Healthcare Externship Handbook SLHS 64900 - Purdue University · PDF fileHealthcare Externship...
Transcript of Healthcare Externship Handbook SLHS 64900 - Purdue University · PDF fileHealthcare Externship...
Healthcare Externship
Handbook
SLHS 64900
A Guide for Graduate Clinicians and Supervisors in Speech-Language Pathology
Department of Speech, Language, and Hearing Sciences 715 Clinic Drive Lyles-Porter Hall
West Lafayette, IN 47907 2018-2019
Please visit our website to view all graduate handbooks: https://www.purdue.edu/hhs/slhs/graduate/handbooks.html
Barbara S.W. Solomon, M.A., CCC-SLP, Healthcare Externship Coordinator
Office Phone: 765-494-3820
Fax: 765-494-0771 [email protected]
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Table of Contents
Introduction to Healthcare Externships ................................................................................... 3
Healthcare Memo....................................................................................................................... 4
Healthcare Externship Checklist ............................................................................................ 5
Problem Solving ..................................................................................................................... 6
Confirmation Letter ................................................................................................................ 7
General Information ............................................................................................................... 8
Memorandum of Agreement ................................................................................................... 10
Extern Sites
Indiana ............................................................................................................................. 13
States Outside of Indiana ................................................................................................. 16
Professionalism Agreement…………………………………………………………………………. 23
Clinical Externship Information Form ...................................................................................... 24
Verification of ASHA Certification ........................................................................................... 25
Attendance Policy .................................................................................................................. 26
Medical Externship Interview Experiences ............................................................................. 27
Healthcare Suggestions/Comments ........................................................................................ 28
ASHA Supervision Standards ................................................................................................... 33
Sample Policy and Procedure for Speech Pathology Graduate Externship Program .............. 34
Sample Externship Clinical Objectives ................................................................................... 36
Sample Externship Clinical Skill Time – Frame ...................................................................... 39
Summary of Client Contact Clock Hours ................................................................................ 40
Supervisor and Clinical Population Data ................................................................................ 42
Externship Clinical Skills Competency Form (CSCF) .............................................................. 44
Feedback Tool: Supervisor(s) and Facility ............................................................................ 55
Practicum Record Form .................................................................................................... ….. 57
American Speech-Language-Hearing Association – Web Site: State Overviews ………………61
State of Indiana Legislation, State Association Contacts and Licensure Information ............... 62
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Introduction to Healthcare Externships Healthcare Externships are scheduled as the last component of the MS-SLP clinical program. Students complete all on-campus coursework and all other clinical assignments before the Healthcare Externship is commenced. This clinical assignment must be at least 10 weeks (full time, five days per week) in length to meet the requirements of the Dept. of Speech, Language, and Hearing Sciences clinical practicum guidelines. Students enroll in SLHS 64900 for a minimum of two credits (P/F). Arrangements for this externship are made between Purdue University and the Healthcare Facility. Students must receive prior approval from the Department of Speech, Language, and Hearing Sciences to take part in this experience. In addition, a contract (Memorandum of Agreement) is required. The objectives for the Healthcare Extern Experience are:
to provide the student with a full-time transition experience between the university environment and professional employment,
to provide the student an opportunity to experience varied approaches and philosophies relating to the professional practice of Speech-Language Pathology and/or Audiology, including diagnostic and rehabilitation clinical practices,
to provide the student direct clinical experience in providing evaluation and treatment services,
to provide the student the opportunity for professional interaction with speech-language pathologists, audiologists, and other professionals in related disciplines, and
to provide the student the opportunity to experience the administrative structure and operations of either a speech-language or audiology program in which patient service delivery is the primary mission, which may include aspects of the following:
Roles and Responsibilities of members of a Rehabilitation Team,
Procedures for documentation of services, such as: chart notes and/or service delivery reports,
Introduction to the financial structure of health-related service delivery, such as: billing and reimbursement issues,
Total Quality Management, Outcome Measurement, and/or Consumer Satisfaction. This manual is designed to be used by Graduate Clinicians and Supervisors through the healthcare externship process.
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MEMORANDUM From: Barbara Solomon Subject: Healthcare Externships Your Name: ___________________________________________________________________ E-mail: _______________________________________________________________________ Expected Graduation Date: _______________________________________________________ Where do you think (City, State) you will do your healthcare externship? _____________________________________________________________________________ _____________________________________________________________________________ Are there Hospitals, Rehabilitation Centers, etc. that you have considered? _____________________________________________________________________________ _____________________________________________________________________________ Do you prefer to do an adult, pediatric, and/or pediatric/adult rotation(s)? _____________________________________________________________________________ _____________________________________________________________________________ When will you do your Healthcare Externship? _____________________________________________________________________________ _____________________________________________________________________________ Questions/Comments: ___________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________
715 Clinic Drive West Lafayette, IN 47907 (765) 494-3789 Fax: (765) 494-0771
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Healthcare Externship Checklist Read through H.E.M. (Healthcare Externship Manual) Contact Externships and set an observation date to become familiar with program Notify Externship Coordinator of visits Bring along a resume, list of classes to be completed by end of program and the healthcare
externship handbook Narrow choices of Externship to a maximum of two Set up an interview with top Externship choice Externship Coordinator contacts the Supervisor/Site and confirms that you will do your
externship there Complete two copies of the application packet within one month of being accepted by the
healthcare program Healthcare Externship Coordinator (H.E.C.) sends out healthcare externship confirmation H.E.C. provides a copy of the letter sent to the Extern Starting dates and length of program are determined Supervisor(s) at your externship is determined and proof of ASHA membership is provided to
Purdue University ________ Determine what requirements you must meet before beginning extern (HIPAA, Risk
Management, Orientation, etc.) Registration for two credits (P/F) in SLHS 64900 is required Externship begins. Student Clinician becomes familiar with Healthcare Extern’s policies and
procedures. Pay particular attention to requirements that pertain to attendance, assignments, etc.
H.E.C contacts Externship 2-4 times during length of program ________ Weekly e-mails are sent to graduate clinicians Completion of Externship:
Summary of client contact clock hours (Yellow Form) External practicum sites for Purdue students (Green Form) Externship competency form Feedback tool: Supervisor(s) and facility Original Copy of Log Card ______ Practicum Record Form
**ALL OF THE ABOVE ITEMS MUST BE COMPLETED TO OBTAIN A GRADE FOR SLHS 64900**
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Problem Solving We know that your healthcare externship will be a positive and productive experience. However, if there are problems or if there is a conflict please follow these suggestions: Step 1: Discuss the concern with the supervisor or student. A discussion should include
information about learning styles and suggestions about the MOST beneficial supervisory style for you as a student clinician. Develop a plan to address areas of concern. Goals should be established.
In general, you should
1. Identify the problem in writing 2. Write down the steps that each of you will take to resolve the problem 3. Arrange a follow-up meeting to determine that progress is being made 4. Contact the Healthcare Extern Coordinator if you need advice in determining how
to present or resolve the problem. If the concern is not resolved: Step 2: Contact the Healthcare Extern Coordinator who will in turn hold a meeting with the
supervisor and the student. The H.E.C. will act as a facilitator. Failure to demonstrate identified competencies may result in: Step 3:
1. An extended placement, 2. Co-supervision by an additional supervisor or 3. Possible removal from the placement
ASHA Clock hours will not be granted for a grade of B- or less, an incomplete, or a “Fail” in SLHS 64900.
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Date XX XX Dear Ms./Mr./Dr. ____________, This letter is to confirm our telephone discussion regarding placement of Purdue graduate student for a speech-language pathology externship in your program at Hospital during the summer of ____ (beginning May 13 for 10 weeks). will have completed appropriate course requirements, and have had prior clinical experience supervised by a member of the Purdue staff. To qualify for an off-campus externship our graduate students must have a minimum of a “B” average in both academic and clinical course work, and must be approved by their major professor and the clinic director. Students are also responsible for providing their own health insurance and professional liability insurance. Evidence of such insurance shall be provided by the graduate student upon request. The medical extern experience is a vital part of pre-professional training in the field of Communication Disorders. Two main purposes of this experience are to enhance clinical skills and increase understanding of the professional and administrative responsibilities of speech-language pathologists in the medical setting (see other objectives enclosed). To this end, each student must be supervised by a staff member holding a current ASHA Certificate of Clinical Competence in Speech-Language Pathology. Participating supervisors are responsible for guiding, mentoring, and evaluating students and for completing a few related forms for our accreditation report. When the externship has concluded, we would like to receive a verification of the clinical clock hours recorded by the student, and an evaluation. You may use the evaluation form provided by Purdue, use an alternate evaluation form of your choice, or simply evaluate the student in a letter to me. Your willingness to be involved in this training experience is greatly appreciated. You may contact me at the numbers listed below, at my direct office number of (765) 494-3820, or by e-mail at [email protected]. I will need to confirm that you have officially accepted the externship application, and that all necessary documentation, including a memorandum of agreement, is on file. I will be consulting with you several times during the externship and I look forward to working with you to assist in making this a very positive experience. Here is the link for our department’s healthcare externship handbook: http://www.purdue.edu/hhs/slhs/graduate/handbook.html Sincerely, Barbara S.W. Solomon, M.A., CCC-SLP Clinical Professor ASHA Fellow Healthcare Externship Coordinator cc: Graduate Clinician
715 Clinic Drive West Lafayette, IN 47907 (765) 494-3789 Fax: (765) 494-0771
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HEALTHCARE EXTERNSHIPS
General Information
Healthcare Externships may be completed at any medical or rehabilitation facility in
which a practicum experience that has an emphasis in pediatric and/or adult care (including voice, dysphagia & neurogenics) can be appropriately provided. The Healthcare Externship must be supervised on-site by a certified speech-language pathologist (i.e., they must have their CCC). Graduate students are encouraged to begin consideration of possible places for the Healthcare Externship as soon as they begin the graduate program. The placement arrangements will be coordinated by Barbara Solomon, M.A., CCC-SLP, Healthcare Externship Coordinator. The process for arranging the Healthcare Externship includes the following:
Student begins to consider possible sites for the Healthcare Externship that they wish to experience. Factors to consider in the selection include: client population, availability of supervision on-site, number of supervisors, length of commute from where you will be living during the externship, & location where you wish to be living during this final phase of your graduate program (NOTE: Students typically initiate this placement process, and ALL STATES are included as possible sites). During the first year of the graduate program, visit potential sites that you are considering:
Contact the director of the Dept. of Speech-Language Therapy, or a lead speech-language
pathologist at the facility & explain that you are interested in visiting them. The purpose of your visit is to explore the possibility of doing a Healthcare Externship at their facility. Therefore, you would like to meet with them to learn about their SLP program, as well as to see the facility.
PUT YOUR BEST FOOT FORWARD with EVERY contact. When you visit the facility, dress professionally & ask questions that will allow you to gain the information you need to determine whether this would be a good place for your externship. Take a well-prepared resume that provides them with an overview of who you are, what your academic background includes, and what type (and potential dates) of externship you are seeking.
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Since you will be visiting & considering more than one facility, you should not make a commitment to any facility at the time of your first visit. Get the name & title of the contact person, their phone number, e-mail address, business card and the complete name and address of the facility. You MUST have this information to include in your Externship Application Packet that you turn in to Mrs. Solomon.
It would be helpful to ask about the patient caseload, length of externship typically required,
possible pediatric/adult rotations, and the type/amount of supervision offered. You may ask if there are skills they would like you to gain (e.g., familiarity with a particular assessment tool) before your placement.
Plan to visit at least 1-3 possible sites for the Healthcare Externship. You will be required to include at least two choices in your Externship Application Packet.
During the Spring Semester of the first year of graduate school, you will be given an Externship Application Packet (with directions for completion) that you must submit to the Externship Coordinator so that formal placement arrangements can be made.
Important considerations:
Sites for Healthcare Externships may be in high demand. To make the best possible impression on a potential site, you should consider doing any/all of the following:
Volunteer to assist the SLP’s during your vacation/breaks.
Prepare a portfolio that demonstrates your clinical skills (lesson plans, reports, etc.).
Have a list of references (name, title, address, & phone number) available; in some cases you may be required to include letters of recommendation.
Some sites will require you to take a pre-externship exam. Don’t panic! This is a procedure that is used to determine what baseline information you would have when/if you work in their facility. DO tell them what courses you have not yet taken, but WILL take before you do a Healthcare Externship. The earlier you visit, determine your choices, and submit the Externship Application, the sooner you may be placed and a Memorandum of Agreement established. Many sites now arrange placements up to one year in advance.
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MEMORANDUM OF AGREEMENT CLINICAL EXTERNSHIP IN SPEECH-LANGUAGE PATHOLOGY/AUDIOLOGY
This agreement is made and entered into effective the _______________________ day of __________________________ 20______, by and between Purdue University on behalf of the Department of Speech, Language, and Hearing Sciences, hereinafter referred to as the "UNIVERSITY", and ___________________________________________________________________ hereinafter referred to as the "EXTERN FACILITY", located at FACILITY ADDRESS:____________________________________________________ ________________________________________________________________________ Whereas, the UNIVERSITY has graduate student speech-language pathologists/audiologists who would benefit from clinical learning experiences; Whereas, the EXTERN FACILITY has certain facilities that would be beneficial to graduate students in speech-language pathology/audiology; Now, therefore, in consideration of the mutual promises herein, it is agreed that: (1) The EXTERN FACILITY will be made available to graduate student speech-language
pathologists/audiologists from the UNIVERSITY. (2) The UNIVERSITY will provide information about the graduate student and the externship objectives. (3) Student extern assignments and minimal levels of academic preparation and clinical learning
experiences for the student will follow the nationally recognized certification standards of the American Speech-Language-Hearing Association (“ASHA”).
(4) The UNIVERSITY and the EXTERN FACILITY shall each designate a staff representative
who will be responsible for coordinating clinical learning experiences for the student. The
representatives will also be responsible for insuring that supervision of students meets the
minimum requirements established by the Council of Academic Accreditation (“CAA”) of
the American Speech-Language-Hearing Association. The EXTERN FACILITY
representative has authority to plan and arrange the work schedule of the student. (5) The EXTERN FACILITY will maintain records concerning the progress/evaluation and clinical
contact hours for each student. Clinical contact records provided by the UNIVERSITY shall conform to the format suggested by the CAA of the ASHA. Student progress/evaluation records and clinical contact records shall be forwarded to the UNIVERSITY at the completion of the assignment.
(6) The EXTERN FACILITY will retain full responsibility for patient care by providing appropriate
professional supervision of students. (7) The graduate students will conform to all procedures and policies established by the EXTERN
FACILITY for the duration of the assignment. (8) The graduate student will maintain in effect liability malpractice insurance and is responsible for
providing his or her own health insurance. Evidence of such insurance shall be provided to the EXTERN FACILITY prior to the arrival of the student.
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(9) Prior to the start of the clinical learning experience the University shall provide EXTERN FACILITY with a Certificate of Insurance evidencing professional liability coverage for the student with limits of not less than $1,000,000.00 per occurrence and $3,000,000.00 aggregate.
(10) This agreement shall be in effect until terminated by either party. Either party may terminate this
agreement upon written notice to the other. Notice will be given enough in advance to allow for all currently enrolled graduate students to complete their externships.
EXTERN FACILITY: Date Date PURDUE UNIVERSITY: ____________________________________________Date ______________________________ Contract Analyst: ____________________________________________Date ______________________________ SLHS Externship Coordinator:
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Purdue University Department of Speech, Language, and Hearing Sciences
The objectives for the Healthcare Extern Experience are:
to provide the student with a full-time transition experience between the university environment and professional employment,
to provide the student an opportunity to experience varied approaches and philosophies relating to the professional practice of Speech-Language Pathology and/or Audiology, including diagnostic and rehabilitation clinical practices,
to provide the student direct clinical experience in providing evaluation and treatment services,
to provide the student the opportunity for professional interaction with speech-language
pathologists, audiologists, and other professionals in related disciplines, and
to provide the student the opportunity to experience the administrative structure and operations of either a speech-language, or audiology program in which patient service delivery is the primary mission, which may include aspects of the following:
Roles and Responsibilities of members of a Rehabilitation Team,
Procedures for documentation of services, such as: chart notes and/or service delivery reports,
Introduction to the financial structure of health-related service delivery, such as: billing and reimbursement issues,
Total Quality Management, Outcome Measurement, and/or Consumer Satisfaction.
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Purdue University has had contracts with the following: INDIANA HEALTHCARE EXTERNSHIP LOCATIONS (UPDATED: 2.14.18)
LOCATION CITY, STATE
A Step Ahead Indianapolis, IN
A Work in Progress Indianapolis, IN
Allisonville Meadows Fishers, IN
American Senior Communities Indianapolis, IN
Community Hospital Munster, IN
Community Hospitals of Indiana, Inc. & Hospital South, Inc. (Community Hospital Hook Rehab)
Indianapolis, IN
Community Howard Regional Health Kokomo, IN
Cornerstone Autism Lafayette, IN
Courter Communications, LLC Carmel, IN
Cumberland Pointe West Lafayette, IN
Deaconess Hospital Evansville, IN
Easterseals Crossroads Indianapolis, IN
Easterseals Rehab Center Evansville, IN
Elkhart General Hospital Elkhart, IN
ENT Associates Fort Wayne, IN
Eskenazi Hospital Indianapolis, IN
Franciscan Health- Crown Point Crown Point, IN
Franciscan Health- Rensselaer Rensselaer, IN
Franciscan St. Francis Health Indianapolis, IN
Goshen General Hospital Goshen, IN
Hancock Regional Health Greenfield, IN
Hendricks Regional Health Danville, IN
Hopebridge Pediatric Specialists Kokomo, IN
Hooverwood, The Indianapolis Jewish Home Indianapolis, IN
Howard Regional Health System Kokomo, IN
Indiana School for the Deaf Indianapolis, IN
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Indy Pediatric Speech Solutions Indianapolis, IN
IU Health Bloomington Bloomington, IN
IU Health (University Hospital, Methodist, Riley) Indianapolis, IN
Kindred Rehab Care (Regency Place) Lafayette, IN
Kingston Care Centers of Fort Wayne Fort Wayne, IN
Lafayette ENT Lafayette, IN
Lafayette Regional Rehabilitation Hospital (LRRH) Lafayette, IN
Life Care Centers Indianapolis, IN
Lutheran Hospital of Indiana, Inc. Fort Wayne, IN
Memorial Hospital South Bend, IN
Methodist Hospital Merrillville, IN
North Central Speech-Pathology Services Hobart, IN
Otolaryngology and Associates Indianapolis, IN
Paragon Rehabilitation, Inc. Indianapolis, IN
Parkview Memorial Hospital Fort Wayne, IN
Pediatric Physical Therapy Services Lafayette, IN
Positive Result Therapies Kokomo, IN
Rehabilitation Hospital of Indiana Inc. “RHI”
Indianapolis, IN
Riverview Hospital
Noblesville, IN
Speech Pathways Lafayette, IN
St. Anthony Healthcare Lafayette, IN
St. Elizabeth Regional Health Lafayette, IN
St. Joseph Community Hospital of Mishawaka, Inc. Mishawaka, IN
St. Margaret Hospital and Health Center (Franciscan Health) Hammond, IN
St. Mary’s Hospital Hobart, IN
St. Vincent’s Health Evansville, IN
St. Vincent Hospitals and Health Services Indianapolis, IN
Union Hospital Terre Haute, IN
University Place West Lafayette, IN
Veterans Administration Medical Center Indianapolis, IN
Voice Clinic of Indiana Carmel, IN
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Purdue University has had contracts with the following: OUT-OF-STATE HEALTHCARE EXTERNSHIP LOCATIONS (UPDATED: 2.14.18)
LOCATION CITY, STATE
Advocate Health Hazel Crest, IL
Akron Children’s Hospital Akron, OH
Alexian Brothers Hospital Network Schaumburg, IL
All Bright Therapies Chicago, IL
American Institute for Stuttering New York City, NY
Associates in Pediatric Therapy Louisville, KY
Atlantic Health System Morristown, NJ
Aurora Sheboygan Memorial Hospital Milwaukee, WI
Banner Health Phoenix, AZ
Barnes-Jewish Hospital St. Louis, MO
Barrow Neurological Institute at St. Joseph’s Hospital Phoenix, AZ
Baylor University Medical Center Dallas, TX
Bilingual Therapies Chicago, IL
Blaine Block Institute Cincinnati, OH
Briarwood Milestones Ann Arbor, MI
Brigham Women’s Hospital Boston, MA
California Pacific Medical Center San Francisco, CA
Cardinal Hill Rehab Hosp. Louisville, KY
Carle Clinic Association Urbana, IL
Case Medical Center Cleveland, OH
Cedars Sinai Medical Center Los Angeles, CA
Center for Bilingual SLP (The) Miami, FL
Center for Life Skills
Solon, OH
Center for Pediatric Therapy Miami & Coral Gables, FL
Central Coast Language and Learning Center Monterrey, CA
Central DuPage Hospital
Winfield, IL
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Central Florida Speech and Hearing Lakeland, FL
Central Maine Medical Center
Lewistown, ME
Centre for Neuro Skills Bakersfield, CA
Charlotte Speech and Hearing Clinic Charlotte, NC
Child Serve Rehab
Johnston, IA
Children’s Healthcare of Atlanta
Atlanta, GA
Children’s Hospital/Mott Children’s Ann Arbor, MI
Children’s Hospital
Detroit, MI
Children’s Hospital
Cincinnati, OH
Children’s Hospital
Denver, CO
Children’s Hospital and Research Center Oakland, CA
Children’s Hospital Orange, CA
Children’s Hospital Los Angeles, CA
Children’s Hospital San Diego, CA
Children’s Hospital and Health Center Pittsburgh, PA
Children’s National Medical Center Washington, D.C.
Chilton Memorial NJ
Christus Santa Rosa Healthcare San Antonio, TX
Christus Spohn Hospital Corpus Christi Corpus Christi, CA
CLASS Federal Way, WA
Cleveland Clinic Foundation (The) Cleveland, OH
Cleveland Speech and Hearing Cleveland, OH
Columbia University Medical Center/Presbyterian Hospital New York, NY
Communication Innovations Therapy Madison, WI
Condell Medical Center Vernon Hills, IL
Cook Children’s Healthcare System Fort Worth, TX
CPT Rehab Addison, IL
Denver Health Medical Denver, CO
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Drake Center Cincinnati, OH
Duke University Medical Center
Durham, NC
DuPont Children’s Hospital
Wilmington, DE
Durham Regional Hospital Durham, NC
East Ohio Regional Hospital
Martins Ferry, OH
East Tennessee Children’s Hospital
Knoxville, TN
Easterseals of Southern California Southern California
Edward Hospital
Naperville, FL
Fraser Minneapolis, MN
Frazier Rehab Institute
Louisville, KY
Froedtert Milwaukee, WI
Genesis Medical Center Davenport, IA
GF Strong Rehabilitation Centre Vancouver, BC
Goepfert Speech Associates Hershey, PA
Good Samaritan Hospital of Maryland, Inc. (The)
Baltimore, MD
Good Shepherd Penn Partners Philadelphia, PA
Greater Baltimore Medical Center Baltimore, MD
Harborview Medical Center Seattle, WA
Hasbro Children’s Hospital Providence, RI
Healthpro Heritage Chicago, IL (other locations)
Health South Austin, TX
Helen Devos Children’s Hospital Grand Rapids, MI
Hennepin Co. Medical Center Minneapolis, MN
Henry Ford Health System Detroit, MI
Holy Cross Hospital Silver Spring, MD
Illinois Masonic Medical Center Chicago, IL
Ingalls Memorial Hospital Harvey, IL
Jackson Memorial Hospital Miami, FL
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John F. Kennedy Medical Center Edison, NJ
Kennedy Krieger Institute Baltimore, MD
Kessler Institute of Rehabilitation Saddle Brook NJ
Lahey Clinic Boston, MA
Lancaster General Lancaster, PA
Long Island Jewish New Hyde Park, NY
Loyola University Medical Center Chicago, IL
Lurie Children’s Hospital of Chicago Chicago, IL
Magee Rehabilitation
Philadelphia, PA
Manor Care
MARIANJOY, Inc.
Wheaton, IL
Mary Free Bed Hospital
Grand Rapids, MI
Massachusetts General Hospital
Boston, MA
M.D. Anderson
Houston, TX
Medstar (National Rehab Hospital) Washington, D.C.
Memorial Health University Medical Center
Savannah, GA
Memorial Herman (TIRR) Texas
Memorial Hospital
Colorado Springs, CO
Memorial Hospital Pawtucket, RI
Memorial Medical Center Springfield, IL
Memorial Regional Hospital Hollywood, FL
Mercy Health Muskegon, MI
Mercy Health Cincinnati, OH
Mercy Health Norton Rehabilitation
Norton Shores, MI
Mercy Medical Center
Cedar Rapids, IA
Merit Care Fargo, ND
Miami Children’s Hospital Miami, FL
Miami Valley Hospital
Dayton, OH
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Milestone Therapy Mokena, IL
Morton Plant Hospital Clearwater, FL
Mount Sinai Medical Center New York, NY
Nassau University Medical Center
East Meadow, NY
NHC Murfreesboro, TN
Northwest Hospital Seattle, WA
Northshore University Health System Chicago, IL
Northwestern Memorial Healthcare Chicago, IL
Norton-Kosairs Hospital
Louisville, KY
NYU- Rusk New York, NY
Orlando Regional Healthcare
Orlando, FL
OSF Healthcare System
Peoria, IL
Pediatric Therapy Associates
Miami, FL
Porter Memorial Hospital Valparaiso, IN
Provena St. Joseph’s
Joliet, IL
Rady Children’s Hospital
San Diego, CA
Rehabilitation Institute of Michigan
Detroit, MI
Ridgeview Medical Center Chaska, MN
Rockford Memorial Hospital Rockford, IL
Schwab Rehab Center Chicago, IL
Seattle Children’s Hospital
Seattle, WA
Sentara Hospitals Virginia Beach, VA
Sharp Rehabilitation Center
San Diego, CA
Shirley Ryan Ability Lab (RIC) Chicago, IL
Shriner’s Chicago, IL
Silver Cross Hospital New Lenox, IL
South Miami Hospital, Inc.
Miami, FL
Sparrow Hospital Lansing, MI
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Spaulding Rehabilitation Hospital Boston, MA
Speech and Language Resources Framingham, MA
Spot on Therapies Naperville, IL
St. Elizabeth’s Hospital
Edgewood, KY
St. Francis Hospital
Tulsa, OK
St. John Hospital
Springfield, IL
St. John Medical Center
Tulsa, OK
St. Joseph Mercy Ypsilanti, MI
St. Joseph’s Hospital of Atlanta Atlanta, GA
St. Joseph’s Hospital and Medical Center
Phoenix, AZ
St. Louis Children’s Hospital
St. Louis, MO
St. Luke’s Hospital
Chesterfield, MO
St. Luke’s Medical Center
Milwaukee, WI
St. Mary’s Medical Center
West Palm Beach, FL
St. Paul Rehab
St. Paul, MN
Swedish American Hospital
Rockford, IL
Tampa General Hospital
Tampa, FL
Texas Children’s Hospital
Houston, TX
Thornapple Manor Hastings, MI
Trinitas Regional Medical Center Elizabeth, NJ
Trinity Medical Center Rock Island, IL
Tucson Medical Center Tucson, AZ
UC Davis Sacramento, CA
UNC Hospitals Chapel Hill, NC
University Center for the Development of Language and Literacy
Ann Arbor, MI
University Health System Bexar County, TX
University of California at San Francisco
San Francisco, CA
University of Illinois at Chicago Chicago, IL
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University of Kentucky Lexington, KY
University of Colorado Hospital Denver, CO
University of Michigan Health System (UCLL)
Ann Arbor, MI
University of Texas Medical Branch (UTMB)
Galveston, TX
University of Washington-Medical Center
Seattle, WA
University of Wisconsin Hospital Madison, WI
Veterans Administration Medical Center (The) Augusta, GA
Veterans Administration Medical Center (The)
Boston, MA
Veterans Administration Medical Center (The)
Chicago, IL
Veterans Administration Medical Center (The)
Danville, IL
Veterans Administration Medical Center (The)
Fort Howard, MD
Veterans Administration Medical Center
Lexington, KY
Veterans Administration Medical Center (The) Martinsburg, WV
Veterans Administration Medical Center (The)
Milwaukee, WI
Veterans Administration Medical Center (The)
Portland, OR
Via Christi Regional Medical Center
Wichita, KS
Virginia Commonwealth: University Medical Center of Virginia Richmond, VA
Wake Forest University Baptist Medical Center
Winston Salem, NC
Wake Med Cary Outpatient Rehabilitation
Cary, NC
Weisskopf Child Evaluation Center
Louisville, KY
Westmoreland Regional Hospital-The Barclay Rehab Center
Greensburg, PA
Wheaton Franciscan Healthcare/ Ascension Milwaukee, WI
William Beaumont Hospital
Royal Oak, MI
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PROFESSIONALISM AGREEMENT
During my SLHS 649 experience, I am a guest at the healthcare externship setting. I
understand that my task is to learn so that I can become a more effective educational
professional. I agree to abide by the specific institutional values and policies as well as
highest standards of professionalism at all times.
I agree to maintain professional, legal, and ethical conduct at all times. I will respect the
privacy of all clients/patients, families, and medical professionals and protect the
confidentiality of confidential personal information that I encounter.
I agree to be on site when and where I am expected. In the event that I cannot attend or
will be late, I will follow proper notification procedures to let the appropriate individuals
know in advance.
I agree to maintain a professional demeanor and appearance, in accordance with the
standards of the site where I am placed.
I agree to complete my assigned tasks, duties, and responsibilities on time.
I agree to interact and communicate in a positive and professional manner with all
clients/patients, families, and medical professionals. I will avoid bias, prejudice, or lack of
fairness toward individuals or groups of people.
I agree to remain committed to improving my own instructional practices. I will remain
flexible and open to feedback from others.
I agree to demonstrate commitment to my field of study and to the speech-language
pathology profession.
I agree to follow the ASHA Code of Ethics and Scope of Practice.
I understand that failure to comply with this agreement may result in the execution of a
remediation plan and/or placement termination. ASHA clock hours will not be granted
for an incomplete or a “Fail” in SLHS 649.
__________________________________________ _____________________
Healthcare Externship Coordinator Date
__________________________________________ _____________________
SLHS 649 Graduate Student Date
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CLINICAL EXTERNSHIP INFORMATION FOR BARBARA SOLOMON NAME EXTERN FACILITY ADDRESS DURING EXTERNSHIP CITY STATE ZIP RESIDENCE PHONE DURING EXTERNSHIP ( ) E-Mail ______________________________________________ EXTERN DATES to YOUR SUPERVISOR (IF KNOWN) IMPORTANT: TO RECEIVE AN EXTERNSHIP GRADE YOU MUST RETURN THE ATTACHED FORMS – (1.) EXTERNAL PRACTICUM – SUMMARY OF CLIENT CONTACT CLOCK HOURS (YELLOW FORM) (2.) EXTERNAL PRACTICUM SITES FOR PURDUE STUDENTS: SUPERVISOR AND CLINICAL POPULATION DATA (GREEN FORM) (3.) PURDUE UNIVERSITY EXTERNSHIP COMPETENCY FORM (WHITE FORM). Plan a final conference with your supervisor to go over the evaluation. See that the above forms are returned to me before the end of the semester in which you are doing your externship. Please include a breakdown of your acquired clinical clock hours and any comments you feel would be informative for the next graduate student to utilize the facility. Also, be sure to have your supervisor sign your log cards and include his/her ASHA ID number.
715 Clinic Drive West Lafayette, IN 47907 (765) 494-3789 Fax: (765) 494-0771
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Attention: Barbara Solomon, Healthcare Coordinator Department of Speech, Language And Hearing Sciences
VERIFICATION OF ASHA CERTIFICATION Please fill in the information below and fax or mail it back in the envelope provided.
Name of Purdue Extern Student__________________________________________ Extern Facility________________________________________________________ Address of Facility_____________________________________________________ Extern Date(s)_________________________________________________________ Extern Facility e-mail___________________________________________________ Name of all Supervisor(s) ASHA# State Phone # E-Mail Who will Provide Supervision License # ________________________ ______________ ______ ____________ _________________ ________________________ ______________ ______ ____________ _________________ ________________________ ______________ ______ ____________ _________________
(Use additional sheets for supervisors’ ASHA Membership cards)
C CCopy of
715 Clinic Drive West Lafayette, IN 47907 (765) 494-3789 Fax: (765) 494-0771
Copy of
ASHA Membership
Card
Copy of
ASHA Membership
Card
Copy of
ASHA Membership
Card
Copy of
ASHA Membership
Card
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Attendance Policy Purdue University requires that graduate Clinicians participate in their Healthcare Externship for a minimum of ten weeks of full-time experience. Absences are to be avoided and must be approved by your externship supervisor. The SLHS Externship Coordinator must be notified of any absences. If you need to take time off (due to illness, critical family responsibilities, etc) you must complete a minimum of 40 working days to receive a passing grade in SLHS 64900. Purdue’s requirements are suggestions. Your healthcare extern supervisor will determine the attendance policy. Some externships have strict policies regarding any days missed and these days are usually added on to the original end date of the externship. Establish the externship’s policy at the beginning of your experience. How many days will you be able to take for personal or medical reasons? If days need to be made-up when will those occur? At the end of your experience? On Saturdays? If your experience needs to be extended please plan accordingly.
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Medical Externship Interview Experience: From a past student: Interviewing for my medical externship site was interesting, to say the least. Here are some things to keep in mind:
Start Early!!!!!
Scout out several hospitals in the area where you’d like to be.
There are several reasons for this: 1. Some hospitals, unbelievably, will have already chosen someone (even though
you’re doing this almost a year-and-a-half in advance)! 2. Some hospitals have loyalties to particular universities! 3. Depending on the type of facility you have chosen (e.g., private vs. public), getting
an approved contract can take up to 10 months!
Don’t settle with a particular facility immediately. Although they may want to know your decision immediately, you have A LOT of time here! Tell them you’ll let them know within a week. Why?? You need to see what else is out there.
I visited three hospitals within a one week period during the spring break of my second semester.
I had the opportunity to see a variety of facilities (from county run to university centered to rehabilitation only). It was well worth the time to visit each site. Had I chosen the first one I visited, I definitely would have been disappointed in the long run.
I felt that all three of my interviews were very different from those of my fellow graduate students. I didn’t have to take a test, nor did I encounter any grueling questions. Unfortunately, you are attending these interviews early in your first year, so the knowledge you currently have is quite under-representative of the expertise you will actually have at the conclusion of your graduate career. Keep this in mind and don’t be afraid to reiterate this information, especially if they’ve seen how few hours you have on your log cards. My interview was with the Head of the Department of Speech Pathology, however, this is generally not the case. Most often you meet with someone referred to as the “Externship Coordinator/Supervisor.” This person has the most integral role in determining whether or not you will be accepted, what the length of the externship will be, as well as providing much of your supervision while you are there. You want to make sure you ask what the minimum length of the externship should be. This is because SLHS states that it must be a period of at least 8 weeks, but many facilities prefer at least ten or as many as twelve to fourteen. Ask about the caseload, in reference to acute versus rehabilitation, as well as child versus adult. Most facilities are impressed that Purdue offers such a wide range of courses, including Dysphagia, Pediatric Oral Motor, and Traumatic Brain Injury. This is because other universities only offer this coursework as a portion of other courses. Much of the interview focused on my interests and the areas in which I felt I would like more expertise. My interview was very relaxed (in terms of pressure) in comparison to others, but I felt they learned a lot about me, as I did them.
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HEALTHCARE SUGGESTIONS/COMMENTS/IDEAS FROM THE GRADUATING CLASS OF 2015!
1) YOUR CLINICAL SKILLS
a. I would recommend reviewing your CSCF from the first externship during the second
externship to pinpoint areas you've progressed in, as well as areas for additional growth.
2) RESOURCES
a. Make copies of every resource, therapy activity, and idea ...everything!! (As long as your
supervisor says ok to it!) This way you'll have an abundance of information/resources for
future use!
b. Use everyone as a resource, not only your supervisor, and discuss ideas/create
relationships with others (e.g., other teachers, PT's, OT's, and other professionals.)
Specifically having those conversations I think gave me different perspectives and
increased my knowledge on different therapy approaches as well as general knowledge
regarding different professional scopes.
c. My biggest suggestion would be to look through all the formal speech/language/cognitive
tests possible before leaving Purdue.
d. If you are working in a more specialized setting, take the time to study the specialty
before and during your externship. Don't be afraid to ask your supervisor for any
information they may have. If it's a big organization, chances are they have lots of
resources for you regarding many areas. I am working inpatient rehab but had interest in
learning about infant feeding-I asked for information about it and got a ton!
e. My suggestion is to take advantage of the resources (both people and therapy materials)
available to you during your externships. You're surrounded by people who have a wealth
of knowledge, so ask all the questions you can. If there's a handout or a worksheet that
you like, make a copy of it (if permissible). If there are certain phrases or wordings that
your supervisor consistently uses in his/her reports, write them down. Ask your
supervisors what materials they have found particularly useful and what they would
recommend for someone just starting. Externships are a time to learn as much as possible,
so don't be afraid to let your curiosity show!
f. Utilize their materials! It is great if you can bring in some of your own, but their materials
are yours to use and they will be much more appreciative if you can bring a new spin to
their old materials so they can continue to use your ideas in the future.
g. Email your supervisors early on and ask if they have any suggested readings for the
populations you will be seeing a lot of. I did this, and my supervisors gave me a lot of
research to read and learn ahead of time that has helped me greatly during therapy.
h. My advice for future classes regarding externships is to take advantage of the resources
available at their placements. It can definitely be overwhelming to begin a new placement
and take over the caseload within the first few weeks, but if you take some time to go
through materials and ask your supervisor about resources, it can be a great opportunity
to learn more. If they are in a setting where multiple disciplines make up the treatment
team, I highly recommend asking other professionals questions… and take notes! There
are so many things I wrote down the first few weeks that I would've definitely forgotten,
but I have compiled a lot of great resources and knowledge in a notebook.
i. Spend extra time planning and looking up materials your first couple of week. It will put
you ahead of the curve at the beginning and make a good impression. As you get used to
the clients and therapy you won't need as much time to plan.
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j. I would advise them to really use their supervisors as resources about not only the
specific placement duties -- but also about general career advice.
3) BEING CONFIDENT
a. Once you are treating patients independently or even co-treating, act like a provider and
not like a student! Speak with confidence so the patient knows they are well taken care
of.
b. Try to show as much confidence as possible even if you may not be feeling too confident
on the inside. I learned over the two years of grad school that appearing confident can
get you very far. Of course confidence comes with experience, but at your externship
have your game face on as much as possible and know that everyone at Purdue made sure
you are ready for this (and if you don't feel that way work on your game face in the
mirror and fake it until you do feel that way!!! It won't take long for it to all come
naturally).
c. You know more than you think you do. You should feel confident in your knowledge and
skills!
d. Be confident! We all know more than we think we do and it is important to show that at
your externships. Your supervisors appreciate your input, so do not be afraid to give it.
4) TERMINOLOGY
a. Google-google-google medical terminology you don't understand! Make a list because
you will most likely see the same terms over and over again.
b. For anyone coming to RIC, it would be helpful to review the main disorders that you may
see (types of stroke, dysarthria, TBI, encephalopathy, aphasia, dysphagia, etc.) and
maybe have some running ideas for therapy ideas for goals such as auditory
comprehension, expression, executive functioning, etc.
5) BE PREPARED FOR ANYTHING!
a. Even if you have your externship lined up a year and a half in advance it is possible that
it could fall through. Not likely, but possible! If something of this nature happens, don't
freak out like I did because it will all work out in the end (Mrs. Solomon will save the
day :)!). I think that could apply to getting to your externship and it not being what you
expected also. If your mind is open and you are prepared for anything I think that will
make it a less stressful; and more meaningful experience in the end!
6) LEARNING OPPORTUNITIES
a. Take every opportunity you can in your externships. Even if it's not something you see
yourself doing in your career, if there's a learning opportunity, you only stand to benefit.
b. Ask a lot of questions and find opportunities to learn as much as you can. Your
supervisors want to help you and are able to help you find opportunities for observations
at other places. I was able to observe at the NICU and spend some time observing with
OTs and PTs. This was extremely helpful for me because I feel more confident that I
could refer children to them now.
7) WORK WEEK
a. Know that you’ll be in for some crazy hours. It's not unusual for me to end up putting in
an additional 1-3 hours for documentation outside the scheduled work week: I'm in
before 8 every day and there for 11-12 hours most days
8) TEAMS
a. Try to work with/observe other disciplines. I saw OT's, PT's, dieticians, respiratory
therapists, a developmental/behavioral team, and MD's (plastic surgeons, GI specialists,
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developmental pediatricians). If you get to work with surgeons, try and observe a
surgery. I saw a double flap palatoplasty which really helped me understand what occurs
anatomically with children with cleft palate. Observing others also helped me understand
what is in our scope of practice. If you have an outpatient placement, try and observe
inpatient too. It helped me understand how everything fits together
9) WE KNOW SO MUCH!
a. I would say that in general I think we were all so much more well-prepared than any of us
thought we were. It has been fun to get to use the knowledge that we worked so hard to
gain in class/clinic! That sounds cheesy but it is true. I would also tell them that it is a
very valuable trait to be able to complete paperwork quickly but thoroughly. If it takes
too much time, it will take away from your experience. You don't want to be too bogged
down with paperwork! I was thankful that my supervisor highly advised that my
treatment notes not take too long.
10) JOURNAL
a. Make a "goal" sheet as you're writing evals/individualizing goals for patients. This is one
area I felt lagging in after leaving campus. It's impossible to get good at EVERYTHING
by the time you leave Purdue, and goal writing is one of those things I had a tough time
with at first. I've had to come up with some pretty general goals that I now use often and
some really specific goals for the "special cases." They are great to have as a reference
when you need to get creative.
b. Make copies of all activities you use during your externship. Start a "bank" of different
tasks so you have something to go off of during your first job. Use file folders (or some
sort of organization) to separate language/cognition and all their subcategories (e.g.
expression - verbal and written, comprehension - reading and auditory, cognition -
memory, problem solving/reasoning, attention/concentration, visuospatial, numerical
reasoning, executive functioning, etc.) This has been so helpful for me to organize
different tasks, and now I have hundreds to start with thanks to my supervising SLP!!
c. Keep a notebook throughout your placement to write down any new terms you encounter
and their definitions. Especially in inpatient, there is an entirely different language
through which medical professionals communicate and some of your success at your
placement hinges on being able to understand those terms. You can also write down
acronyms, as a lot of docs will write many in their notes without defining them.
11) OBSERVE
a. Observe as many different clinicians as possible. This is the last true observation time
you get, and you'll want to see as many different styles as possible to determine what you
think you like and what you may not like so much.
b. Try to observe other disciplines if they will let you at your placement. Some of the most
valuable experiences I gained at my externships were when I branched out and observe
OT, PT, social work, etc. This is the last opportunity you will have as a "student" in
name, so make it count and learn all you possibly can.
12) ASK QUESTIONS
a. My suggestion for the next class is to not be afraid to tell your supervisor(s) where you
would like more help/additional experience. I wasn't feeling very strong with goal
writing, so I told my supervisors I'd like more practice, and they were appreciative that I
told them.
b. Ask to see things while you are there!!! I have really taken advantage of being at a large
hospital. I've often asked my supervisor if I can see a specific kind of patient or see
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another aspect of speech (e.g., inpatient peds, outpatient peds, outpatient adults, the voice
center, etc.). I have even asked to spend the day with different supervisors within
inpatient adult. My supervisor is more than willing! Don't feel like you need to stay in
that one setting for the whole summer. This is a prime opportunity to find out what
interests you and what doesn't.
c. Even if your supervisors aren't comfortable letting you take over some aspect of their job
(making diet recommendations, filling out Medicaid paperwork, etc.) ask if you can give
it a shot, they can give you feedback, and then they can complete the actual work. It helps
to get in all the practice you can even if they technically won't allow you to do it. Also,
consider getting practice with situations you may not encounter during your externship
but could in a job. For example, if you don't get practice writing goals for a certain kind
of client, ask to go over some hypothetical situations.
d. Requesting written feedback every week has been very helpful for seeing growth. If you
or your supervisors aren't documenting it, it is would be very easy to forget the good
things you did each week.
e. When appropriate once at your externship, make sure to ask for extra opportunities to
observe/participate if you want to learn more. For example, by asking, I was able to
observe pediatric OT and PT services when we had outpatients cancel. I also got to
observe another SLP do a 2-month infant VFSS and another SLP that worked with
different populations. If I hadn’t asked, I wouldn’t have gotten those opportunities.
Usually, people were more than happy to host an extern when I asked my supervisor for
help arranging the experiences.
f. If they don't give feedback readily, make sure you ask for it. It can be quite a shock if you
hit midterm and you have a different feeling for how your externship is going than they
do. Be honest with them about where you thought you could improve from specific
sessions and ask for their suggestions.
g. Take advantage of new opportunities. On our "slow" days, I have tried to be assertive
about observing other disciplines, and found all to be interesting and valuable
experiences!
h. Ask lots of questions! Your supervisor(s) are there to teach you and share their
knowledge base with you, take advantage of what they have to offer!
i. Ask to observe other therapies (OT, PT, etc.) if possible. Or even ask to observe at
another facility if they offer something that's not at your placement (I observed at a Level
3 NICU)!
j. Never be afraid to ask for help. Sometimes it is difficult to admit you don't know
something, but it is way worse to go on without knowing the correct answer/way to do
something!
k. Always ask for feedback/advice and keep communication open. It's helpful to me to ask
my supervisor what she would have done differently after I lead a session.
l. Ask for observation opportunities with other SLPs who work there and who might
specialize in something different. I've learned a lot from these observation opportunities,
and sometimes it's nice to get a different perspective.
13) BE YOURSELF!
a. Be friendly with all assistants, aids, techs, etc. These people can make your job a lot
easier!
b. Make an effort to get to know all of the SLPs on the team your first week at the
externship. It makes your position there more comfortable and "semi-permanent" instead
of just a short time student. Also, chances are you'll share clients and need to discuss their
cases or be supervised by the other SLPS when your supervisor is unavailable.
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14) MISCELLANEOUS
a. Ask your facility if they will be providing you with scrubs before going out and buying
your own! You will most likely never wear that particular color again and they are oddly
expensive.
b. See if you could stop in and observe for a day before you start. I was totally blown away
by the diversity of my patients, their backgrounds and their disorders, and having a little
more time to process everything I think really would've helped
c. Always be thinking about how the things you're learning fit into the "big picture"
d. I would encourage students to get some experience with FEES interpretation. I think we
get a lot of experience interpreting VFSS (particularly at the IUHA), but I wasn't very
familiar with FEES (luckily I caught on quickly). Watching flexible endoscopy at ENT
was helpful in preparing me for FEES interpretation.
e. If leaning toward medical setting interest, consider two healthcare externships vs. only
one. Talk with an advisor, previous students, etc to get an idea of the pros and cons of
two vs one healthcare externship. (I somewhat regret not considering this more
seriously).
f. When you go to perspective externship sites for observations/interviews, make sure you
consider who your supervisor would be just as much as (if not more than) you consider
the placement/facility itself. The majority of your learning and day-to-day experiences
will rest on your supervisor. Make sure the person seems like he/she will mesh with your
personality, learning style, and interests to ensure you have the most enjoyable and
beneficial externship experience.
15) BE UP FOR A CHALLENGE
a. Be up for a challenge (in your externships and all your placements). Of course, don't do
anything you're uncomfortable with, and a good supervisor should never make you feel
out of your depth, but try and push yourself to do new things at your externship like
working with a population you didn't think you had any interest in. You will learn about
an area you weren't necessarily interest in and you will definitely learn a lot about
yourself.
b. DON'T PANIC BEFORE! Your supervisor knows you are a student and will not expect
you to know everything! Remember, it is part of your education and a learning
experience. They know that they will have to teach you and help you master certain
skills!
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American Speech-Language-Hearing Association Membership & Certification Handbook
Speech-Language Pathology - 2014 Standards & Implementation Procedures
Standard V-e
Supervision must be provided by individuals who hold the Certificate of Clinical
Competence in the appropriate profession. The amount of direct supervision must be
commensurate with the student's knowledge, skills, and experience, must not be less than
25% of the student's total contact with each client/patient, and must take place periodically
throughout the practicum. Supervision must be sufficient to ensure the welfare of the
client/patient.
Implementation: Direct supervision must be in real time. A supervisor must be available to
consult with a student providing clinical services to the supervisor's client. Supervision of
clinical practicum is intended to provide guidance and feedback and to facilitate the student's
acquisition of essential clinical skills. The 25% supervision standard is a minimum requirement
and should be adjusted upward whenever the student's level of knowledge, skills, and experience
warrants.
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POLICY AND PROCEDURE FOR SPEECH PATHOLOGY GRADUATE EXTERNSHIP PROGRAM AT WINONA HOSPITAL
(Used with permission from Winona Hospital) I. NAME : Speech-Language Pathology graduate student externship II. PURPOSE: The following policy and procedures are formulated to serve as a guideline for the speech pathology
department at Winona Hospital, the graduate student extern, and the sponsoring university from which the student is from.
III. POLICY: Winona Memorial Hospital has agreed to participate in the education of graduate student externs from
Speech Pathology programs within the United States. The speech pathology staff will provide the student with an environment for learning, practicing, and expanding therapeutic skills. The student will arrive at Winona with the necessary skills to participate in the program with anticipated success. All parties will adhere to the procedure guidelines unless circumstances permit departure (i.e., illness, vacation, decreased caseload etc.).
V. PROCEDURE - WINONA MEMORIAL HOSPITAL AND SPEECH PATHOLOGY STAFF:
1. The speech pathology staff will provide the student and his/her university with written guidelines/expectations prior to the beginning of the externship experience.
2. The supervising speech pathologist will have at least 3 years clinical experience and be proficient in diagnosis and treatment of communication, cognition and swallowing disorders. He/she must have verbalized a desire to supervise the student with rational of his/her goals and specific contributions discussed with a mentor/senior speech pathologist.
3. The supervising speech pathologist will have an assigned mentor/ senior speech pathologist if he/she has not supervised a graduate student clinician before and if he/she has less than 3 years clinical experience.
4. The senior speech pathologist will have at least 5 years experience and be proficient in diagnostics/treatment of communication/cognition and swallowing disorders.
5. The supervising speech pathologist will provide the student with written and verbal feedback consistently throughout the externship experience.
6. The supervising speech pathologist will provide the student with written midterm and final evaluations and grades. These evaluations will be sent to the student’s supervisor at his/her university.
7. The supervising speech pathologist will maintain verbal contact with the student’s university supervisor throughout the externship experience.
8. The supervising speech pathologist will follow the teaching objectives established by this policy and procedure and inform the student of these objectives at the beginning of the externship experience.
9. All of the speech pathologists who participate in the supervision of the student extern will hold state licensure and ASHA certification.
10. All of the speech pathologists who participate in the supervision of the student will hold a Masters Degree in Speech-Language Pathology from an accredited university. He/she will also possess the Certificate of Clinical Competency from ASHA.
11. The supervising speech pathologist will maintain acceptable performance on the criteria outlined in his/her job description.
12. The supervising speech pathologist will be responsible for these duties: a. providing orientation for the student b. meeting with the school supervisor for on-site visits c. scheduling of experience with other disciplines d. communicating with other staff members regarding the student’s progress e. maintaining the student’s file with appropriate information f. co-signing all documentation written by student
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VII. PROCEDURE - GRADUATE STUDENT CLINICIAN:
All students participating in the graduate externship at Winona Memorial must meet all of the following criteria: 1. Possess a B.A. or B.S. in speech-pathology or related field and currently be enrolled in a graduate program in
speech language pathology. 2. Successful completion of an interview with the manager of the speech pathology department, coordinator of
graduate student externship program and the supervising speech pathologist. 3. Maintain a GPA of 3.5 (on 4 point scale) or 5.5 (on a 6 point scale) 4. Successful completion of clinical practicum in the university clinic. 5. Completion of all courses related to adult neurogenic population. 6. Successful completion of a dysphagia course at the university. If this is not available, the supervising speech
pathologist will provide independent study material to the student that is to be completed prior to start of externship.
7. Provision of current immunization record. TB testing falls under this category. 8. Provision of professional liability insurance. 9. Three letters of recommendation along with his/her undergraduate and graduate transcript.
In addition to these 9 criteria, there are specific objects outlined in this policy and procedure that the graduate student must meet prior to completion of the graduate student externship. He/she must also provide the supervising speech pathologist with a written evaluation (using Winona Memorial Hospital’s form) of the supervising speech pathologist as well as the externship experience prior to exiting from the program.
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WINONA MEMORIAL HOSPITAL
Clinical Objectives for Graduate Student Clinicians
Objective I - Professional Conduct: The student will develop outstanding standards of professional conduct.
1. Student abides by professional code of ethics. 2. Student has neat, clean and appropriate appearance. 3. Student shows respect for all members of the rehabilitation team as well as support staff. 4. Student is aware of and follows all departmental policies and procedures. 5. Student demonstrates understanding of the speech pathologist’s role as it relates to other disciplines. 6. Student accepts constructive criticism and is aware of his/her own strengths and weakness relative to the
clinical setting. 7. Student demonstrates curiosity and enthusiasm about his/her profession. 8. Student demonstrates self-discipline and dependability in meeting responsibilities. 9. Student is able to discern and handle appropriately confidential information. 10. Student demonstrates interest in his/her patients. 11. Student demonstrates confidence in his/her clinical skills and promotes feelings of confidence from his/her
patient and other clinicians. 12. Student is able to respond appropriately to patients’ behavior and seeks assistance when needed.
Objective II - Communication: The student will develop effective communication skills.
1. Student presents ideas logically and clearly to patient, family members, and other health professionals. 2. Student is knowledgeable and uses appropriate terminology to meet specific communication situations. 3. Student is able to give instructions to patients and family members that are easily understood and appropriate. 4. Student develops effective rapport with patients, family members and other staff members. 5. Student is able to report progress as well as significant non-clinical information to other staff members and
medical staff. 6. Student is able to summarize and present diagnostic findings to patients, family members and other staff
members in a clear, concise manner verbally. 7. Student is able to write clear, concise evaluations, discharge summaries, staffing notes and progress notes
according to department guidelines.
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Clinical Objectives (cont.)
Objective III - Diagnostic/Treatment skills: The student will develop outstanding diagnostic/treatment skills.
These are general guidelines for all diagnostic/therapeutic situations
1. Student will perform a thorough chart review and document relevant information. 2. Student will demonstrate ability to analyze patient’s medical, social and psychological history as it relates to
rehabilitation. 3. Student will choose appropriate diagnostic tools. 4. Student will administer the diagnostic tools appropriately, demonstrating sensitivity to the patient’s specific
status at time of evaluation. 5. Student will score and interpret the diagnostic results accurately 6. Student will discern reliability of testing results. 7. Student will use informal assessments appropriately 8. Student will establish a realistic plan of treatment with appropriate long and short term goals. 9. Student will write functional long and short term goals. 10. Student will re-evaluate treatment programs and revise them when appropriate. 11. Student will record and maintain objective data for each goal addressed. 12. Student will observe and report non-language behavior which may affect the patient’s progress. 13. Student will demonstrate flexibility/ability to adapt task within a session to meet the patient’s needs. 14. Student will provide appropriate feedback/reinforcement to patient during the session. 15. Student will involve patient and/or family members in treatment when appropriate. 16. Student will analyze effectiveness/ineffectiveness of treatment techniques in a timely and accurate manner. 17. Student will utilize time effectively. 18. Student will complete the FIM and the Patient/Family Education sheet.
These are specific guidelines for dysphagia diagnosis and treatment
1. Student demonstrates knowledge of the anatomy and physiology of the oral, pharyngeal and upper 1/3rd of the
esophageal swallow. 2. Student obtains pertinent information from the patient’s chart which provides diagnostic/prognostic information
relative to dysphagia. 3. Student accurately performs a mealside dysphagia assessment using the appropriate forms. 4. Student accurately summarizes and reports findings of the mealside evaluation in the medical chart. 5. Student makes appropriate recommendations for diet modifications, positioning communicates findings of the
mealside evaluation to medical staff, other disciplines and the patient/family members. 6. Student performs a modified barium swallow study with 90% independence at the completion of the student
externship. 7. Student demonstrates ability to prepare the barium in the correct consistencies for each patient specifically. 8. Student administers the barium and food items in the appropriate order and demonstrates flexibility of thinking
to meet the patient’s specific needs. 9. Student analyzes the oral, pharyngeal stage of the swallow with 90% independence and minimal input from the
supervising speech pathologist at the completion of his/her externship experience. 10. Student makes observations of the upper 1/3rd of the esophageal stage of swallowing with input from the
supervising speech pathologist.
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Objective III (Cont.) specific guidelines for dysphagia diagnosis and treatment 11. Student identifies and reports the type of dysphagia, level of risk of aspiration, presence of
aspiration/penetration and any other diagnostic factors which cause a patient’s diet to be modified from a regular consistency.
12. Student demonstrates knowledge of the effects of normal aging on the swallow and makes diagnostic/prognostic statements accordingly.
13. Student demonstrates knowledge of specific neurogenic disorders on the swallowing mechanism and makes diagnostic/prognostic statements accordingly.
14. Student completes the modified barium swallow checklist in a timely manner with minimal input from the supervising speech pathologist at the completion of the externship experience.
15. Student makes appropriate recommendations for diet changes, alternative methods of nutrition, therapeutic intervention and follow up studies.
16. Student communicates results, recommendations and prognosis to the patient, family members, other disciplines, and medical staff.
Objective IV - Time Management and Knowledge of the clinic’s specific policies and procedures for practicing
speech pathology: The student will develop outstanding time management skills. The student will abide by the clinic’s policy and procedures.
1. Student is familiar with the operation of equipment prior to use in treatment. 2. Student demonstrates safe, accurate use of equipment and supplies. 3. Student maintains a clean and neat work station. 4. Student is knowledgeable and abides by standard precautions as stated in the policy and procedure handbook. 5. Student is able to effectively schedule patients according to procedure. 6. Student is able to make scheduling adjustments to accommodate unexpected changes. 7. Student assembles all necessary materials for work prior to initiating treatment/evaluation. 8. Student independently schedules one hour of observation for each discipline during his/her externship
experience or; student independently schedules to follow a patient for an entire day through all aspects of care. This objective is dependent upon the nature of the patient case load at the beginning of the student’s externship.
9. Student manages his/her schedule so that she/he completes the day’s work in an 8 hour time frame. 10. Student completes all documentation in a timely manner and in accordance with the department’s guidelines. 11. Student will maintain a treatment log with number of adult hours obtained during the externship experience.
This log will be sent to the student’s university and a copy will remain in the students file at Winona. 12. Student will become proficient in all billing procedures.
TIME-FRAME FOR ACHIEVING CLINICAL OBJECTIVES DURING THE GRADUATE STUDENT EXTERNSHIP
EXPERIENCE GOAL: At the completion of the graduate student externship experience at Winona Memorial hospital, the student will be able to do the following:
1. Perform a Modified Barium Swallow Study in conjunction with the Radiology department with 90% independence and minimal supervision.
2. Perform speech-language evaluations/treatment on patients in all areas of the hospital (i.e., acute rehabilitation department, medical/surgical units, skilled nursing unit and out-patients).
3. Attend weekly care conferences and rehabilitation team conferences. The student will report progress on his/her patients and will become proficient in completion of the FIM forms as well as the patient conference form.
4. Develop and maintain a functional plan of treatment for all patients on his/her caseload. 5. Become familiar with the videostroboscopy equipment and procedure.
39
CLINICAL SKILL TIME-FRAME FOR GRADUATE STUDENT EXTERNS Skill/Activity 1. Orientation 2. Therapy Observations 3. Chart Review 4. Accurate completion of billing forms 5. Selections of appropriate diagnostic tools 6. Accurate completion of diagnosis of acute
rehabilitation patient 7. Accurate identification of anatomy and
physiology of the oral/pharyngeal swallow 8. Accurate interpretation of training tapes of
various types of dysphagia 9. Accurate completion of evaluation forms 10. Accurate completion of short/long-term goals 11. Report at team conference 12. Accurate completion of daily progress notes 13. Identification and use of informal diagnostic
tools 14. Appropriate interaction with other disciplines 15. Making appropriate referrals 16. Independent completion of evaluation plan of
treatment, discharge planning and objective/subjective information gathering
17. Counsel patients and family 18. Complete a Bedside swallowing evaluation
independently 19. Perform a Modified Barium Swallow Study with
minimal supervision
Timeline for achievement Within two weeks Within two weeks Within two weeks Within two weeks Within three weeks Within 4 weeks Within 4 weeks Within 4 weeks Within 5 weeks Within 5 weeks Within 4 weeks Within 4 weeks Within 5 weeks Within 5 weeks Within 6 weeks Within 8 weeks Within 8 weeks Within 8 weeks Within 8 weeks
Approved: Director, Rehabilitation Approved: Speech-Language Pathology Program Coordinator Approved: Hospital Administration
41
External Practicum Sites for Purdue Students: Supervisor and Clinical Population Data
(See reverse side for instructions)
Name of facility: ___________________________________________________Semester: ________________ Location: ________________________________________________________________________________________ Facility Supervisors: ______________________________________ ASHA CCC No. _________________________ ______________________________________ ASHA CCC No. _________________________ Student Clinician: __________________________________________________________________________________ SLHS external practicum supervisor for this placement _____________________________________________________
External Practicum Sites for Purdue Students: Supervisor and Clinical Population Data
(See reverse side for instructions)
42
Name of facility: ___________________________________________________Semester: ________________ Location: ________________________________________________________________________________________ Facility Supervisors: ______________________________________ ASHA CCC No. _________________________ ______________________________________ ASHA CCC No. _________________________ Student Clinician: __________________________________________________________________________________ SLHS external practicum supervisor for this placement _____________________________________________________
Average Number of Clients Available per semester at this Facility **
Total Children Adults
ARTICULATION
Evaluation
Intervention
VOICE & RESONANCE
Evaluation
Intervention
FLUENCY
Evaluation
Intervention
LANGUAGE DISORDERS (Receptive & Expressive)
Evaluation
Intervention
SWALLOWING DISORDERS
Evaluation
Intervention
COGNITIVE ASPECTS OF COMMUNICATION
Evaluation
Intervention
SOCIAL ASPECTS OF COMMUNICATION
Evaluation
Intervention
COMMUNICATION MODALITIES
Evaluation
Intervention
HEARING
Evaluation
Intervention
Other (specify)
Age range for adults: ________-________ yrs., for children: ________-________ yrs. **Refers to clients available at this facility (not just the ones that a particular student clinician works with). Cognitive: attention, memory, sequencing, problem-solving, executive functioning Social aspects: challenging behavior, ineffective social skills, lack of communication opportunities Communication modalities: oral, manual, augmentative, and alternative communication techniques and assistive technologies
44
PURDUE UNIVERSITY CLINICAL SKILLS COMPETENCY FORM
Extern Clinician: _________________________
Supervisor: _______________________________
Mid-term Evaluation Date: _____ Recommended Grade: Letter Grade ___ Pass___ Fail___
Final Evaluation Date: _____ Recommended Grade: Letter Grade ___ Pass___ Fail___
KEY EXPERIENCES:
-
-
-
-
-
STRENGTHS/ACCOMPLISHMENTS:
-
-
-
-
-
RECOMMENDATIONS FOR FUTURE CLINICAL GROWTH:
-
-
-
-
-
Please check the Culturally and Linguistically Diverse Populations Served (ASHA Standard V-f):
Culturally and Linguistically Diverse
Populations
Culturally and Linguistically Diverse Populations I served
while at my externship
Deaf/hard of hearing
Blind/Visually Impaired
Hispanic
Afro-American
Asian
Russian
Transgender
English Language Learner
Child/adult living in a home that is below the
poverty level
Muslim
Amish
Other
A+ 97%-100%
A 93%-96%
A- 90%-92%
B+ 87%-89%
B 83%-86%
45
CLINICAL SKILLS COMPETENCY FORM
APPROACH TO CLINICAL WORK Mid-term Final
A. Clinical Perspective Purdue 4
B. Organizational Skills Purdue 4
C. Clinical Initiative/Decision-Making Purdue 4
D. Participation in Supervisory Process Purdue 4
E. Flexibility in Clinical Practice Purdue 4
TOTAL 20
EVALUATION Mid-term Final
A. Conducts screening and prevention procedures VB; 1a 4
B. Collects and integrates case history information VB;1b 4
C. Selects and implements evaluation procedures VB;1c 4
D. Adapts interviewing and testing procedures VB; 1d 4
E. Interprets results and makes recommendations VB; 1e 4
F. Completes administrative and reporting functions VB; 1f 4
G. Makes appropriate recommendations and referrals VB; 1g 4
TOTAL 28
INTERVENTION Mid-term Final
A. Develops treatment plans VB; 2a 4
B. Implements intervention plan VB; 2b 4
C. Effectively utilizes materials & instrumentation VB; 2c 4
D. Measures/evaluates performance and progress VB; 2d 4
E. Modifies intervention plan to meet needs of clients VB; 2e 4
F. Completes administrative and reporting functions VB; 2f 4
G. Identifies associated conditions & makes referrals VB; 2g 4
TOTAL 28
INTERACTION/PERSONAL QUALITITES Mid-term Final
A. Communicates effectively w/ patient, family, etc. VB; 3a 4
B. Collaborates with other professional VB 3b 4
C. Counsels and collaborates with patient, family, etc. VB; 3c 4
TOTAL 12
Overall Rating (add four rating TOTALS) 88
0 = ABSENT: Specific direction from supervisor does not alter unsatisfactory performance/evaluation skills; Inability to make change. 1 = TAUGHT: Specific repeated direction/demonstration from supervisor required to perform clinical skill and to accurately evaluate self/patient. 2 = EMERGING: Specific supervisory direction results in some generalization and application of knowledge to perform competently and accurately. 3 = PRESENT: General and some specific supervisory direction results in competence and accurate evaluation of self/patient. 4 = DEVELOPED: Demonstrates independence but some supervisory direction needed to perform competently and accurately evaluate self/patient. 5 = EXCEPTIONAL: Demonstrates independence by taking initiative; displays superior competencies and accurately
evaluates self/patient.
46
Professional Competency
Professional Behavior (VB; 3d) Mid-
term
Final
Ethical Practice: Conducts all clinical work in accordance with Purdue University Professional
Protocol and the Code of Ethics and Scope of Practice in Speech-Language Pathology set forth
by the American Speech-Language Hearing Association. (See Graduate Handbook.)
Responsibility: Consistently prepares for and completes clinical services, conferences, and other
practicum activities. Uses universal safety precautions whenever necessary.
Punctuality: Completes all clinical practicum responsibilities in a timely manner and follows
prescribed clinical procedures for service delivery.
Confidentiality: Protects and maintains confidentiality of clinical information as prescribed by
HIPAA guidelines and clinic protocols.
Personal Appearance: Presents professional image through appropriate personal appearance
and dress, identification with professional nametag, and professional demeanor.
Written Communication Skills (V-a) Mid-
term
Final
Consistently and accurately conveys professional information from coursework, supervisory
input, clinical activities and other resources.
Consistently writes information in a clear and organized manner using accurate spelling and
grammar.
Consistently and accurately uses professional writing conventions, terminology and style to
clearly communicate information in a manner consistent with audience and/or clinical setting.
Oral /Nonverbal Communication (V-a) Mid-
term
Final
Consistently and accurately uses oral communication that demonstrates speech and language
skills in English, which, at a minimum, are consistent with ASHA’s most current position
statement on students and professionals who speak English with accents and nonstandard
dialects.
Consistently and accurately conveys correct information from course work, supervisory input,
clinical activities and other resources.
Consistently and accurately describes behaviors of client.
Nonverbal language, including but not limited to affect, eye contact, tone, or body language, is
consistently appropriate for clinical interactions.
Consistently models appropriate communication in all clinical settings and provide appropriate
clarification to clients, family members, or other professionals when needed.
Oral and nonverbal communications are appropriate for the cultural, socioeconomic, and
semantic needs of the audience.
Effectively and promptly communicates with supervisor regarding all aspects of case
management.
Interacts and communicates in a professional and positive manner with students, peers, school
and university personnel, and others. Avoids bias, prejudice, or lack of fairness toward
individuals or groups of people.
PLEASE INDICATE S= SATISFACTORY OR U = UNSATISFACTORY
47
Clinical Skills Rating Scale
0 = Absent: Specific repeated direction from supervisor does not alter unsatisfactory
performance/evaluation skills; inability to make change.
1 = Taught: Specific repeated direction/demonstration from supervisor required to perform clinical skill
and to accurately evaluate self/client.
2 = Emerging: Specific supervisory direction results in some generalization and application of
knowledge to perform competently and accurately evaluate self/client.
3 = Present: General and some specific supervisory direction results in competence and accurate
evaluation of self/client.
4 = Developed: Demonstrates independence but some supervisory direction needed to perform
competently and accurately evaluate self/client.
5 = Exceptional: Demonstrates independence by taking initiative; displays superior competencies and
accurately evaluates self/client.
Approach to Clinical Work
A. Clinical Perspective
Initiates and accomplishes professional activities related to overall case
management
Demonstrates ability to focus on client’s needs and to modify case
management as needed to meet those needs
Demonstrates clear understanding of assessment, intervention, and case management
responsibilities
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
B. Organizational Skills
Accomplishes clinical work in an efficient and effective manner
Thoroughly plans and prepares for all clinical activities to increase
competence
Organizes information within a theoretical perspective that is guided by current research and
clinical experience
Comments:__________________________________________________________________________
____________________________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
48
C. Clinical Initiative/Decision-Making
Demonstrates an active and responsible approach to clinical work
Seeks and considers alternative interpretations of clinical data,
observations, other relevant information
Seeks and considers alternative approaches for providing effective
professional services
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
D. Participates in the Supervisory Process by:
Actively participating in own clinical development by recognizing and
stating own needs and requesting meaningful feedback
Positively responding to supervisory feedback by thoughtful
consideration of new ideas and information
Implementing supervisory suggestions to maximize clinical growth and effectiveness
Initiating discussions of clinically relevant information and issues to facilitate clinical
effectiveness
Demonstrating strategies to analyze and develop own clinical effectiveness including self-
observation and analysis of knowledge and skills
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
E. Flexibility in Clinical Practice
Actively develops a variety of clinical perspectives, models, and
strategies
Demonstrates self-confidence in considering and utilizing a variety of
clinical perspectives, models, and strategies
Demonstrates and applies a range of interaction styles and clinical approaches to provide
services appropriate to each client
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
49
Evaluation Skills
A. Conducts screening and prevention procedures.
Selects/adapts screening procedures appropriate for each individual
client
Effectively administers and accurately scores screening instruments
Accurately interprets screening results and makes appropriate recommendations
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
B. Collects and integrates case history information.
Gathers information from clinic file, client, family, caregivers, and
professionals
Thoroughly reads and summarizes information
Formulates questions to clarify and update information
Obtains needed information taking into consideration perspectives of client, family, and other
agencies
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
C. Selects and implements evaluation procedures (non-standardized tests, behavioral observations, and
standardized tests).
Develops comprehensive assessment battery to accomplish clinical
purpose
Selects appropriate standardized tests for individual client
Plans for and develops non-standardized probes
Appropriately administers standardized test to obtain representative client performance
Accurately observes and records relevant communication and other behaviors
Consistently and accurately scores standardized tests and analyzes results of non-standardized
measures
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
50
D. Adapts interviewing and testing procedures to meet individual client needs.
Recognizes need to adapt assessment battery and testing procedures to
accommodate needs unique to specific client
Plans for and implements modifications based on client’s responses
and participation
Actively utilizes a variety of resources to obtain relevant assessment information
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
E. Interprets and integrates test results and behavioral observations, synthesizes information gained from
all sources, develops diagnostic impressions, and makes recommendations.
Determines validity and appropriateness of information obtained
Interprets assessment information to determine client’s current
functioning
Compares client performance to peer group
Determines profile of skills including strengths, difficulties, and error patterns
Diagnoses communication difficulties and their impact for client and family
Determines client’s responses to trial teaching procedures
Considers factors contributing to communication difficulty
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
F. Completes administrative and reporting functions necessary to support
evaluation.
Consistently and accurately prepares for evaluation session.
Organizes formal/informal test results
Writes a comprehensive and accurate evaluation report that is appropriate to the clinical
setting and needs of the client
Completes a comprehensive written report of assessment results including accurate description
of client’s current status, strengths, and needs.
Completes appropriate billing in a timely manner
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
51
G. Makes appropriate recommendations and referrals for clients/patients.
Develops appropriate recommendations for case management
including referrals and consultations
Develops appropriate recommendations for intervention and/or re-
evaluations to address client’s needs
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Intervention Skills
A. Develops focused, measurable and achievable treatment plans.
Includes meaningful and measurable long-term and short-term
goals
Selects effective treatment strategies and approaches based on
academic and diagnostic information
Develops treatment plan in coordination with client, family, and relevant others
Develops thorough lesson plans to support achievement of short-term goals including clinical
materials/instrumentation, motivating activities, instructions, and feedback
Implements suggestions from previous sessions and supervisory conferences
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
B. Implements intervention plans.
Utilizes treatment time to address client communication and other
needs
Applies treatment contexts, approaches, and strategies to foster client
progress
Implements strategies to involve client, family, and relevant others to support communication
progress
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
52
C. Effectively utilizes materials and instrumentation for prevention and intervention.
Appropriately uses materials, instrumentation, instructions, prompts,
and feedback to facilitate client participation and change
Recognizes and utilizes spontaneous teaching opportunities to facilitate
client progress
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
D. Measures/evaluates client performance and progress.
Accurately observes and records client and clinician behavior
Analyzes observational data to determine effective and ineffective
aspects of treatment
Periodically monitors client progress through appropriate data collection
Consults with client, family, and relevant others concerning progress and changing needs of
the client
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
E. Modifies intervention plan to meet individual needs of clients.
Modifies treatment procedures, materials, and/or instrumentation
within sessions based on client’s response
Modifies subsequent sessions based upon session analyses and
supervisor feedback
Modifies goals and approaches in response to client progress and changing needs
Utilizes a variety of resources to gain information concerning approaches to treatment
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
53
F. Completes administrative and reporting functions necessary to support
intervention.
Maintains appropriate and comprehensive clinical records
Completes appropriate clinical reports in a timely manner
Writes professional reports characterized by comprehensive and accurate description of the
intervention process, client’s status, client’s strengths/needs.
Completes case management activities necessary to address needs of individual clients, their
families, and relevant others
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
G. Identifies associated conditions and refers clients, their families, and relevant others for additional
services as appropriate.
Recognizes associated conditions and/or needs warranting professional
attention, such as: audiological, educational, medical, psychological,
social, and vocational
Appropriately refers and supports clients, their families, and relevant
others in obtaining appropriate services
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Interaction and Personal Qualities
A. Communicates effectively with client, family, caregivers, and relevant others.
Communicates clearly and effectively with client, family, caregivers,
and relevant others demonstrating sensitivity to cultural/linguistic
backgrounds, preferred modes of communication, and
communication status
Uses communication characterized by:
o Responsiveness to others
o Appropriateness of tone/level/demeanor
o Flexibility in communication strategy and style
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
Expected Rating
4
54
B. Collaborates with other professionals in case management.
Gathers and considers information from supervisors and other
professionals
Accurately and clearly describes client’s behavior/communication
status, strengths, and needs to supervisors and other professionals.
Accurately and clearly describes the intervention process
Makes appropriate decisions based on shared information
Initiates activities and contributes information that promotes mutual problem solving
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
C. Counsels and collaborates with clients, family, caregivers, and relevant others regarding
communication and swallowing disorders.
Obtains information from client, family, and relevant others pertinent
to case management
Accurately and clearly explains information regarding client status
and needs using appropriate terminology
Facilitates discussion of attitudes and feelings pertinent to progress
Effectively uses conventional counseling strategies such as listening and reflecting to facilitate
progress
Engages client, family, and relevant others in problem solving activities to facilitate progress
Comments:__________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
Rating for Midterm: Rating for Final:
Expected Rating
4
Expected Rating
4
55
HEALTHCARE EXTERNSHIP
SITE FEEDBACK FROM THE EXTERNSHIP STUDENT
Site Supervisor(s): ____________________ Site Name: __________________ Date: _________
Directions: Indicate if your site supervisor(s) provided the following opportunities by circling
the appropriate response to the right of each item. Please comment in each area.
S = Satisfied D = Dissatisfied
Orientation Provided procedures, orientation, and clinical responsibilities. S D
Allowed enough time for me to observe him/her and other therapists. S D
Gradually introduced me to actual therapy. S D
Comments:
Preparation/Planning
Worked with me on planning therapy/diagnostic sessions. S D
Encouraged me to set goals and work to meet them. S D
Shared his/her resources with me. S D
Comments:
Diagnostics and Therapy
Provided suggestions for diagnostic/therapy procedures. S D
Encouraged me to use my own ideas. S D
Allowed me to become independent and use a variety of therapy techniques. S D
Comments:
56
Professional Relationships
Provided support and encouragement. S D
Treated me respectfully. S D
Encouraged me to gain self-confidence. S D
Was a positive influence on my externship experience. S D
Allowed me to gradually assume full responsibility. S D
Comments:
Supervision
Observed me according to ASHA standards. S D
Provided sufficient feedback regarding the observations of my work. S D
Made me feel willing to communicate honestly and openly in
conferences and conversations. S D
Comments:
How would you rate this clinical experience?
Did you feel prepared to enter this clinical placement?
____________________________________________________________________________________
Summarize the Caseload you worked with:
____________________________________________________________________________________
Print Name ____________________________ Signature _____________________________
57
Your Name
SLHS PURDUE UNIVERSITY
Speech-Language Pathology
PRACTICUM RECORD FORM FOR THE ASHA CERTIFICATE OF CLINICAL
COMPETENCE
You must have documentation on file in the department of at least 25 clock hours of supervised
observation of evaluation and treatment of children and adults with disorders of speech, language, or
hearing. The record of these clock hours must be signed by staff who held the ASHA Certificate of
Clinical Competence at the time that the observations were done. Have you met this requirement?
yes _____ no _____
You must have documentation on file in the department of all of your clinical practicum clock
hours. These cards or forms must be signed by the ASHA-certified persons who supervised your
practicum. Have you met this requirement?
yes _____ no _____
In the table below, show the total number of clock hours of practicum hours you have in each of the
categories. One chart is for undergraduate hours and one chart is for graduate hours. Do not
include the observation hours reported above.
UNDERGRADUATE Speech-Language Hours
Evaluation Intervention
Arti
cu
lati
on
Flu
en
cy
Vo
ice &
Res
Sw
all
ow
ing
Rec/E
xp
La
ng
uag
e
Co
gn
itiv
e
So
cia
l A
spec
ts
Co
mm
.
Mo
dali
ties
Arti
cu
lati
on
Flu
en
cy
Vo
ice &
Res
Sw
all
ow
ing
Rec/E
xp
La
ng
uag
e
Co
gn
itiv
e
So
cia
l A
spec
ts
Co
mm
.
Mo
dali
ties
C A C A C A C A C A C A C A C A C A C A C A C A C A C A C A C A
C
A
C
A
UNDERGRADUATE Audiology Hours
Evaluation/Screening of hearing _____ Habilitation and Rehabilitation of hearing impairment _____
UNDERGRADUATE
TOTAL A/SLP Participation Clock
Hours
58
GRADUATE Speech-Language Hours
Evaluation Intervention
Arti
cu
lati
on
Flu
en
cy
Vo
ice &
Res
Sw
all
ow
ing
Rec/E
xp
La
ng
uag
e
Co
gn
itiv
e
So
cia
l A
spec
ts
Co
mm
.
Mo
dali
ties
Arti
cu
lati
on
Flu
en
cy
Vo
ice &
Res
Sw
all
ow
ing
Rec/E
xp
La
ng
uag
e
Co
gn
itiv
e
So
cia
l A
spec
ts
Co
mm
.
Mo
dali
ties
C A C A C A C A C A C A C A C A C A C A C A C A C A C A C A C A
C
A
C
A
GRADUATE
Total SLP Participation Clock Hours
You must have had at least 325 clock hours at the graduate level. Have you met this requirement?
yes _____ no _____
You must have completed a minimum of 400 clock hours of supervised clinical experience in the
practice of speech-language pathology, including 25 hours in clinical observation and 375 hours in
direct client/patient contact. Have you met this requirement?
yes _____ no _____
MINOR AREA (Audiology) show the number of Graduate clock hours:
Evaluation/Screening of hearing _____ Habilitation and Rehabilitation of hearing impairment _____
TOTAL GRADUATE AUDIOLOGY CLOCK HOURS ________
You must have at least 10 clock hours in the evaluation/screening of hearing. Have you met this
requirement? yes _____ no _____
You must have at least 10 hours in the habilitation/rehabilitation of individuals who have hearing
impairment. Have you met this requirement? yes _____ no _____
59
You must have at least 50 clock hours of supervised clinical practicum in each of three
different clinical settings. The speech, language, and audiology clinic at Purdue is one of those
settings. In the space below, give the name and city of each program where you have had
supervised clinical practicum, and give the total number of clock hours obtained in each
setting.
Were at least 25% of your diagnostic/treatment sessions directly supervised?
yes _____ no _____
What was the exact date on which you completed all of your clinical practicum requirements?
[Month/Day/Year]
What was your ASHA examination score?
What is your exact date of graduation from Purdue? [Month/Day/Year]
Are your external practicum forms, SITE Forms, log cards and observation hours attached to
this application? yes _____ no _____
I have reviewed my final Academic and Clinical KASA and it is accurate. yes _____ no_____
PROGRAM LOCATION
CLOCK HOURS
Purdue West L
TOTAL
(include undergraduate and graduate
speech-language pathology and audiology hours)
(must be a minimum of 375 participation hours)
Plus observation hours
GRAND TOTAL
(participation plus observation hours)
60
SIGNATURES
When you sign below, this means that you have checked this Practicum Record Form for
accuracy in meeting ASHA’s minimum practicum requirements for certification.
_______________________________________
Student Date
_______________________________________
Graduate Program Director Date
_______________________________________
Healthcare Externship Coordinator Date
61
ASHA State-by-State - http://www.asha.org/advocacy/state/
ASHA's state advocacy team advocates on issues related to the professions at the state and local level and provides members and state speech-language hearing associations with assistance and resources. Find the ASHA State Team liaison [PDF] for your state.
Summary of State Requirements and Contact Information Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Overseas Association of Communication Sciences
U.S. Territories
SCHOOL FUNDING ADVOCACY
GRASSROOTS ADVOCACY
TAKE ACTION
2018 PUBLIC POLICY AGENDA
State Hot Topics
Information and resources for advocating on important issues in the states.
State Advocacy Resources
Information about how to advocate at the state level and advocacy networks that can help.
Interstate Compact
Information on efforts to develop an interstate compact for audiologists and speech-language
pathologists who wish to practice in multiple states.
State Trends
Information on licensing trends, legislative, and regulatory updates across the states.
State Model Bills and Mandates
Language that can be used to craft legislation and links to current state requirements.
State Association Resources
Information for state association leaders.
62
Indiana State Contact Information
Speech and Hearing Association
Indiana Speech-Language-Hearing Association Central Office
2346 South Lyndhurst Drive
#D101
Indianapolis, IN 46214
Phone: 317-916-4146
E-mail: [email protected]
For meeting information, visit the http://www.islha.org/
State Regulatory Agencies
Speech-Language Pathology and Audiology Licensing
Indiana Professional Licensing Agency
Attn: SLPA Board
402 West Washington Street; Room W-072
Indianapolis, Indiana 46204
Board Phone Number: (317) 234-2067
http://www.in.gov/pla/speech.htm
E-mail: [email protected]
Education Agency Contacts
Office of Special Education
Indiana State Department of Education
South Tower, Suite 600
115 W. Washington Street
Indianapolis, IN 46204
http://www.doe.in.gov/licensing/speech-language-pathologist-licensure
(317) 232-9010
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