Problem Solving and Information Exchange for Clinic Directors

1. Problem Solving and Information Exchange for Clinic Directors Cara Boester, M.A., Illinois State University Katie Strong, M.A., Michigan State University Gail Whitelaw, Ph.D., The Ohio State University

2. Gail M. Whitelaw, Ph.D. Director, The Ohio State University Speech-Language-Hearing Clinic

3. OHIO STATE AT A GLANCE Established in 1870 63,000+ students Located in Columbus, OH, the state capital and 15th largest city in the United States Recently transitioned from quarters to semesters

4. Speech and Hearing Science at a Glance Department of Speech and Hearing Science in the College of Arts and Sciences Department established more than 85 years ago As of April, 2013: 510 UG students, 56 MA in SLP students, 45 AuD students, 20+ PhD students http://sphs.osu.edu/aboutus

5. Speech-Language-Hearing Clinic at a Glance The OSU Speech-Language-Hearing Clinic has been providing services to Central Ohio and beyond continuously since 1930 Fee for service clinic providing a comprehensive range of speech-language- hearing services including language/literacy assessment and treatment, fluency services, hearing aid fitting and dispensing, tinnitus assessment and treatment, educational audiology consulting

6. The Ohio State University campus : Placement opportunities Major medical center which includes the James Cancer Hospital, Nationwide Children’s Hospital, Wexner Ohio State Medical Center, the Nisonger Center (which houses the Leadership in Neurodevelopmental and Other Disorders—LEND—program), Dodd Hall Rehabilitation Hospital, outpatient clinics including physical rehabilitation and otolaryngology All provide placements for MA-SLP and AuD students

7. Off campus placements : Central Ohio and beyond Off campus placements • School placements ranging from preschool to high school • Specialized programs including school program focused on children with autism, program specific to hearing loss, Ohio School for the Deaf, Ohio School for the Blind • Rehabilitation and SNF placements • Columbus Colony

8. Off campus placements : Central Ohio and beyond Off campus placements • Medical Center placements • Three major medical center groups in Columbus • Incredible placements in hospital settings within a 50 mile radius • Specialized opportunities • Singing health specialization associated with voice clinical program • ARC programs ranging from children to older adults

9. Preceptorships for 4th year AuD students 4th years • Process begins in 3rd year • Full time 4th year placements: These are generally paid experiences • Students placed across the country, ranging from Mass Eye and Ear to Oregon Health Sciences Medical Center to Rhode Island Hospital to University of Miami Medical Center • These placements take “care and feeding” and have both similarities and differences from other placements • Take creativity, flexibility, and problem solving

10. Cara Boester, M.A., CCC-SLP Director of Clinical Experiences - SLP Department of Communication Sciences and Disorders

11. Illinois State University • Campus = 20, 000 students • CSD Students • 250 undergraduate students • 85 SLP graduate students • 30 AuD students (1st 9, 2nd 6, 3rd 7, 4th 8) • CSD Faculty/Staff • 11 full time Faculty; 7 SLP, 4 AuD (3 new hires) • 14 full time Admin Professionals (Master Level) • 10 SLP • 4 Aud

12. Organizational Structure

13. Clients • SLP • Approximately 150 clients per semester • Approximately 75 client during the summer • AuD • Approximately 975 appointments per fiscal year

14. Internships • Part time Internships (local) • Approximately 35 per semester • Local schools, medical settings, private practice • Full time Internships – 2, 10 week placements • One Medical – 2 (su’12), 46 (sp ‘13), 2 (su ‘13) • One Educational - 2 (fa’12), 46 (sp ‘13), 2 (fa ‘13)

15. Katie A. Strong, M.A., CCC-SLP Graduate Program Director

16. East Lansing, Michigan • Student population • 48,906 total: from all 83 counties in Michigan, all 50 states in the United States, &more than 130 other countries • 36,747 undergraduate, • 10,247 graduate/professional • 1,912 non-degree • 13.5 percent international • Faculty/academic staff: 5,000

17. Students, Faculty, and Clinical Placements • Students • 62 MA students • 3 Ph.D. • Faculty • 9 tenure track (soon to be 10) • 1 academic specialist • Clinical Placements • Community based

18. Typical Sequence of Courses Fall 1 (12 credits) • CSD 803 Research Methods (3) • CSD 813 Neuroanatomy& Neurophysiology of Speech, Language, and Hearing (3) • CSD 860 Articulation & Phonological Disorders (3) • CSD 880 Clinical Proseminar: Professional Issues in SLP (3) Spring 1 (12 credits) • CSD 815 Acquired Language Disorders (3) • CSD 820 Language Assessment & Intervention: Early Stages (3) • CSD 855 Assessment & Treatment of Dysphagia (3) • CSD 883 Clinical Practicum in SLP (3) Summer 1 (9 credits) • CSD 821 Language Assessment & Intervention: Later Stages (3) • CSD 865 Motor Speech Disorders (3) • CSD 883 Clinical Practicum in SLP (3) Fall 2 (9-12 credits) • CSD 830 Fluency Disorders (3) • CSD 840 Voice Disorders (3) • CSD 883 Clinical Practicum in SLP (3) • Elective (3) Spring 2 (6-9 credits) • CSD 883 Clinical Practicum in SLP (3-6 credits) • Elective (3)

19. Internship Format Spring 1 5 week part time (3 days) school based setting Summer 1 9 week full time in medical setting Fall 2 15 week part time (3 days) setting dependent upon student interests and KASA needs Spring 2 15 week variable time ranging from part time to full time setting dependent upon student interests and KASA needs

20. Internship Settings • Community based internships • Over 100 off campus clinical supervisors across Michigan & U.S. • School-based settings • Early On (birth to three), Preschool based classrooms, K-12, Center-based programs • Medically oriented settings • Hospitals, nursing homes, outpatient clinics, community mental health, brain injury facilities • Practicum Class to support and process experiences

21. Problem Solving and Information Exchange for Clinic Directors Objectives: After attending this session participants will be able to: • Outline possible difficulties associated with externships as well as internal practicum • List three strategies for use in clinical education to address pressing needs • List three national trends in clinical education

22. Poll Everywhere…. • What is the ONE most pressing issue in your clinic related to clinical education?

23. Contracts/Affiliation agreements

24. Contracts Current Practice Challenges Out of state agreements that requiring to “abide by (that state’s) law..” General time frame to establish a contract can 6-12 months or even longer. Sites won’t establish new contracts with additional schools • Collaborate with General Counsel to establish affiliation agreements (typically 5 years) • Standard educational agreement (student specific for each placement) • Legal access • Coordination with internship/externship sites • Special issues in long term affiliation agreements (externships, 4th years) • “Non-compete” clauses • Interim licensure/student licensing

25. Balancing clinical education with other issues

26. Balance • Generational considerations • Clinical education in the new millennium • Incorporating technology into clinical education • The concept of the “reverse mentor” (Higher Unlearning by John Uldrich, 2011) • What do students “bring to the plate” and how to harness these skills while providing a strong foundation of clinical education • Demands of clinical education with financial demands • Can income production and clinical education “peacefully co-exist”

27. Insurance/background checks/immunization

28. Insurance - Background Checks - Immunization Current Practice: …Wide Variation Challenges Logistics of records Limited access “Protecting minors” Need for multiple background checks or physicals in one year Cost, time, etc. Redundancy and cost Sites are now requiring Students to have this completed on site Two step TB be within 90 days which may require a student to get 4-5 TB tests in one year • Clinic Director tracks all of this information • Give the packet to the student to give to their sites • Background checks done through an approved company and results are sent to me • Recent change – FBI goes through student now • State comes to me through our University • Clinic Director does not manage any of this information and student manages it directly with site.

29. Qualifications of supervisors/preceptors

30. Qualifications of supervisors Current Practice Challenges Training? Education? Desire to be a supervisor? How do you decide who will be a supervisor? Do you work with a coordinator at the site? Supervisor/preceptor training/education Supporting the growth and development of clinical supervisors • Rely on coordinator’s discretion • ASHA Number • License Number • Site survey feedback from interns • Decide whether to use again or not • Selecting supervisors beyond the C’s

31. Supervision Challenges • What do when you have a bad preceptor? • When they are horrible at this? • Or one who is not ready and you think they’d be great. • Providing guidance to those who are preceptors?

32. Challenges for supervisors/preceptors

33. Student issues • Technical standards • Mental health issues in students • Evaluating student performance • Documenting student performance issues • Dismissing students from the program • Role of supervisors input

34. Assessment of students

35. Assessment of students • Graded or pass/fail • How much weight does that grade get (may be in more than facility in a given semester), • Differences in placement settings or as a student progresses through their programs, accepting feedback (in house /out of house) • Sometimes its not keeping the outside supervisor out of the loop but acting in the role of the university

36. Assessment of supervisors/preceptors

37. Assessment of supervisors • End of semester required but anonymous survey for each student in a placement • General trends shared with faculty and supervisors

38. Benefits/ Thank you/motivation of supervisors

39. Options for acknowledging the contribution of supervisors • Notes from students • Opportunities available from the program • Paying for certification/licensure • Providing opportunities for continuing education • Recognition event (banquet, luncheon, etc.) • Adjunct faculty title (library access, resume addition) • Others • Verbal thank you • Written thank you at end of semester

40. National trends

41. Trends impacting clinical education/clinical preparation • Affordable Care Act (ACA): Preparing future professionals with a focus on cost containment and quality services • Electronic Health/Medical Records • Changes in coding: ICD-10 and more coming down the road • Simulated patients • Telehealth/telepractice

42. Trends impacting clinical education/clinical preparation • Identifying qualified preceptors • Particularly a challenge for AuD programs • Cost of clinical education in an era of shrinking higher education budgets • Aides/assistants; where will these training programs be housed and how will assistants be trained • Technology • Others….

43. Closing remarks • Anything you wanted to have answered that wasn’t addressed today?

44. Thank you! Feel free to contact us with any further questions Cara Boesterclboest@ilstu.edu Katie Strong strongk@msu.edu Gail Whitelaw whitelaw.1@osu.edu