deficit. Assessment: Testingdone to document progress in tx, goes in the tx categorynot dx category. Assessment hours are for full evaluationsand re-evaluations. Also includes discussion of resultswith patient/family. Treatment: Intervention servicesprovided to a patient. Also includes family educationrelated to patient tx needs.

Aud Service Categories: Evaluation; Amplification;Treatment; Speech/Lang Screening

category.

Prevention examples: rec to family signs of aspiration; language lessonPreK class of typical children; vohygiene strategies; phonological

awareness tasks for child withphonological disorder.

CODES USED ONLY FOR SPEECH/LANGUAGE HOURS LOGS

Severity Level 0 = Normal 1 = Mild2 = Moderate 3 = Severe

3

Patient ID Never include last name. For individual services:use initials, or first name (only). For group

treatment: ID by group number and create anartifact for clinical portfolio that lists the initials ofgroup members and background info on the grouptreatment format & focus

EM; Tom; Gp #3

Patient Diagnosis Medical or Educational diagnosis code. If there isno known medical/educational diagnosis thencommunication diagnosis should be indicated

Examples of Medical & Educational

diagnoses: cochlear implant; otitis mediaprematurity; CVA; Parkinsons; DownSyndrome; cerebral palsy; learning disablCommunication diagnosis: phonology;dysarthria; dysphagia; SLI; aphasia; apra

SLP students are also required to document their diagnostic and treatment time in relation to the nineDisorder types required by ASHA. Table 2 provides details on the 9 disorder types:

Table 2. Nine Types of Communication Disorders (SLP)

BROAD AREA Disorder Type Examples

(applies to diagnostic & treatment services)

SPEECH

Articulation Production of phonemes Strategies to improve motor speech

production

Production of multisyllabic word forms

Fluency

Stuttering behaviors Rate of production

Voice & Resonance including respiration &phonation

Loudness level Pitch Intonation variation


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Swallowing: oral, pharyngeal, esophageal,& related functions including oral functionfor feeding; orofacial myofunction.

MBS measures Strategies to decrease aspiration Feeding & swallowing strategies

LANGUAGE

Receptive & Expressive Language

(phonology, morphology, syntax, semantics,& pragmatics) in speaking, listening,reading, writing & manual modalities

Increasing length & complexity ofutterances

Expanding expressive/receptive vocabulary

Measurement/tx of phonological processuse

Cognitive Aspects of Communication(attention, memory, sequencing, problem-solving, executive functioning)

Cognitive notebook use to improve accessof long term memory about family

Word retrieval strategies

Social aspects of Communication includingchallenging behavior, ineffective socialskills, lack of communication opportunities

Behavior management techniques Develop more effective peer interaction

patterns

Communication Modalities including oral,

manual AAC techniques & assistivetechnology

Identifying appropriate AAC devices &strategies

Increasing use of effectiveness of AACtechniques (e.g., PECs; picture notebook)

HEARING Hearing impact on speech & language.Aural rehabilitation

Hearing aid trouble shooting Hearing screening Speech reading skills Speech/voice production as influenced by

hearing impairment Language deficits as influenced by hearing

impairment

It is the students responsibility to be able to use the documentation codes appropriately and

independently. By the end of the first term of Network clinical education, students should be ableto clearly explain the documentation categories & system. When students move to Outplacementpracticum, their supervisors are typically not familiar with the various types of information required incurrent documentation (ASHA began requiring this type of documentation for SLP students in 2004).Please contact the appropriate Clinic Coordinator if you have questions about coding of hours.

It is recommended that students update their electronic hours logs weekly, or minimally each month.When students are in outplacement settings it is particularly important to keep their electronic hours logscurrent so that they can monitor progress towards meeting hour requirements in anticipation ofgraduation. Data from hours logs are saved on a server (details to follow) and it is recommended thatstudents always save a current copy of the electronic file for themselves. Data entered into hours logs isaudited for accuracy each semester by a CSD Clinical Administrative Assistant.

Formative Assessment of Clinical Competency. In addition to documentation of hours, measures willbe completed at midterm and end of term for each practicum experience to provide formative measures ofstudent progress on developing clinical competencies. The Formative Assessment of ClinicalCompetency forms (SLP; AUD) are used to provide formal written feedback. Student competency levelof relevant behaviors (subskills experienced on three or more occasions during the last 4 weeks of thegrading period) are scored using the CSD Clinical Skills Scoring System (Table 3). Determination of theappropriate score requires that both the Student Clinician Behavior column and the Clinical EducatorRole column are considered when assigning a score to describe competency level.


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Students will develop a Clinical Portfolio that provides additional supportive evidence of clinical skillacquisition & refinement across the program. Each student is also responsible for maintaining an up-to-date Knowledge and Skills Acquisition (KASA) form tracking acquisition of clinical skills and knowledgerequired by the ASHA standards (details in Academic Handbook). Electronic versions of the KASA arelocated on the ProSeminarcourse web site for you to download.

Tracking Progress. NOTE: During the 2007-08 academic year the CSD Clinic Committee is workingtowards transitioning our electronic clinic tracking systems (formative & hours logs) to a new web-basedformat. The guidelines conveyed in this section are based on the tracking systems used since 2003.Students will receive updated information when the new system is implemented.

At midterm time clinical instructors and students will meet for a midterm meeting to discuss studentprogress and skill level up to that point in the term. The clinical instructor will score the studentsperformance on clinical competencies that the student has participated in. Additionally, the student willcomplete a self-evaluation using the appropriateAssessment of Clinical Competency form. The originalforms (self eval and clinical instructor eval) will be turned in by the student to the Clinic Administrator.

At the end of the term the supervisor will use the electronic Formative Assessmentfile to complete theend of term evaluation and will send the electronic file back to Clinic Administrator . The student willagain complete a self-evaluation of their performance. The clinical instructor and student will meet for adiscussion of the students performance. Students are required to turn in the following items at the end ofeach term to the Clinical Administrator: hard copy of clinical instructors evaluation of the student usingthe Assessment of Clinical competency (with signatures); self evaluation; hard copy of hours log (with

clinical instructor initials and signature on bottom of each page); hard copy of observation log andelectronic copy of students evaluation of clinical instuctor. Practicum grade will not be submitted tothe University by the Clinic Coordinator until all paperwork has been turned in.

Hard copies of end of term documentation is maintained in each students department file. Copies of

midterm paperwork may also be maintained when there are concerns about a students performance inpracticum. This paperwork will provide formative measures of student progress across practicum trainingexperiences, including acquisition of clinical competencies and clinical hours. Students are required tomake & retain copies of all clinical paperwork for their own files before turning in original items to

the Clinic Administrator.


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Table 3. CLINICAL SKILLS SCORING SYSTEM*(modified 8-07)

Practicum Type Student Clinician Performance Clinical Educator Role

Score NET OUT4thAuD3rd-5thCScD

Key for Scoring Symbols: x = Below; there are concerns; performance is below expectations for students

in program; X = Meets Expectations; score is appropriate for students level in program; E = Excels; Level

Escores are the goal for a student to meet by the end of graduate training for that level of program (e.g.,

of 4 or 5 is goal by last Network practicum). Score behaviors using appropriate numerical value*

1X x x

Skill is absent or implemented with difficulty.Efforts to modify behavior are unsuccessful.Demonstrates incomplete understanding of theclinical disorder/ process. Difficulty in evaluatingself.

Maximum supervision required. Providdetailed input before, during & aftersession. Direct instruction, backgroundinformation and/or demonstration arenecessary. Direct service provided byclinical educator

2X x x

Skill is beginning to emerge. Efforts to modifybehavior results in varying degrees of success.Needs instruction to prioritize client needs, and torefine/adapt skill. Able to implement behavior ifpreviously discussed/modeled. Limited self-evaluation.

Provides guidance prior to session. Somassistance/demo is needed during sessiProvides post-session input to facilitatappropriate follow-up. Directly facilitastudent self-evaluation.

3X

X(newtypecaseor

activ.)

x

The skill is present but under-developed. Skill is

implemented appropriately, but inconsistently.Does not independently modify behavior duringthe session. Post-session, student aware of theneed to modify behavior, and able to identifypossible changes to be made after session.

Oversees session plan. Occasional inpu

needed during session to insure accuraappropriate, and optimal services. Focuon increasing student awareness ofwhen/how to improve the skill. Inputprovided on the optimal method of cha

4E X

X(newtypecaseor

activ.)

The competency/skill is implemented appropriatelymost of the time. Working on refining the behaviorto an outstanding level (i.e., increase consistency,efficiency, or effectiveness). During session awareof need for change and modifies behavior some ofthe time. Demonstrates independent clinicalproblem solving some of the time.

Monitors student performance and planPrompts student regarding client needspossible alternative areas to consider sof the time. Seldom intervenes duringclient session.

5E E X

Behavior is skillfully implemented consistently.During session modifies behavior as needed mostof the time. Demonstrates independent clinicalproblem solving most of the time. Able to generateaccurate self-evaluation most of time.

Supervisor confirms student hypotheseplans most of the time. Collaborates wstudent regarding client needs and suggpossible alternative areas to consider sof the time. Monitors student performamost of the time.

6E E

The competency/skill is implemented at anoutstanding level most of the time. Demonstratesindependent & creative problem solving in clinicsessions most of the time. Able to modify ownbehavior to maximize clinical effectiveness asneeded. Shows initiative with the competency/skillmost of the time.

Supervisor confirms student hypotheseand plans some of the time. Verifiesstudent assertions regarding client needValidates student initiated solutions.Monitors student performance some oftime.

7E

The competency/skill is consistently implementedat an outstanding level (appropriately, consistently,& efficiently). Consistently demonstratesindependent & creative problem solving. Initiatesthe development of new skills. Consults supervisoroccasionally as needed (e.g., difficult case; newdiagnosis) with questions & possible solutions.

Supervision primarily occurs during nocontact time through discussion withclinician. Focus of interaction is on cliproblem solving with agenda initiated clinician. Progress on clinician goalsmonitored by clinician with input fromsupervisor

*Note: Scores of 1-5 may be used in Network; Scores of 1-6 may be used in Outplacement settings; Scores of

1-7 may be used in AuD Externships

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PART II: CLINICAL EDUCATION GUIDELINES AND EXPECTATIONS

Prerequisites to Clinical Education

Practicum Registration

Only graduate students are eligible for participating in clinical education activities in the CSD program.Students must be enrolled in one of the practicum courses (CSD 2065, 2056, 2066, 2057, 2656, 2659 or2067) for the number of credits appropriate for their assignment. When enrolled in Network practicumstudents are typically registered for 1-2 credits. One credit of Network practicum includes beingscheduled for approximately two hours of patient contact time and two hours of clinical teaching time.The actually day/time of each Network assignment varies in relation to the Network Supervisors caseloadand setting.

In Outplacement Practicum credits vary in relation to the number of days per week at the site. One creditcovers up to one day of Outplacement practicum in Fall & Spring terms. However when students areenrolled as full-time students during the Fall and Spring terms, they may register for the maximumnumber of practicum credits possible for the scheduled experience they are assigned, without going into

overload status (over 15 credits. For example, if the student is enrolled in 13 credits of academiccoursework, and they want a 3 day/week outplacement, they may register for 2 credits of outplacementpracticum but participate in training 3 days per week. In the Summer term, the registration forOutplacement Practicum follows a somewhat different formula as the term is only 12 weeks in lengthcompounded by clinical instructor vacation time as follows: 1 credit = up to 1 day/wk; 2 credits = up to 3days/week; 3 cr = up to 5 days/wk).

Observation Requirements

Observations of certified professionals providing services to clients with communication disorders helpstudents develop an understanding of the nature of communication disorders and the clinical processesand professional expectations involved in audiology and speech-language pathology. As part of clinical

education, students are required to participate in some observational experiences prior to participating inany patient-contact time, and throughout their clinical training activities. Client observations should besupplemented by post-session discussions with the professionals providing the services, and/or by post-session reflections completed by the graduate student clinician.

Prior to beginning practicum training CSD students must complete at least 15 hours of observation ofclinical activities, with at least of those being within their discipline area (SLP or Audiology).Observation activities (live or through video-taped sessions) should include experiences with varied agelevels and should include evaluation and treatment activities. Observation hours completed inundergraduate programs or through community visits can count towards the 15-hour requirement if theobservations were completed with ASHA certified professionals. A copy of the documentation ofobservation experiences must be given to the Administrative Assistant (Clinic Administrator) for filing in

the students CSD folder before the student participates in graduate practicum training. (See requirementsof the documentation below.)

CSD graduate students are required to complete a total of 25 hours of observation in their discipline

(minimally) by the end of their graduate program. Students will document the observation hourscompleted at each practicum assignment each term on an observation log form, turning them in to theClinic Administrator with end-of-the-term paperwork (contact hour logs, clinical evaluation forms, &clinical instructor evaluation forms). Observation hours should continue to be documented even aftermeeting the 25 hour requirement.


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Documentation of observation experiences completed during the graduate program must include thefollowing information: Date of the observation (month, day, yr); Site of the observation; Clientcharacteristics: diagnosis and age level (I/T = 0-2 yr; PK = 3-5 yr; SA (school age) = 6-18 yr; EA (earlyadult) = 19-29; MA (middle age) = 30-64; GR (geriatric) = 65+ years; Definition of the activitiesobserved (e.g., screening; prevention; amplification; evaluation &/or treatment); Length of observation(e.g., .25 = 15 min; .5 = 30 min); Name, signature, and ASHA certification number of the professional

who supervised the observation.

Academic Background

Students must have completed the majority of post-baccalaureate academic requirements at theundergraduate level (see Academic Handbook) prior to enrollment in practicum. SLP students must beenrolled in or have completed theIntroduction to Clinical Decision Making course when initial practicumexperiences begin.

Communication Competency Requirement

In order to participate in clinical practicum, students must demonstrate the ability to communicate

intelligibly and effectively, in English, with patients and clinical instructors. This includes the ability tocomprehend oral and written instructions, and to compose written reports of clinical observations,evaluation & treatment sessions, and outcomes. Students must demonstrate English writing that isgrammatically correct and uses basic rules of technical writing (e.g., punctuation; capitalization)appropriately.

Students must be able to comprehend English language expressed orally and in written form. They mustalso demonstrate oral English speech and language production that is readily understandable by clients.Moreover, students must be able to appropriately model articulation, voice, fluency, vocabulary andgrammar of the English language. A students speech and language skills must be intelligible andcomprehensible enough for administration of speech, language, and hearing assessment techniques andintervention strategies in a reliable and valid manner.

Students not meeting communication competency may not be able to participate in clinical

education until adequacy of English language skills are demonstrated. Any concerns regardingstudent communication competence should be brought to the appropriate Clinic Coordinators attentionimmediately. A student may initiate discussion regarding their own communication skills. Additionallyacademic advisers, faculty members, or clinical instructors may identify students who are notdemonstrating adequate communication competence in one or more areas.

Equipment (Speech/Language Pathology)

Graduate students in speech/language pathology are expected to have at their disposal an audio-recorderfor use in practicum. You will use these in your practicum experiences to record speech/languagebehaviors. A tape recorder will continue to be an important tool as you enter your professional settingupon completion of the program. Micro-cassette recorders are not recommended. In the past two yearsstudents have found digital recorders to be optimal for recording speech samples. Some digital recordersallow students to download audio files on to their computer. Check with the Director of ClinicalEducation for some guidance on this issue.

Professional Liability Insurance

All student clinicians must carry malpractice insurance through a policy written for the University.Students must purchase the policy through the School of Health & Rehabilitation Sciences; the policiesrun from August 1 through July 31. The insurance covers each student for claims up to Five Hundred


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Thousand Dollars ($500,000). Because this plan is comprehensive and relatively inexpensive, ourprogram has opted to take advantage of the University group insurance. There is no discount for part-timecoverage. Checks should be made out to the University of Pittsburgh and should contain your SocialSecurity Number. These fees should be submitted to the Clinic Administrator at the beginning of yourfirst fall term, and in the summer term for subsequent years. Students may not engage in clinic practiceunless this obligation is met.

Medical Clearance

All students participating in practicum through the School of Health and Rehabilitation Sciences (SHRS)must have a medical examination by their physician including blood work and appropriate immunizationscompleted. Physical exams and TB Mantoux test series must be done annually. SHRS forms are providedto take to your physician. Some outplacement training sites will require copies of this documentation aswell, which will be provided by the student clinician to the site. Students may not engage in clinicpractice unless there is a current (within 12 months) medical examination form on file.

Cardio Pulmonary Resuscitation (CPR) Certification

All students participating in practicum through the School of Health and Rehabilitation Sciences (SHRS)are required to have completed a CPR training course (effective 2007-08 academic year), and to maintaincurrent CPR certification. CPR training will be offered by SHRS every year during orientation forincoming and returning students. Documentation of current CPR certification must be on file with theClinical Administrator

Criminal Background/Child Abuse Clearances

The School of Health & Rehabilitation Sciences (SHRS) requires that a student must meet the backgroundchecks required by the state and for the site(s) in which they obtain their clinical education. In theCommonwealth of Pennsylvania anyone working with children or the elderly must have a criminal and

child-abuse background check (Act 33/34). Additionally, Pennsylvania requires FBI background checksfor anyone who has lived out of state in the last 5 years to be obtained before submitting the paperworkfor the Pennsylvania checks. The Commonwealth of Pennsylvania (effective April 1, 2007) also requiresanyone who works/volunteers/engages in interaction in a school setting (public &/or private schoolsettings) have current FBI background checks on file. Therefore effective for the 2007-08 academic yearall CSD students are required to have current FBI checks. The FBI checks reportedly take 8-10 weeks tocomplete. These procedures are required annually while enrolled in practicum training experiencesin the CSD department.

Many practicum training sites (i.e., Childrens Hospital of Pittsburgh; all school settings) will require youto provide the original documentation of these clearances. Some sites may also require additionalbackground checks before being permitted to participate in clinical education activities. The University

does not guarantee a students clinical education requirements can be met if their backgroundprecludes them from placements in required sites.

Student Clinical Laboratory Fee

Students will be billed for a clinic laboratory fee at the beginning of each term in which they areregistered for a Network and/or Outplacement clinic assignment. These fees will be paid throughregistration in the course. The clinical fees are applicable to both speech-language pathology andaudiology students. Fees are used to replenish the diagnostic collection and purchase of clinical tools usedfor graduate student training. Suggestions for acquisition of new materials are welcomed. Submit yourideas in writing to the appropriate Clinic Coordinator.

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HIPAA Training

Prior to participating in clinical education or observation activities in the graduate program students mustcomplete the UPMC (University of Pittsburgh Medical Center) HIPAA training on privacy protection forpatients. Students receive information on how to access the web-based training program and certificationfor UPMC prior to beginning their graduate program. After they have successfully completed the program

they should download a copy of the HIPAA Certificate. A copy of the certificate must be turned in to theClinic Administrator. A copy should also be retained by the student for their own files, as they may needto provide evidence of the HIPAA certification to future clinical training sites. Note that students mayalso be required by practicum sites to complete additional agency-specific HIPAA training.

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General Guidelines for Clinical Education

Clinical Coordinators

For each discipline area in the Communication Science and Disorders Department there is a coordinator

who oversees clinical education in that domain:

Cheryl Messick 412-383-6547 [email protected] of Clinical EducationCoordinator of SLP Practicum & Aud SLP Practicum

Elaine Mormer 412-383-6610 [email protected] of AuD Network & Outplacement Practicum

Barb Vento 412-383-6748 [email protected] of AuD Externships

Students are encouraged to communicate with the coordinators of each area on a frequent basis and toconvey any concerns, suggestions, questions or compliments. Coordinators work to develop a clinicaleducation program of the highest quality for graduate students. Input from students helps to ensure thatthe clinical education experiences are effective and optimal. Clinical Coordinators are available forclinical advising sessions by appointment. Students are also encouraged to talk to the Director of ClinicalEducation (Dr. Cheryl Messick) at any time.

CSD Department Clinic Committee

Clinical Education goals, procedures and issues are overseen by the CSD Clinic Committee which ischaired by the Director of Clinical Education and includes all full-time and some part-time clinical facultymembers. Current members of the clinic committee include: Mike Biel, Jim Coyle, Geoff Fredericks,

Paula Leslie, Cheryl Messick, Chris Matthews, Elaine Mormer, and Barbara Vento. A studentrepresentative from each of the disciplines (SLP and Audiology) is also requested annually to serve as amember of this committee and to serve as a conduit for information and suggestions from audiology andSLP students.

Clinic Committee meetings are typically scheduled on the fourth Tuesday of the month (11:15-12:30) asneeded, with at least 2 meetings held per term. The Clinic Committee works to review, modify, anddevelop guidelines, activities and procedures for clinical education for AuD & SLP clinical (professional)programs. When new guidelines are developed they are sent to the CSD curriculum committee for initialreview (if needed) and then are presented to the full faculty for final approval. The Clinic Committee alsoreviews student performance in clinic on an on-going basis as needed each term. Student representativesto the committee cannot be present at when individual student performance or issues are discussed.

Determination of Practicum Assignments

Prior to registration each term, students should communicate with the appropriate clinical coordinator (ina face-to-face meeting, through email, &/or using a Practicum Request Form completed near midtermtime) regarding practicum assignments for the upcoming clinical term. Typically request forms are usedto make assignments while students participate in Network Clinical Education. When students prepare tomove to Outplacement &/or Externship practicum, clinical advising sessions with the appropriateCoordinator will typically be scheduled. Students should initiate communication with the individualcoordinator describing the preferred setting types, possible sites, type of hours sought, and number ofcredits to be completed. If a student is interested in a specific site/setting, they should communicate with

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mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


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the coordinator as soon as possible in their graduate program so that advanced plans can be made to helpmeet the students request (as possible).

Coordinators will make recommendations to students regarding possible outplacement/externshipplacements. Guidance regarding optimal sites for individual needs or goals will be discussed. ClinicCoordinators have a history of working with sites and can often provide insights on the viability as well

as pros and cons of a particular type of placement in relation to a students goals and needs. Students areencouraged to listen to and weigh the suggestions and recommendations of the Clinic Coordinators, as

their goal is to develop the optimal placement based on student needs/characteristics. It is the ClinicCoordinators responsibility to help develop a series of practicum experiences for each student to enablethem to meet ASHA and CSD Department requirements, and to pursue individual goals. At the sametime, the department works to maintain strong and collaborative relationships with the many sites thatprovide outplacement assignments to our students year after year.

The clinic assignments must always be arranged by the appropriate clinic coordinator. Students will notreceive credit for practicum hours obtained under the supervision of a non-approved clinical supervisor.As defined by ASHA guidelines,students may NOT make their own arrangements for practicumassignments or clinical experiences.

Enrollment in clinic practicum is dependent on the successful completion (grade ofCor better) incoursework and clinic in the prior semester. A failing grade, or multiple grades at a Clevel, may precludethe student from participating in clinical practicum. Deficits in performance on professional expectationsmay also be cause for removal from practicum. Remediation plans (Clinic Remediation Plans) and/orrestrictions from clinical practicum will be made at the discretion of the Clinic Coordinator, the ClinicDirector, and the students adviser.

Enrollment in Clinical Practicum

Practicum requirements for each graduate program are defined in the academic handbook. SLP Mastersstudent are required to complete a minimum of 10 credits of practicum. AuD students should refer to the

Academic Handbook description of clinic credit requirements. Most students complete more than theminimum required practicum credits during their graduate program. One of the required credits ofpracticum must be completed in the students counter area (details below), with the remaining credits intheir own discipline.

In the first fall term, students typically register for one credit of Network Practicum in their discipline area(CSD 2065 for Speech Network Practicum; CSD 2056 for Audiology Network Practicum). In subsequentsemesters during the first year, students may register for 1 or more clinic credits as determined by therecommendation of the clinic coordinator, the students academic adviser, and individual time constraints.Typically 1 credit of practicum is equal to .5 to 1 day per week of time in Network sites. In Outplacementsites the amount of practicum per credit is variable. Course registration varies depending on the site anddiscipline as follows:

CSD 2065 Speech Practicum: NetworkCSD 2056 Audiology Practicum: NetworkCSD 2066 Speech Practicum: OutplacementCSD 2057 Audiology Practicum: OutplacementCSD 2067 Speech Practicum SchoolsCSD 2656 Advanced Audiology Practicum: NetworkCSD 2659 Au.D. Externship

All students in the CSD clinical education programs participate in Counter Area educational activitiesthat include academic and clinical education experiences. Counter Area experiences refer to the


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acquisition of knowledge/skills in the students related discipline area (audiology background for SLPstudents; SLP background for audiology students). Counter area coursework and clinical experienceshelp students to understand the strong inter-relationship between hearing abilities and communicationabilities. It also provides an opportunity for students to understand how hearing impairments impact oncommunication skills, and how communication disorders manifest themselves and sometimes co-occurwith hearing disorders. The Counter Area practicum typically occurs either in the first or second terms of

clinical education.

Counter area clinical training activities focus only on clinical skills that are within the scope ofpractice of the students discipline. For example, both audiology and SLP students learn to screenspeech, language, & hearing, and to make appropriate referrals. SLP students achieve counter-areacompetencies by enrolling in one credit of Network Audiology Practicum (CSD 2056), and audiologystudents complete one credit of Network SLP Practicum (CSD 2065). Half of the SLP students will enrollin CSD 2601 during their first fall semester of graduate training, and the other half will complete CSD2601 in their first spring term. Audiology students will be assigned to enroll in CSD 2065 in their first fallsemester . Counter-area expeiences focus on skills within the scope of practice including screening,prevention, trouble-shooting, describing behaviors, and making appropriate referrals. In addition to theCSD Clinical Education counter area practicum experience, opportunities will be periodically announced

for students to participate in speech, language & hearing screening experiences in the community.Students are expected, and may be required, to participate in several community screening programsduring their graduate program. It should be noted that students typically have more flexibility in theirschedules to complete theses screenings during their first year in the graduate program.

Practicum for the AuD (Clinical Doctorate in Audiology)

AuD students will follow the general outline for clinical placements as described below for the first twoyears of study. Network practicum experiences occur in the first year of study and are managed byUniversity of Pittsburgh clinical instructors who provide an optimal learning environment for thebeginning student. Practicum experiences move on to Outplacement (community-based) experiences(year two) after the student achieves Basic Clinical Competencies and Core Clinical Skills and are ready

for faster paced learning.

AuD students return to the network clinical environment in year three, for a combination of intense,advanced clinical practicum along with outplacement experiences. Although a portion of 3rd year clinicaleducation occurs in the Network, students are expected to meet the expectations at an Outplacement levelin these assignments. In the 3rd year environment, students may work together in order to practice clinicalactivities and to observe master clinicians.

In the fourth year of the AuD program, students move into full-time externships. Externship assignmentsare developed with the AuD Externship Coordinator. The process of securing an externship positionbegins in the students 3rd year of the AuD program. At this time AuD students receive a copy of the CSDAudiology Externship Handbookwhich provides guidelines for that level of practicum. Externship

positions provide an intensive clinical education experience for students to apply classroom knowledge tothe complex clinical settings. Students are supervised in their externship experiences by University ofPittsburgh-affiliated master clinicians. Although students are encouraged to identify possible externshipsites of interest, in all cases, the Externship Coordinator will be the individual to make first contact withthe facility. The American Academy of Audiology website has a listing of facilities that are acceptingapplications for externs and this is a good starting point for students. Fourth year students participate inthe ongoing Advanced Clinical Seminar via an online format. The program is fortunate to haveoutstanding clinical faculty who serve as role models for other supervisors who participate in thisexpanded rogram.

Practicum for the CScD (Clinical Doctorate in Speech Language Pathology)


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CScD students, who begin the CScD program with a bachelors degree, will follow the general outline forclinical placements as described for the Master SLP students in this handbook for the first two years ofstudy. That is, they are considered Masters students until they meet the clinical competencies of thatdegree. Network practicum experiences occur in the first year of study and are managed by University ofPittsburgh Clinical Instructors who provide an optimal learning environment for the beginning student.Practicum experiences move on to Outplacement (community-based) experiences (year two) after the

student achieves Basic Clinical Competencies and Core Clinical Skills and are ready for faster pacedlearning.

In the fall of the second year for CScD students in the masters program, and approximately 9 monthsbefore a certified SLP enters the CScD program as a 3 rd year CScD student, students will work with theCScD Practicum Coordinator to develop options for a half time clinical position (Year 3 of CScDprogram). By the end of the second year of the graduate program, students will have completed therequirements for the Masters degree, and will begin a clinical fellowship experience that provides thepracticum experience for the CScD program. Students will work to meet the expectations andcompetencies of the site they work for while achieving ASHA competencies and program competenciesin Medical Speech/Language Pathology. Details regarding clinical experiences & expectations in thethird through fifth years of the CScD program are provided in the CScD Handbook.

PA Educational Certification for School-Based SLP

In most states, the practice of speech-language pathology in the schools requires that a professionalcomplete educational certification requirements that exceed ASHA requirements for clinical certification.Educational certification (and state licensure) requirements differ from state to state. SLP studentsinterested in meeting the requirements for Pennsylvania Educational Certification for Speech-LanguageImpaired (required for SLPs who provide school-based speech-language pathology services inPennsylvania), will need to successfully complete at least one School Practicum experience (CSD 2067)during their second year of graduate clinical education. The School Practicum will serve as one of thestudents outplacement practicum experiences and must be done as a 4 day/week placement (minimally).

Students seeking school certification should pick up the Checklist for PA Educational (and complete theApplication for Admission to PA Certification Form (forms are located past the faculty mailboxes in FT4033 where the clinical forms are housed). This form should be completed by June 15th of the first year.Dr. Messick typically conducts an informational meeting for all first year SLP students during the winterterm of the first year, where the requirements are described and paperwork is distributed.

TheApplication for Admission to PA Certification Form initiates the process of working towardscompleting the requirements for the PA educational certification program. Prior to beginning the schoolpracticum experience, students must complete the PPST-I praxis exams and theApplication forAdmission to PA Certification Form and turn in those items to Dr. Messick for processing. Students areadvised to periodically check the Pennsylvania Department of Education web site atwww.teaching.state.pa.us/teaching throughout their graduate program to stay abreast of any changes

implemented by the state. Students should review the School Practicum Handbookfor details regardingthe requirements for educational certification

It should be noted that a School Practicum experience can serve as a pediatric outplacement option forany SLP student, even if the student is not interested in meeting all of the requirements for schoolcertification in Pennsylvania. School-based outplacement experiences provide an exciting and interestingsetting for students to acquire and meet pediatric-based clinical competencies with varied populations.Within the school systems, there are different types of school placement settings including traditionalSLP, early intervention (3-5 year old focus), or special education school. All students are encouraged toconsider completing a school practicum placement, as ones career interests often change across time.Students should also take time during the first year of the graduate program to arrange observations
http://www.teaching.state.pa.us/teachinghttp://www.teaching.state.pa.us/teaching


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through the Director of Clinical Education to visit different types of school settings so that they have abetter understanding of the options available.

Students who may seek employment in a school setting in another state should contact the educationalcertification board for the state of interest to determine the requirements. Some states have morerequirements than those of Pennsylvania, while others have fewer. There are some states where ASHA

certification is the sole requirement for provision of services in the schools.

Professional Expectations

When participating in practicum students are expected to behave in a professional manner at all times.That is, they are expected to demonstrate appropriate behavior and demeanor in all interactions, includingthose with clients, family members, staff, & clinical instructors. Graduate student clinicians are expectedto meet professional responsibilities (e.g., arrive early; come prepared; take responsibility for theiractions), without being instructed directly to do so. Regular attendance at all scheduled clinical sessionsis expected throughout the semester.

As noted by Dr. Michael Chial, (ASHA Leader) the notion ofProfessionalism refers to the manner,spirit, and methods of a profession and reflects the underlying principles and values of practitionersincluding the following:

One accepts that the idea of on time, prepared, appropriate, and properly are defined

by the situations, by the nature of the task, or by another person

One places the importance of professional duties, tasks, and problem solving above your own

convenience

One takes active responsibility for expanding the limits of your knowledge, understanding, and

skill. You take responsibility for your actions, your reactions, and your inaction. This

means you do not avoid responsibility by offering excuses, by blaming others, by emotional

displays, or by helplessness.

Opinions, actions, and relations are developed with others upon sound empirical evidence and

upon examined personal values consistent with the discipline

It is important for students to take initiative in all aspects of their clinical education including planning forfuture needs, meeting clinical responsibilities, initiating communication, and documenting ones progressin the program.

Student attainment of professional expectations will be formally measured at midterm and end of term ineach practicum experience. A standard set of behaviors are included in Clinical Evaluation forms to

measure attainment of Professional Expectations (See Formative Assessmentforms in Appendix B). Itshould be noted that the Clinic Committee developed the list of Professional Expectations based on theassumption that they were behaviors required in any work/professional setting, and that they could andshould be achievedby all students (including first term Network students). Unacceptable performance onProfessional Expectations will result in lowering of a students grade, and can result in removal frompracticum experiences. A student may be required to participate in a Clinic Remediation Plan when theyhave difficulties with professionalism.

Learning Modules

Students enrolled in clinical education (Network, Outplacement, & School Practicum) must have workingknowledge of a variety of professional constructs that apply to the practice of SLP and audiology

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services. Areas of knowledge of concern for practicum include the following: Scope of Practice of thediscipline;ASHA Code of Ethics; Universal Precautions; medical terminology; and client confidentiality.While these topic areas are covered at various points in the curriculum in academic coursework, studentswill also complete required learning modules on the topics each fall and spring term that they are enrolledin practicum.

Students are required to visit the Clinic Courseweb site (courseweb.pitt.edu) they are registered inand complete the learning modules identified each term. Students are expected to obtain a passinggrade (80%) on each learning module. Quizzes may be taken multiple times. A students grade inpracticum may be lowered if they have not satisfactorily completed the required learning modules forthat term. The specific topic areas of focus will be indicated on the courseweb site.

Clinical Grading Procedures

The purpose of clinical grades is to provide feedback on progress towards attainment of clinicalcompetencies. Secondly, clinical grades provide formative assessment of student performance across theirclinical education program in meeting ASHA & CSD Department clinical requirements. Students areformally evaluated (in writing) at least twice per term (mid-term and at the end of the semester) in

placements that are 12 weeks in length or longer. The mid-term grading provides a mechanism foridentifying students strengths and areas to improve. The final semester grade will be based on thestudents performance at the end of the semester across the last 3-4 weeks of the term.

Each term students and Clinical Instructors will receive a Clinic Calendar defining the dates and deadlinesfor the term, including midterm and end of term evaluations. Students are expected to schedule theirmidterm and end of term conferences with their supervisor at least one week before the events are

to occur. Prior to meeting with their supervisor for the end of term evaluation, they should complete theelectronic form of the Supervisor Evaluation Form and email it to Clinic Administrator.

CSD Department Clinical Formative Assessment Forms are used to measure student levels ofperformance on Professional Expectations and Clinical Competencies. The appropriate clinical evaluation

form and scoring system must be used for midterm and end of term evaluations. A students grade inclinic will be determined by the ClinicCoordinator converting the mean score earned on the end of terminto a letter grade. In our program the grade conversion scales have been developed from three years ofstudent clinician data which have been used to develop mean and standard deviation scores. These datahave been analyzed to provide normative guidelines on student performance. Thus each studentsperformance is compared to that of peer graduate student clinicians who were at the same level of clinicaleducation. There are separate grade conversion scales for the following levels of student practicum:

Network Grade Conversion Scales Outplacement Grade Conversion Scales

First Network Practicum (SLP & AuD) First Outplacement Practicum (SLP)School Pract as first Outplacement (SLP)First Outplacement Practicum (AuD)

Second+ Network Practicum (SLP & AuD) Second+ SLP Outplacement Pract (SLP)School Pract as 2nd(plus) Outplacement (SLP)Second+ AuD Outplacement Pract (AuD)


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It should be noted that your Clinical Instructors will not have a copy of how the mean performance scoresconvert into letter grades. The Clinical Instructors responsibility is to provide accurate feedback on thelevel to which you have performed the Clinic Competencies based on the CSD Department scoringsystem. The CSD Department Clinic Coordinator will convert the score earned into a letter grade. Therationale for clinical instructors to be blind to the students grade in clinic is to allow clinical instructorsthe luxery and freedom to focus on giving clear and accurate feedback on student performance without

having to consider grading issues. The grade conversion scales then provide students and ClinicCoordinators with a clear comparison of hos the student is doing compared to expectations for theircurrent level of clinic experience. Students can find a copy of the current grade conversion scale on theCourseWeb site for their practicum course. Students should not share copies of the conversion scaleswith the clinical instructors.

While in a Network/Bridge practicum experience letter grades are converted into and recorded on thetranscript as a letter grade. Outplacement & School practicum grades are graded on a pass/fail scale. Thatis, a letter grade will appear on the grading scale, but on the transcript the grade is recorded either as S(Satisfactory), or U(Unsatisfactory).

If a student is assigned to more than one practicum site in a term, the grade for practicum is calculated by

weighting the grade by the number of hours/week per site. For example, if 2 days per week of clinic arecompleted at one site and 1 day/week at another, the grade at the 2-day site would comprise 66% of thestudents grade, while the 1-day site would be weighted at 33%.

It is the students responsibility to ensure that end of term clinic paperwork is turned in by the due date atthe end of the term. End of term paperwork includes a signed copy of the clinical instructors assessmentof the student, the students self assessment, hours logs, and observation logs. In Network placements theCore Clinical Skills form should also be turned in. The original (hard copy) hours logs (contact time &observation time) must include clinical instructor signatures. The electronic copy of the forms will alsoneed to be emailed to the department (instructions to follow) by the clinical instructor. Students notturning in all of their paperwork will receive an I grade for that semester. Students are alwaysrequired for making & retaining a copy of their clinc paperwork before turning in copies to the

department. Students should keep their own file of clinical documentation across the program.

Clinic Probation and Clinic Remediation Plan

When a student is having significant difficulties in practicum they may be placed on Clinic Probation anda Clinic Remediation Plan will be developed. The remediation plan is a written document that includes adefinition of the difficulties being experienced, specific objectives that need to be met, and mechanismsfor assisting the student to achieve the objectives (e.g., specific experiences, support, or learningassignments). Difficulties may represent one particular area of performance or may include a number ofproblems. Once the plan has been developed by the Clinic Coordinator, the student must successfullymeet the goals of the Remediation Plan before being permitted to participate in any subsequent practicumexperiences. Registration for a Clinic Remediation is typically done under CSD 2065/2056 Network

Practicum. Academic advisers are informed when a student is having difficulties in practicum.

The nature of the Clinic Remediation Plan is individually determined and is defined largely by theparticular problem(s) a student presents. Thus, the Plan may focus intensively on one aspect of clinicalwork, or may be a more general program focusing on a broad set of concerns. For example, a remediationplan may focus on professional expectations, clinical competencies, self evaluation skills, interpersonaldifficulties and/or weaknesses in integrating academic information into clinical practice. The student willmeet with the Clinic Coordinator in order to help develop and/or review the Remediation goals,objectives, and requirements. The Clinical Instructor may be asked to contribut to &/or review the plan.The students academic adviser may be involved in the remediation process, and will be kept informed ofthe students progress throughout the term. The student is encouraged to share the Remediation Plan with


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their current Clinical Instructor, so that they can help develop learning experiences to assist the student toimprove performance in areas of concern. In some cases members of the Clinic Committee may be askedto review the Clinic Remediation Plan.

One of the functions of the remediation program is to identify, as early as possible, those students whomay not be suited for clinical work in the field of speech-language pathology or Audiology. The student

must achieve all objectives of the Clinic Remediation Plan to obtain a passing grade in practicum whenon Clinic Probation before they are permitted to resume the regular sequence of clinical educationpracticum. While on a Remediation Plan, the students performance in clinic will be evaluated by their

Clinical Instructor using the regular Formative Assessment of Clinical Competencies form. Theirperformance on the Clinic Remediation Plan will be determined by the Clinic Coordinator, typicallybased on data provided from the Clinic Instructor.

When a student is participating in a Clinic Remediation Plan, their grade for that experience isdetermined as follows:

1. If the student fails to meet the objectives of the Remediation plan they will receive a failinggrade in Practicum (regardless of their performance on the Formative Assessment of Clinical

Competencies).

2. If they meet the goals of the Remediation plan, their grade in practicum will be determined bytheir score on the Formative Assessment of Clinical Competencies form.

Failure to meet Remediation requirements will be grounds for dismissal from clinical education. Across astudents graduate education program they will be permitted to participate in no more than two formalclinic Remediation plans.

Student-Clinical Instructor Problem Solving Procedures

Occasionally a student or clinical instructor will perceive some problem in the supervisory relationship. If

not resolved, such a problem may interfere with this relationship and couldaffect client care. The ClinicCommittee has developed procedures for coping with problems between students and supervisors toprovide early and speedy resolution of problems. These procedures help to ensure fair treatment ofstudents and Clinical Instructors in the problem solving process.


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If a student or Clinical Instructor perceives that a problem exists, the following procedures should beimplemented:

1. Discuss the problem together. Often simple misunderstandings can be resolved by discussion.The Clinic Coordina

Documents

Clinical Education Handbook August 2007