It’s a great time to serve as a clinical educator in audiology or speech-language pathology. As a professional organization, the American Speech-Language-Hearing Association (ASHA) recognized the need to educate clinical supervisors about the principles and practices of evidence-based clinical instruction across practicum settings (e.g., on-campus clinic, off-campus clinic, AuD externship, or clinical fellowship). This recognition is operationalized in the 2020 standards of the ASHA Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC; ASHA, n.d.-a). These standards require that clinical supervisors complete professional development activities in the area of clinical instruction/supervision. Similarly, academic standards of the Accreditation Commission for Audiology Education (ACAE) require accredited programs to demonstrate that clinical instructors possess training in clinical education practices (ACAE, n.d.). Beyond the education of clinical instructors, the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) standards require graduate programs to offer curriculum activities that address clinical education and supervision of students and support personnel (ASHA, n.d.-c). These requirements are an acknowledgment that effective clinical education is both an art and a science, much like the clinical services we provide.
Spreading the Word
Clinical education directors engaged in an iterative process to strategize ways to meet the requirements of the new standards. Views were shared on the Community posts of Special Interest Group (SIG) 11 and via conference presentations at the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD), ASHA, and the American Academy of Audiology (AAA). The challenges lay first in disseminating these requirements to our clinical educators in communication sciences and disorders (CSD), and second, in providing access to learning materials necessary to achieve the continuing education requirement. Most programs depend on volunteer clinicians to provide clinical instruction in off-campus clinics, AuD externships, and clinical fellowships. Thus, clinical education directors (myself included) initially expressed concern about asking these volunteers to extend their commitment further through the completion of continuing education requirements. In my professional travels, many clinicians share their challenges about maintaining clinical productivity while providing coaching, feedback, and mentoring to students. Clinicians also seek guidance on providing productive feedback and managing the complexity of the clinical educator–student relationship.
With the January 2020 implementation of the CFCC standard looming, many directors report that clinical educators welcomed the opportunity to participate in these continuing education activities. Many academic programs reached out to clinical educators with information about the requirement and with no-cost (or low-cost) options to meet the requirement (e.g., face-to-face or online learning modules/courses). Associations responded with the creation of easily accessible resources for clinical educators to enhance and reflect on their student mentoring and teaching.
Additional Resources for Clinical Educators
As a seasoned clinical instructor, it is exciting to observe the growth and accessibility over the past decade of learning activities around clinical education. An extensive peer-reviewed body of literature exists in the field of health professions education, and data-based studies confirm several basic clinical tenets. These studies are reported in journals from related disciplines such as nursing, medicine, occupational therapy, athletic training, and teacher education, as well as in our own professions of audiology and speech-language pathology. For example, an article in the Athletic Training Education Journal (Levy et al., 2009) provides an extensive literature review of effective and ineffective characteristics of clinical educators. In another article—this one published in Perspectives in Medical Education—Lefroy and colleagues (2015) offer specific guidelines on how to, and how not to, provide feedback during clinical education. Teaching and Learning in Communication Sciences and Disorders is a peer-reviewed journal that publishes research and thought pieces about clinical education and clinical supervision.
The table below shows a sampling of four available online courses/modules, brief content descriptions, and information about how to access each. The content for the CAPCSD eLearning courses is developed by an instructional design group and content matter experts. Course content is then monitored on an ongoing basis by committee members on the CAPCSD eLearning initiative.
|ASHA||https://www.asha.org/professional-development/supervision-courses/||Two online courses cover building blocks and competencies for supervision. The courses offer up to 3 hours of learning activities.|
|American Board of Audiology- Certificate Holder-Audiology Preceptor (CH-AP™)||https://www.eaudiology.org/precepting||Four online courses address the role of preceptors, assessment, learning, and professional issues in clinical instruction. The courses offer up to 8 hours of learning activities.|
|CAPCSD eLearning courses in clinical education||https://www.capcsd.org/elearning-courses/||Three online courses cover foundations, relationships, and feedback in the clinical environment. Each course contains five modules with 2.5 hours of learning activities, equaling up to 37.5 hours (a fourth course is planned).|
|Preceptor Education Program (PEP) for Health Professionals and Students||https://preceptor.ca/index.html||Eight modules cover the basics of providing clinical education across any health care discipline. Each module takes 30–45 minutes to complete for up to 6 hours of learning activities.|
Collecting Feedback on the CAPCSD eLearning Courses
In conjunction with subject matter design experts, the CAPSCD committee developed a post-module survey to obtain participant feedback about the quality and experience of the learning materials. Participants complete the survey at the end of each module to attain a certificate of completion for that module. Survey questions probe many aspects of the learner experience, including the following open-ended question: “What did you find most valuable about this online offering?”
CAPCSD conducted a non-published content analysis of this open-ended question with 3,000 participants who completed the learning modules. The analysis revealed the following major findings:
- Learners place high value on hearing how peers think about and address the challenges that clinical educators face.
- Participants appreciate learning about evidence-based frameworks that explain the process of knowledge and skill acquisition.
- Clinical educators appreciate tools that guide their interactions with students. For example, supervisors responded very positively to a structured format for student self-reflections, a clinical educator self-assessment questionnaire, and a formula for working through difficult conversations with students.
Our professional associations called upon individuals in the CSD discipline to educate clinicians about the art and science of clinical education practices. This article discussed several avenues for further educating clinical supervisors. In addition to the packaged programs discussed above, the ASHA Practice Portal on Clinical Education and Supervision includes related resources on a wide array of clinical education topics (ASHA, n.d.-b). It is exciting to see that clinical educators and academic programs embrace the new standards and welcome available resources. Just as we teach evidence-based practice in clinical assessment and treatment, we are now teaching evidence-based practice in clinical supervision. What a great investment in the future of our professions!
Accreditation Commission for Audiology Education. (n.d.). ACAE accreditation standards. https://acaeaccred.org/standards/
American Speech-Language-Hearing Association. (n.d.-a). Certification standards to change in 2020. https://www.asha.org/Certification/Certification-Standards-Change-in-2020/
American Speech-Language-Hearing Association. (n.d.-b). Clinical Education and Supervision [Practice Portal]. https://www.asha.org/Practice-Portal/Professional-Issues/Clinical-Education-and-Supervision/
American Speech-Language-Hearing Association. (n.d.-c). Standards for accreditation of graduate education programs in audiology and speech-language pathology. https://caa.asha.org/wp-content/uploads/Accreditation-Standards-for-Graduate-Programs.pdf
Lefroy, J., Watling, C., Teunissen, P. W., & Brand, P. (2015) Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. Perspectives in Medical Education 4(6), 284–299. https://doi.org/10.1007/s40037-015-0231-7
Levy, L. S., Sexton, P., Willeford, K. S., Barnum, M. G., Guyer, M. S., Gardner, G., & Fincher, A. L. (2009). Clinical instructor characteristics, behaviors and skills in allied health care settings: A literature review. Athletic Training Education Journal, 4(1), 8–13. https://doi.org/10.4085/1947-380X-4.18