Introduction to clinical education - Trinity College, Dublin · Introduction to clinical education...

Introduction to clinical education

15th and 16th of September, 2011 Programme and general information

Roinn an Staidéir Chliniciúil ar Urlabhra agus Teangacha, Scoil na nEolaíochtaí Teangeolaíochta, Urlabhra agus Cumarsáide, Coláiste na Tríonóide, Baile Átha Cliath 2, Éire

Clinical Speech and Language Studies, School of Linguistic, Speech & Communication Sciences, Trinity College, Dublin 2, Ireland

Introduction to Clinical Education

Programme

Thursday 15th of September, 2011

9.45 Overview of undergraduate education programme

Martine Smith

10.45 Break

11.00 Overview of the clinical education programme

Clothra Ní Cholmáin

Placement education – roles and responsibilities

Placement pathways

12.30 Lunch available locally

2.00 Evaluating clinical competencies


Formative assessments

Student assessments and clinical examinations

Giving and receiving feedback

Friday 16th September, 2011

9.30 Placement practicalities and possibilities


Schedules and learning objectives

What students should know by..

What students should be able to do by…

What if he/she doesn’t know/do…

10.30 Break

11.00 Facilitating student learning during placements

Lindsay Harrison & Katie Walsh

Induction packs

Health and safety

Creating learning opportunities

12.30 Lunch available locally

1.45 Tea/ coffee 2.00 Annual Clinical Educator meeting

Table of Contents Introduction to clinical education 2 Clinical education 3 Outline of the clinical education programme 4 Types of placements 12 Learning 14 Learning Styles Questionnaire 15 Learning enablers and constraints19 Induction to clinical placements 21 Your workplace as a learning environment 23 Placement learning opportunities 25 Practice education resource file 27 Assessment, evaluation, feedback and examinations 29 Feedback 32 Your role as a clinical educator 34 Further reading 35

CSLS Trinity College Dublin 2011-12 1


Introduction to clinical education September 2011

We hope that you enjoy your participation in this programme which aims to provide an therapists new to practice education with an introduction to the clinical education programme of the Department of Clinical Speech and Language Studies, Trinity College. We hope that the course and handbooks will enable you to achieve the following learning outcomes.

Become familiar with the clinical education programme of the department of Clinical

Speech and Language Studies, Trinity College

Be aware of the student learning goals for placements throughout the course

Be familiar with the roles and responsibilities of college, students and clinical supervisors

Evaluate your service agency as a learning environment.

Plan, implement and facilitate student learning in your clinical settings

Outline preparatory documentation to facilitate placement education

Identify your learning needs as a practice educator

Apply knowledge of professional competencies to formative and summative evaluation of

student performance in clinical contexts

Gain confidence in your ability to evaluate and provide feedback on developing

competencies in students

Gain deeper knowledge of adult learning processes and ways to facilitate learning in a

clinical context

Apply principles of learning and feedback as appropriate to adult learners

The aim of the preparatory handbook is to present introductory information on the learning theories, approaches and processes used in the clinical education programme. It is hoped that the presentation of this material prior to the course will allow for interactive sessions during the course. Further details on the education programme and specific placements are in the Handbook for Clinical Education which can be down loaded from the department web site. You will be given to you on registration.


Clinical education

Clinical education is a vital component of educational programmes that enable health care students to achieve both academic and professional qualifications on graduation. The achievement of these outcomes is dependent on partnerships between the Higher Education Institutions (HEIs), Health Service Executive (HSE), the health service agencies (HSAs) at managerial level but is more keenly dependent on good working partnerships between those directly involved in delivering learning opportunities to students in colleges and clinics. Education for professional practice is ultimately dependant on small teams of lecturers, tutors and therapists who prepare and provide students with learning opportunities in clinical situations. Practice education Practice education is the generic term now in use to describe student workplace learning in the Health Service professions. The terms practice learning and student placement are used to describe the range of placement experiences provided to students attending higher education institutions (HEIs). The terms practice placement, clinical placement, fieldwork placement are used interchangeably in the health services. The terminology in use to describe those who engage in the practice education is currently changing and the following are now recommended by the Therapy Project Office. Practice educator. The term Practice Educator is used to describe the key therapist in the practice placement who facilitates the student learning directly and who also has responsibility for the formative and/or summative assessment of competence. The term covers the many roles such as learning facilitator, supervisor, trainer, tutor, mentor, and examiner, undertaken by therapists as they participate in the clinical education of future members of their profession. Therapists in their role as placement educators undertake

To provide clinical learning opportunities for students in their clinical setting To provide students with appropriate feedback to enable them to learn and

develop clinical competencies To participate in assessment of students’ clinical competency.

The role of the practice educator is supported by regional placement facilitators, practice tutors and placement educator coordinators in the Irish Health Services. Detailed information on the roles of all involved is outlined in the Guidelines for Good Practice in Clinical Education and Practice Educator Competencies which can be downloaded from the IASLT or TCD websites.


Outline of the clinical education programme The Department of Clinical Speech and Language Studies at Trinity College, Dublin, provides an undergraduate educational programme to those interested in joining the speech and language therapy profession. The department provides a course that reflects the current knowledge base in the discipline of speech and language pathology as well as meeting employers’ demand for graduates who can adapt to changing service provision contexts. The structure of the programme aims to enhance the student’s ability to learn independently, to integrate information from disparate disciplines within the framework of communication disorders, and to critically evaluate and apply theoretical reasoning to theory clinical problems. Our goal is to educate graduates who have the background knowledge and clinical competencies which will enable them to practice as speech and language therapists on graduation. A variety of teaching approaches are used including problem-based learning, case-based learning, self-directed learning (including use of multimedia), and didactic teaching. The key subject strands are interwoven across the four years to provide course coherence as summarised in the table 1. Table 1 Course Outline Subject Strands

JF Foundation

SF Novice

JS Transition

SS Entry

Speech and Language Pathology

Introduction to SLT: Professional Role, clinical context and content

Assessment Principles: Profiling communication and feeding eating drinking and swallowing

Intervention Principles: Communication and feeding eating drinking and swallowing

Management Communication and feeding eating drinking and swallowing disorders Intellectual impairment

Clinical Education

Observation, Foundation clinical skills CONNECT Audiology Baby study Preschool study FEDS

Assessment & Case management Clinical workshops and practice placements 1.1 Weekly 1.2 Block

Intervention: Clinical intervention workshops Case management Placements 2.1 Weekly 2.2 Block

Ethics, administration and reflection on practice Caseload and case management Placements 3.1 Weekly 3.2 Block

Speech Language & FEDS

Introduction to Language Studies Language acquisition

Assessment and diagnosis communication and feeding, eating

Sociolinguistics Bilingualism Discourse analysis

Seminars Specialist topics

General

Phonetics Speech & hearing Anatomy Physiology Normal swallow

Speech Sciences Linguistics Neuroanatomy

Neurology & Psychiatry Seminars Specialist topics

Psychology

Social and lifespan psychology

Cognitive-neuro-psychology

Learning Memory & Cognition

Counselling principles and practice

Research

Introduction, Cross subject input Library courses

Research methods Principles and methods of empirical research

Research project


Table 2. Clinical education programme: modules and learning goals

Junior Freshman Preclinical Learning goals Pre clinical Contributions from other strands and courses Baby study Nursery - Pre-school placement – Service Location Visit Audiology clinics Introduction to Clinical Practice - Video seminars - SLP Foundation Problem based learning process CONNECT / General client group experience

Develop professional knowledge of Human anatomy ,physiology and lifespan development Critical thinking and problem solving SLT profession and clinical processes General client groups Hearing and audiological assessment Develop basic competency in professional skills of Objective Observation, transcription and analysis Clinical problem solving processes Oral & written reporting skills Team working skills Time management Assessment of hearing Demonstrate in professional practice Respect for others and an understanding of the implications of communication impairments in daily life A range of interpersonal communication skills to communicate effectively and professionally with others Self awareness and self evaluation skills

Clinical Modules Senior Freshman Disorders of communication and swallowing assessment and diagnosis Assessment: General skills workshops Specific assessment skills: Language, FEDS, Fluency, Speech, Voice Placements 1.1 weekly Observation and management of clients under direction with a focus on assessment and diagnosis. Independent learning: PATSY Placement 1.2 15 day Observation / case management block

Develop professional knowledge of Language, anatomy, neurology and psychology to underpin diagnostic skills Knowledge base of principles underlying assessment Develop basic competency in the professional skills of Clinical assessment (sampling, recording, analyzing and evaluating communication and FEDS profiles) Clinical oral and written reporting skills Interpersonal communication styles to facilitate professional communication with clients and co workers

Demonstrate in professional practice in the ability to apply professional and legal guidelines to practice Establish and maintain working relationships with clients to achieve clinical objectives Apply knowledge and skills to typically developing children and to clients in clinical contexts Apply theory to practice in the selection and evaluation of assessments Select therapy goals and use therapeutic skills and techniques under supervision Use a range of interpersonal communication skills to communicate effectively with a wide range of clients, communication partners and co workers Report orally and in writing in a professional manner. Self-evaluate developing professional competencies objectively


Table 2 continued Junior Sophister

Placement 2.1 Observation and management of clients under the guidance of a speech and language therapist Clinical tutorials Independent learning: Video observation and use of specialized programmes Clinical workshops intervention; AAC, Language, FEDS, Fluency, Speech, Voice Placement 2.2. Case and caseload management Block placement in health service clinics (20 days)

Develop professional knowledge of The cognitive processes that foster language Linguistic diversity Models of assessment Principles of intervention Therapy approaches Intervention with specific client groups Caseload and service management options

Develop competency in critical thinking and in the application of professional knowledge to individual clients in

Diagnosis Therapy planning Therapeutic interactions Evaluation Reporting

Demonstrate in professional practice the ability to

apply professional and legal guidelines to practice relate in a professional manner to clients and co workers apply theoretical knowledge and research skills to evidence based practice in client and caseload management use a range of communication and interpersonal skills to facilitate therapeutic interactions with a range of clients objectively evaluate own developing professional competencies.

Senior Sophister Professional studies: Counselling, Ethics and administration Dysphagia intellectual impairment Specialist seminars Placement 3.1 10 day clinical practice case and caseload management Independent learning: Video observation and use of specialized programmes Placement 3.2 30 day clinical practice block

Develop professional knowledge of Speech and language therapy services in the

context of global, national and local health policies

Service and caseload management Service delivery options Audit mechanisms Research in practice

Consolidate and genralise clinical competencies and professional skills across a range of care groups and service locations Develop and demonstrate professional skills required by specific client groups Demonstrate in professional practice the ability to apply clinical research skills to case, caseload

and service management apply ethical decision making in case and

caseload and service management apply professional and legal guidelines to

practice use professional decision making skills in case,

caseload and service management


The success of the clinical education programme is dependent on collaboration and co working between the college, students and practice educators. The roles and responsibilities of all are summarised in table 3 and can be read in greater detail in Guidelines for Good Practice in Practice Education (T.P.O. 2008). Table 3 Pre-placement College Ensure that practice educators and students have information

about the content and structure of the clinical education programme and the learning goals for each placement

Ensure that all pre-placement requirements are met to e.g. Garda clearance, vaccinations, etc.

Ensure that all practice educators are provided with information relating to the specific students assigned to their clinics.

Ensure that students have the opportunity to acquire an adequate knowledge base for the placement

Ensure that the student has shown potential to use the professional skills required in the placement

Ensure that students are aware of the professional code of ethics and conduct

Ensure that the student is aware of the placement learning goals Ensure that the students and practice educators are aware of the

supports and resources available to them in the Department and the College to meet their learning needs

Student Attend pre placement clinical briefings and read all relevant practice education placement documentation.

Read materials from the professional knowledge base relevant to their clients and service setting which enable them to link and apply theory to therapy.

Practise the specific skills required for their placement with peers i.e. developing familiarity with new assessment tools, IT systems, etc.

Conduct a learning review and identify learning goals for the placement

Prepare and post a clinical CV to the placement educator when placement confirmed

Contact the practice educator to confirm stating details Practice educator

Forward an information pack containing agency policies and procedures, placement details and recommended reading to students

Provide the student with an induction session outlining agency specific policies and procedures

Design and implement placement education procedures which ensure that quality of client care and service management are maintained

Select student caseload and service delivery options Notes


During the placement College Have links available to support placement educator and students

should the need arise – practice education coordinator, college mentors, college tutor.

Student Respect the professional ethical code and conduct guidelines and follow agency guidelines in all policies and procedures

Show respect for the clients and the host agency service by observing written and unwritten codes of dress and conduct.

Notify the Practice Educator as soon as possible if he/she is absent due to sickness or a family emergency. Notify the College of any days missed on placement and provide a medical certificate in accordance with policies.

Engage in active learning to facilitate the integration of theory and practice.

Act within the guidelines laid down by their placement educator in administration and record keeping as well as in client and caseload management.

Engage in active learning to set and achieve clinical learning goals

Practise honest self evaluation of performance and professional behaviour and share learning goals and needs with placement educator

Accept feedback from placement educators and modify behaviour if requested

Use reflective practice and independent learning to further develop knowledge and skill base

Complete all reports and evaluations and submit required to the placement

Placement educator

Ensure that students are aware of the service policies and procedures in record keeping, health and safety and general administration.

Ensure that students are aware of the case and caseload responsibilities to be entrusted to them and of the restrictions placed on these by the clinician.

Agree a learning plan with the student which reflects the learning goals of the placement and takes account of the student’s own earning needs and expectations

Establish schedule of direct and indirect supervision Establish evaluation and feedback schedule. Promote reflection and encourage the development of clinical

reasoning skills.

Involve the student in discussion of clinical learning goals and supervision process.

Assist the student in the description and measurement of his/her progress in developing clinical competencies

Notes


Post placement College Collect evaluation forms and add to student profile Review learning plans of students who have not achieved the

required levels of clinical knowledge or skills in the core competencies.

Collect general placement feedback from students* Collect feedback from placement educators * Student Attend pre and post placement clinical briefings Complete and return placement evaluation forms Reflect on learning, complete learning review form and set new

learning goals

Return hours form to the department Placement educator

Sign student hours form (students must return this form to college to be credited with the certified hours)

Return student evaluation forms Provide general i.e. non student specific feedback to department

if warranted.

Conduct long term and short term cost/ benefits analysis of student placement

Individual clinics, clinicians and students are not identified on placement evaluation forms. Information obtained from the forms and clinical debriefing sessions is compiled and summarised and is then reviewed with students at clinical briefings, with college staff and therapists at clinical steering committee meetings and the annual clinical educators meeting. Notes


Placement programme Students undertake two placements during each academic year as outlined in table 4. Table 4 Year Level Weekly Block 1 junior Freshman 0 Connect project general 2 Senior Freshman 1 Mondays (term time) from

January to March 15 days September

3 Junior Sophister 2 Thursdays (term time) from October to January

20 days May/June

4 Senior Sophister 3 Short block plus Mondays OR Fridays September to December

30 days February March

Table 5. Over view clinical education schedule (June 2011) week Year 1 Year 2 Yr 3 Yr 4

1

Sept 5

Clinical practice 1.2 12 clinical days 3 research days1

2 12 SF 1.2

3

19

SF 1.2

Clinical practice 3.1 Monday Clinical briefing Tues – Fri. 4 day mini block

4

26

Clinical briefing General &SCCEP B Clinical policies and procedures Audiology

Clinical briefing Service management report Clinical workshop Record keeping Setting, recording and evaluating objectives

Clinical practice 3.1 Monday or Friday FEDS workshops

5

3

Clinic visits

Clinical workshops A Assessment Sampling and recording B Communication and language C Audiology screenings

Thursdays Clinical practice 2.1

Clinical practice Monday or Friday

6

10

Clinic visits

Clinical workshop a Setting, recording and achieving objectives B Audiology screenings

Thursdays Clinical practice 2.1


7

17

Clinic visits

Clinical workshops Formal assessment Skills practice formal tests B Audiology screenings

Thursdays Clinical practice


8 24

Clinic visits

Bank holiday Thursdays Clinical practice

Clinical practice Friday

9

31

Connect workshop

Informal assessments Informal assessment pack Clinical workshop Speech



10

Nov 7

CONNECT Clinical workshop Voice Thursdays Clinical practice


1 14 CONNECT Clinical workshop Voice Thursdays Clinical practice

1 Placement 1.2 and 2.1 SF/JS inter block and JS weekly may be combined if this fits with clinical practice


1 Clinical practice Monday or Friday 12

21 CONNECT Clinical workshop Fluency Thursdays

Clinical practice Clinical practice Monday or Friday

13

28 CONNECT 2

Clinical workshop Fluency Lectures CP Thursdays


14

Dec. 5

CONNECT Clinical workshop Clinical diagnosis Reporting


15

12 CONNECT Skills practice Formal and

informal assessments CP Thursdays

16 19 Christmas Vacation 17 26 2012

19 2

20 9 Preschoo

l

21 Jan 16

CONNECT Mondays Clinical practice


Clinical briefing

22 23



23 30



Clinical practice 3.2 30 days block 24 clinic days 1 return day 5 research days between 30th of Jan and 30th of March

24 Feb 6


Clinical workshops intervention FEDS

25 13


Clinical workshops intervention FEDS

26 20


Clinical workshops Intervention Voice

27 27


Clinical workshops Intervention Voice

28 Mar 5


Clinical workshops Intervention fluency

29 12


Clinical workshops intervention fluency

30 19


Clinical workshops x2 Language

31 26

CONNECT Clinical briefing Case Presentations

Clinical briefing Report writing

32 2 9 Easter

33 16 34 23 35 30 exams exams 36 7 exams exams 37 14 Clinical Practice Block 2.2

20 days (16 days clinical 4 research days) between 14th of May and 22nd of June

exams 38 21 exams 39 28 40 3 41 10 42 17 43 24 44 *Level 1

competency

**Level 2 competency Level 3 Competency

2 Audiology clinics will be scheduled when available

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Types of placements The traditional practice placement which relied on a one to one model of supervision is gradually being replaced by the use of paired or group placements in all areas of student education in the health services. Paired and group placements have been found to have benefits for therapists and students in that therapists report that demands on their time is reduced as

Students problem solve together and discussion time with placement educator is more focused.

Group feedback and discussion saves repetition

Students provide support for each other in developing

clinical competencies e.g. practicing test use, assessments, developing intervention materials and practising intervention techniques and strategies

Therapists have used group placements in particular to develop new service delivery models or implement special assessment and /or intervention projects. Students report that having a peer on placement provides them with social support and reduces pressure on individual performance. They also report that they learn from the knowledge and skills of their peers. Students also welcome opportunities skills practice and feedback from a peer without a practice educator present. Paired work prepares students for future professional work by encouraging development of: Team working Reporting and professional discussion skills Ability to share knowledge and skills necessary for professional co-working Ability to work under observation and share goals with others.

Paired placements may be organised in a variety of ways with the main principle being that each student take his/ her quota of clients for direct work but in addition they also share their knowledge of the client /s with their paired partner. They may involve the peer in client management in any of the following ways:

Co-worker in therapy, i.e. direct delivery, e.g., partner in activities, role model, demonstrator, etc.

Observer/ recorder during therapy - to provide feedback on therapy, observations on session management, etc.

Consultant on therapy but not directly involved as observer or participant, i.e., peer does not observe therapy but is familiar with the case notes. Student summarises and discusses therapy plans and implementation with peer and consults on client management session.

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Would paired and / or group placements suit you? your caseload? your service? We suggest that all therapists consider following a paired or group approach to practice placements. We realise that these may not be possible in all settings but would invite all to complete SWOT analyses to identify potential for such placements in their services. You Strengths

Weaknesses

Opportunities

Threats

Caseload Strengths

Weaknesses

Opportunities

Threats

Service Strengths

Weaknesses

Opportunities

Threats

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Learning Speech and language therapy students come to us as adult learners with their learning styles and habits already formed. Students are encouraged to develop knowledge of their preferred learning styles and to relate this to their learning in both academic and clinical work. They complete quizzes and questionnaires during the first year to encourage them to identify and reflect on their learning in an objective manner. They are also made aware that they will need to develop a range of processing and learning styles in order to develop the professional competencies needed to practice as a speech and language therapist. During the education programme it is expected that students will move from lower to higher order learning in all areas of professional knowledge as illustrated using Blooms taxonomy in table 6. This should be evident in their ability to apply critical reasoning skills to the analysis, synthesis and evaluation of client profiles and clinical problems. The questions words on table 3 indicate the type of questions the student should be asking themselves and answering in discussions with practice educators during the course of their undergraduate programme. Table 6 Levels of learning 3

6: Evaluation – make and present judgments, defend opinions by valid and reasoned argument Questions argue, conclude, explain, evaluate, criticize, justify prove, measure, recommend,

2

5 Synthesis reconfigure elements in different ways to solve problems or propose alternative explanations Questions Compile, construct, create, design, develop theorise

1

4 Analysis – exploring information by examining parts, identifying causes, making inferences and finding evidence to support hypotheses. Questions Analyze, categorize, compare, contrast, examine, distinguish, Identify themes, relationships, functions, motives

3Application - Applying acquired knowledge, facts, techniques and rules to solving problems in different contexts Questions: Apply, construct, develop, organize, identify, plan, select, solve, utilize, model

0

2 Comprehension demonstrates understanding of facts and ideas by organizing, comparing, interpreting, stating main ideas. Questions Compare, contrast, compare, contrast, demonstrate, interpret, explain, extend, illustrate, infer, outline, relate, rephrase, translate, summarize, show, classify

1 Knowledge Demonstrates learned material by recalling facts, terms, basic concepts and answers. Questions who, what, why, when, label, list, match

Cognitive levels Low order ---------------------------------------------------------------------------------Higher order The level and depth of learning the students would be expected to demonstrate will vary according to stage of academic and clinical education. It is expected that in each placement students will progress rapidly from application to analysis, synthesis and evaluation in clinical knowledge and skills. The following section includes some quizzes and questionnaires to encourage clinical educators to reflect on their favoured perception and processing styles. Acknowledging differing processing and learning styles may help both student and therapist to identify learning opportunities, evaluation and feedback approaches that will ensure smooth running of the placement. Clinical educators who wish to identify their learning style in detail may use the questionnaire on pages 15-18 or will find on line questionnaires and analysis on the following sites http://www.engr.ncsu.edu/learningstyles/ilsweb.html http://www.active-learning-site.com/ http://www.support4learning.org.uk/education/learning_styles.cfm

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Learning Styles Questionnaire from www.businessballs.com. 5.7.2007 Circle or tick the answer that most represents how you generally behave. (It’s best to complete the questionnaire before reading the accompanying explanation.) 1. When I operate new equipment I generally:

a) read the instructions first b) listen to an explanation from someone who has used it before c) go ahead and have a go, I can figure it out as I use it

2. When I need directions for travelling I usually: a) look at a map b) ask for spoken directions c) follow my nose and maybe use a compass

3. When I cook a new dish, I like to:

a) follow a written recipe b) call a friend for an explanation c) follow my instincts, testing as I cook

4. If I am teaching someone something new, I tend to:

a) write instructions down for them b) give them a verbal explanation c) demonstrate first and then let them have a go

5. I tend to say:

a) watch how I do it b) listen to me explain c) you have a go

6. During my free time I most enjoy:

a) going to museums and galleries b) listening to music and talking to my friends c) playing sport or doing DIY

7. When I go shopping for clothes, I tend to:

a) imagine what they would look like on b) discuss them with the shop staff c) try them on and test them out

8. When I am choosing a holiday I usually:

a) read lots of brochures b) listen to recommendations from friends c) imagine what it would be like to be there

9. If I was buying a new car, I would:

a) read reviews in newspapers and magazines b) discuss what I need with my friends c) test-drive lots of different types

10. When I am learning a new skill, I am most comfortable:

a) watching what the teacher is doing b) talking through with the teacher exactly what I’m supposed to do c) giving it a try myself and work it out as I go

11. If I am choosing food off a menu, I tend to:

a) imagine what the food will look like b) talk through the options in my head or with my partner c) imagine what the food will taste like

12. When I listen to a band, I can’t help:

a) watching the band members and other people in the audience b) listening to the lyrics and the beats c) moving in time with the music

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13. When I concentrate, I most often: a) focus on the words or the pictures in front of me b) discuss the problem and the possible solutions in my head c) move around a lot, fiddle with pens and pencils and touch things

14. I choose household furnishings because I like:

a) their colours and how they look b) the descriptions the sales-people give me c) their textures and what it feels like to touch them

15. My first memory is of:

a) looking at something b) being spoken to c) doing something

16. When I am anxious, I:

a) visualise the worst-case scenarios b) talk over in my head what worries me most c) can’t sit still, fiddle and move around constantly

17. I feel especially connected to other people because of:

a) how they look b) what they say to me c) how they make me feel

18. When I have to revise for an exam, I generally:

a) write lots of revision notes and diagrams b) talk over my notes, alone or with other people c) imagine making the movement or creating the formula

19. If I am explaining to someone I tend to:

a) show them what I mean b) explain to them in different ways until they understand c) encourage them to try and talk them through my idea as they do it

20. I really love:

a) watching films, photography, looking at art or people watching b) listening to music, the radio or talking to friends c) taking part in sporting activities, eating fine foods and wines or dancing

21. Most of my free time is spent:

a) watching television b) talking to friends c) doing physical activity or making things

22. When I first contact a new person, I usually:

a) arrange a face to face meeting b) talk to them on the telephone c) try to get together whilst doing something else, such as an activity or a meal

23. I first notice how people:

a) look and dress b) sound and speak c) stand and move

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24. If I am angry, I tend to: a) keep replaying in my mind what it is that has upset me b) raise my voice and tell people how I feel c) stamp about, slam doors and physically demonstrate my anger

25. I find it easiest to remember:

a) faces b) names c) things I have done

26. I think that you can tell if someone is lying if:

a) they avoid looking at you b) their voices changes c) they give me funny vibes

27. When I meet an old friend:

a) I say “it’s great to see you!” b) I say “it’s great to hear from you!” c) I give them a hug or a handshake

28. I remember things best by:

a) writing notes or keeping printed details b) saying them aloud or repeating words and key points in my head c) doing and practising the activity or imagining it being done

29. If I have to complain about faulty goods, I am most comfortable:

a) writing a letter b) complaining over the phone c) taking the item back to the store or posting it to head office

30. I tend to say:

a) I see what you mean b) I hear what you are saying c) I know how you feel

Now add up how many A’s, B’s and C’s you selected.

A’s = B’s = C’s = If you chose mostly A’s you have a VISUAL learning style. If you chose mostly B’s you have an AUDITORY learning style. If you chose mostly C’s you have a KINAESTHETIC learning style. Some people find that their learning style may be a blend of two or three styles, in this case read about the styles that apply to you in the explanation below. When you have identified your learning style(s), read the learning styles explanations and consider how this might help you to identify learning and development that best meets your preference(s). Now see the VAK Learning Styles Explanation.

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VAK Learning Styles Explanation

The VAK learning styles model suggests that most people can be divided into one of three preferred styles of learning. These three styles are as follows, (and there is no right or wrong learning style):

Someone with a Visual learning style has a preference for seen or observed things, including pictures, diagrams, demonstrations, displays, handouts, films, flip-chart, etc. These people will use phrases such as ‘show me’, ‘let’s have a look at that’ and will be best able to perform a new task after reading the instructions or watching someone else do it first. These are the people who will work from lists and written directions and instructions.

Someone with an Auditory learning style has a preference for the transfer of information

through listening: to the spoken word, of self or others, of sounds and noises. These people will use phrases such as ‘tell me’, ‘let’s talk it over’ and will be best able to perform a new task after listening to instructions from an expert. These are the people who are happy being given spoken instructions over the telephone, and can remember all the words to songs that they hear!

Someone with a Kinaesthetic learning style has a preference for physical experience - touching, feeling, holding, doing, practical hands-on experiences. These people will use phrases such as ‘let me try’, ‘how do you feel?’ and will be best able to perform a new task by going ahead and trying it out, learning as they go. These are the people who like to experiment, hands-on, and never look at the instructions first!

People commonly have a main preferred learning style, but this will be part of a blend of all three. Some people have a very strong preference; other people have a more even mixture of two or less commonly, three styles. When you know your preferred learning style(s) you understand the type of learning that best suits you. This enables you to choose the types of learning that work best for you. There is no right or wrong learning style. The point is that there are types of learning that are right for your own preferred learning style. Please note that this is not a scientifically validated testing instrument – it is a free assessment tool designed to give a broad indication of preferred learning style(s). More information about learning styles, personality, and personal development is at www.businessballs.com. With acknowledgements to Victoria Chislett for developing this assessment.

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Learning enablers and constraints

Think of something which you have recently mastered.

Reflect on your feelings

as you started to learn when you had mastered some elements but others were elusive and unreliable when the task was fully mastered and automatic

What factors facilitated your learning? Did your motivational levels vary during the learning process? Did the facilitating factors remain the same throughout? Think of something which you had difficulty in learning. Reflect on your feelings

as you started to learn when you had mastered some elements but others were elusive and unreliable when the task was fully mastered and automatic or when you gave up

What factors hindered / facilitated your learning? Did your motivational levels vary during the learning process? Did the facilitating / hindering factors remain the same throughout? Think of your time as a speech and language therapy student What helped your learning? What hindered it?

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Learning Enablers and constraints as reported by students during clinical briefing sessions and on feedback forms

Enablers

Knowing what is expected of you Having an agreement about what you will be doing on the placement Having time to think about what you need to know Getting feedback Being successful Having success acknowledged Having to think on your feet (JS/SS) Opportunities to learn in a different ways (e.g. observe therapist, peer

practice) Being allowed to make mistakes Paired placements

Constraints

Not knowing roles of others Not being able to see the point of what you are asked to do Given instructions without explanations Time pressure - Having no time to think Being criticised or getting negative feedback Being compared unfavorably with other students Having to cope with too many new things at once staff, clients, time Not being trusted Not being given feedback Unstructured feedback sessions

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Induction to clinical placements Students attend a pre placement briefing in college where the following topics are covered Learning review Students complete a learning review form and set individualised learning objectives for the pre placement/ placement period. Clinical policies and procedures review Students are introduced to general guidelines policies and procedures covering legal and professional guidelines covering

Consent Record keeping Confidentiality Workplace health and safety Infection control and hand hygiene procedures Conduct at work Dignity At Work Policy HSE

Students are asked to confirm that they have read and understood the general guidelines. They are required to confirm that they have read and understood these guidelines by signing form A. The practice educator may request a copy of this form for the students if required for agency records. Induction packs Practice educators are asked to provide students with an induction prior to the placement. Ideally an information pack should be prepared and sent to students before the start of the placement. Suggested contents Map of Clinic/Hospital and local transport

Contact information (pre-placement)

General introduction to agency/ service or website reference Speech and language therapy

Service structure and locations

Team members

Client groups served

Service delivery options, Clinical pathways, etc.

Data and record keeping policies and procedures

List of frequently used tests

Bibliography/reference list of specific or specialised assessments

Health and Safety policy and procedures Specific guidelines on infection prevention,

Emergency procedures etc.,

Local guidelines for child protection

Contact number in case of emergency cancellation – sick leave, etc.

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The following activity may help you to design an induction pack

appropriate to your service

Note down a brief description of your workplace under the following headings Setting: community care, hospital,

Accommodation

Client group/s

Co workers

SLT Team

Highlight the information that would be helpful for a newcomer to your workplace to know in advance.

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Your workplace as a learning environment Think of what you needed to know when you took up your first job. Identify opportunities for sharing some of this knowledge with students in your workplace. Setting: community care, hospital,

Accommodation

Client group

Co workers

SLT Team

Other

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Review your workplace, case and caseload management and service delivery options as a learning environment for student therapists. Consider the needs of your clients the strengths and weaknesses of the team, the physical environment, as well the learning needs of students at varying stages of the clinical education programme.

SWOT Strengths

Weaknesses

Opportunities

Threats

Are the strengths of the workplace being used to their best advantage in practice education? Are there opportunities for you to use develop new strengths? Are there threats to the participation of the service in practice education programme? How will these strengths and weaknesses influence the learning opportunities of the students assigned to your placement? Are there ways that you can maximise the opportunities and minimise the threats.

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Placement learning opportunities The academic education programme provides students with opportunities to develop the knowledge base that underlies speech and language therapy practice but this knowledge can only be transferred to clients and clinical practice with practice based learning. Practice placements to enable students to relate theory to practice, to master clinical skills and develop the competencies that will enable them to function at graduate/ entry level to the profession as outlined in Speech and Language Therapy Competencies (Therapy Project Office). This can only be learned in clinical contexts under the guidance and supervision of competent speech and language therapists. The main focus in practice placements is on developing the Speech and Language Therapy Competencies

Identification and Assessment of Communication Needs Formulation of Plans for Meeting Communication, Eating, Drinking and Swallowing Needs Intervention Planning, Maintaining and Evaluating Services.

These require opportunities for students to undertake practice with clients under the supervision and guidance of practice educators. Students should have an average of 2 hours per day direct client work during weekly placements and 4 hours per day during block placements. Students at all levels require reflection and client management time for many tasks which are performed automatically by experienced therapists. In order to facilitate this it is recommended that all clinical placements allow for indirect client hours. Students are required to use this time to formally evaluate therapy, prepare equipment therapy plans, consult with peers, practice educators, etc. The indirect hours may also be used to enable students to master other key aspects of speech and language therapy practice as outlined in the Speech and Language Therapy Competencies in particular the competencies that underlie

Professional autonomy and accountability Employer and service agency policies including the structure and function of the health service agency in the context of current developments in education and health care services. Professional Relationships and team working.

Activities to develop competencies in these areas should be included in all placements if possible. Speech and language therapists need to manage time effectively to cope with the range of tasks associated with the professional organization and delivery of a service to clients and communities. Students need to learn the same time management skills. The practice educator should involve the students in a full a range of tasks as is possible during placements. Students should be involved in the routine matters that underlie service delivery such as room and material preparation, clean up, etc as efficiency in these areas will ensure more time for client work in the future. The delegation of routine tasks to students enables them to develop case and service administrative skills and the time recouped by the educator in this way can then be used for some of the additional work associated with student education.

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Students on all block placements are assigned one research day per week. Specific tasks are allocated to these days. The student does not require supervision on these days which may take place in college or clinic settings. They may be allocated additional time during the placement to complete these tasks with specific permission from the practice educator

The research tasks and assignments for the block placements are focused as follows

Level 1 Case, caseload and service delivery

Level 2 Case management – evidence base practice and report writing

Level 3 Case management: case study

Practice educators may find it useful to have students present the outcome of the research days to them or to their teams.

Routine tasks that students could gainfully do in your clinic

Task What students could learn

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Practice education resource file

Practice education offers many learning opportunities for students that do not necessarily involve direct educator time. Many clinicians find it useful to have a set of ‘ready to go’ tasks /activities related to the students learning goals available in a resource pack. These may then be handed to the students in the odd moments when the therapist could be employed elsewhere. Suggestions for activities include

a Student Observational Checklist Adult Speech & Language Therapy

Client Initial: Age: Date: Brief description of client and context

Communication skills Constraints on communication

Posture/Body language Speech, voice and fluency Breath Control Volume Voice Quality Rate Articulation Speech intelligibility Language Auditory Comprehension Spoken language Written language B

Cupboard (clean up) Have students do an inventory of the formal assessments in the test cupboards and identify a subset suitable for use with a specific client group. Formal assessment title

Aspects of communication system samples

Suitable for client who…

May not be suitable for clients who…

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C

Therapy

List 5 familiar TV/ tabletop games e.g. Snap, Lotto, Who wants to be a millionaire?

Identify how you could use these in therapy to achieve specified outcomes with specified client groups.

Game Could use with To achieve

D Observation of clients who are experiencing swallowing difficulties to develop awareness of the impact of difficulties in this area on daily living.

Student should observe

1. social interaction 2. communication 3. effects of environment, posture, cognitive and behavioural function 4. eating/feeding techniques/adaptations

in mealtime contexts such as

eating, drinking and mealtime routines in clients without dysphagia in the agency

eating, drinking and mealtime routines in clients with dysphagia who are feeding independently

others feeding clients with dysphagia and summarize observations in brief objective and subjective reports. E Read the speech and language therapy department’s policies and procedures and note key statements re record keeping / health and safety / client confidentiality

F Prepare general information pack for clients / families of clients with X

These activities do not require the presence of the practice educator

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Assessment, evaluation, feedback and examinations The role of practice educator involves on going assessment and evaluation of the students developing competencies. This is necessary in order to safeguard the client and to ensure that students are achieving the required learning outcomes for their stage of education. Students are assessed for both formative and summative purposes during the clinical education programme. Formative assessment provides students with feedback on their progress and enables them to set clear learning goals. Formative assessments

involves students in self evaluation practice educator and student reviewing and reflecting on performance in a

structured way ensures that learning goals are shared by both ensures that students understand the standards required

Summative assessments determine the extent to which students have achieved the specific learning objectives for their stage in clinical learning. The department in common with other colleges uses the national Student Clinical Competency Evaluation forms and indicators for both formative and summative evaluations of student progress at mid and end of placement points (see SCCEP manual for further information). These topics will be explored in detail on the course. The self appraisal checklists is included in order to encourage reflection on the process of appraisal, evaluation and feedback as many clinical educators indicate that they find this aspect of the educator role poses difficulties for them. You may complete the form (p32-33) or skip to the reflections section if you have recently experienced a formal work appraisal session.

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Interpersonal/Organizational Skills Assessment (Microsoft Word template) Review Information

Your Name:

Date:

Review Period: to

Guidelines

Complete this review, using the following scale: NA = Not Applicable 1 = Needs Work (Unsatisfactory) 2 = Gets By (Marginal) 3 = Meets Requirements 4 = Exceeds Requirements 5 = Exceptional

Repeat the review annually and compare your yearly scores.

Communication

(5) =

Exceptional (4) = Exceeds Requirements

(3) = Meets Requirements

(2) = Gets By

(1) = Needs Work

Processes received information

Listens to others

Communicates effectively

Verbal communications

Written communications such as reports

E-mail etiquette

Telephone etiquette

Leadership

(5) =



(2) = Gets By

(1) = Needs Work

Leads by example

Finds realistic solutions

Acts decisively; meets problems head-on

Brings out the best in team members

Resolves conflicts

Establishes clear expectations

Provides necessary resources

Delegates clearly

Relationships

(5) =



(2) = Gets By

(1) = Needs Work

Strong client advocate

Sets aside personal biases and wants

Gives good, practical advice

Fosters loyalty in co workers

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Project Management

(5) =



(2) = Gets By

(1) = Needs Work

Prioritizes tasks

Responds quickly and well to problems

Manages costs effectively

Develops new strategies

Organizes tasks

Productivity

(5) =



(2) = Gets By

(1) = Needs Work

Makes realistic goals

Meets deadlines

Comes in under budget

Works smarter, not harder

Looks for efficiencies

Completes tasks

Personal Development

(5) =



(2) = Gets By

(1) = Needs Work

Even-tempered under pressure

Sets high standards for self

Sets challenging goals

Reflections What were your feelings when you started to complete the form? Did you find the structured self appraisal form useful? If so, in what way? How did you feel as you completed it? Did it encourage you reflect / set goals for any aspects of your work? Can you apply these reflections to a student evaluation session?

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Feedback Assessments and evaluations need to be followed by feedback i.e. sharing your perception of how a student has performed with them and relating this to their learning objectives. Giving and receiving feedback should increase self knowledge, improve performance and help to maintain a positive working relationship between the practice educator and the student but many find it stressful and disruptive. The following guidelines adapted from (Singh 2006) may help to reduce the stress. Make time for feedback and ensure privacy Try to give feedback as soon after the event as is possible Ask the student to self assess first (self evaluation forms for sessions and general

reviews are included in student placements packs). Concentrate on specific aspects/ activities Specify and limit what you will cover. Own your feedback and acknowledge that it is based on your observations/

perception of the students behaviour e.g. I noticed…, I did not …, I feel…, rather than You didn’t…

Give positives before negatives. Give the student time to think and respond Give balanced constructive feedback. Students need to know what they have done

well and why. They also need to know why some things may not have gone well so you need to recognize these as well.

Negative feedback delivered constructively has the greatest impact on improving performance. Students will usually recognise that they have not done something well but need help frequently to identify what went wrong and why.

Use questions initially to allow student to say what did not go well. Prompt with further questions using levels such as those on table 6 to make feedback specific and establish reasons.

Support student in identifying / exploring alternatives. Anticipate an emotional response from some students, be supportive but don’t get

distracted from the feedback session End on a positive note. Activities to explore feelings about feedback Use the profile generated by the completed appraisal form as if it was that of a colleague to identify and provide feedback on one aspect of their work where they are doing well and two aspects that you feel could be developed.

Constructive feedback should help the learner to know they have achieved and to be clear about what they still have to learn to do to demonstrate competency. Feedback should provide learners with information on which areas of practice should be consolidated and on those areas that require modification.

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Clinical assessments and examinations Table 7 Clinical assessments and examinations Year Module Examiner Evaluation of Recorded as Senior Freshman

1.1.a Clinical workshops

Practice education coordinator/ regional Placement facilitators & tutors

Child screening reports Adult screening report PDL assignments

Grade

1.1 Case management

Practice educator Continuous assessment of clinical competencies

Grade derived from SCCEF 1

Case reports and presentation PDL assignments

Practice education coordinator/ regional Placement facilitators & tutors

Case presentation Grade

1.2 Case management block


Grade derived from SCCEF level 1

Junior Sophister

1.2 Placement education coordinator

Caseload and service management report

Grade on group presentation

2.1 Case management


Grade derived from SCCEF level 2 and PDL evaluations

Practice educator plus colleague

Clinical examination Grade derived from SCCEF level 2

Continuous assessment of clinical competencies

Grade derived from SCCEF level 2

Clinical skills workshops

Placement education coordinator

Completed PDL assignments incl. FEDS portfolio

JS 2.2 Block Practice educator plus academic staff

Case reports SS Clinical Mark derived from SCCEF level 3

Senior Sophister

Placement 3.1

Practice educator Continuous assessment

Placement 3.2

Practice educator Continuous assessment

Practice educator plus college examiner ( plus extern in some instances)

Clinical examination

Lecturers( plus extern in some instances)

Case study 3

The Student Clinical Competency Evaluation Forms (SCCEF) are used by clinical

educators and students in order to monitor developing clinical competencies through the

undergraduate years. The evaluation forms are also used to derive the summative marks

required at the end of each level.

3 Possible change to presentation following placement 3.1

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Your role as a clinical educator As you plan your practice placements it is useful to reflect on your experience and competencies as a practice educator. What kind of teacher, demonstrator, mentor, tutor and supervisor are you? Are some of these roles more comfortable for you then others? Are you making the best use of students in your practice? SWOT Strengths

Weaknesses

Opportunities

Threats

How will your strengths and weaknesses influence the learning opportunities of the students assigned to you? Are you using your strengths to their best advantage in your current work with students? Are there opportunities for you to use develop new strengths? Are there threats to your functioning as a clinical educator? What resources to you need to overcome these? The Guidelines for Practice Education and Practice Educator Competencies (Therapy Project Office) provide useful guidelines to therapists seeking to evaluate their role as practice educators and enable them to identify resources needed for professional development in this aspect of their work.

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Further reading Handbook for Clinical education Clinical Speech and Language Studies, Trinity College

The management of Feeding, Eating, Drinking and Swallowing Disorders / Dysphagia Outline of pre entry clinical education 2010-2014

(Handbooks are revised annually and educators should ensure that they have the current yearbooks. They can be downloaded from the department website or requested from the secretary) Student Clinical Competency Evaluation pack – forms, indicators and manual A copy of the relevant forms and indicators needed for each placement will be sent with the placement information when students are allocated to you. Copies can also be downloaded from the departmental or IASLT websites. Practice based learning Managing the Placement Learning Environment Communication Skills and other useful material for practice education can be downloaded from http//www.practicebasedlearning.org Assessment guidelines Allin L & Turncock, C. (2007) Assessing student performance in work based learning available at http://www.practicelearning.org.uk Learning theories review http://www.practicebasedlearning.org/resources/t&l/theory.htm Learning and teaching strategies http://www.bournemouth.ac.uk/ihcs/PDF/ments2.pdf Mentoring http://www.bournemouth.ac.uk/ihcs/PDF/ments1.pdf Bloom's Taxonomy and Critical Thinking Barbara Fowler, Longview Community College. http://www.teachers.ash.org.au/researchskills/dalton.htm Open access E learning modules on all aspects of practice education designed and edited by Judy McKimm and Tim Swanwick, London Deanery to inform and support the professional development of practice educators in medicine but are excellent for all involved in practice based teaching and learning. http://www.faculty.londondeanery.ac.uk/e-learning Best D, Rose M (1996) Quality Supervision Theory and Practice for Clinical Supervisors.

London: Saunders Boyle B. (1997) Teaching Students the Consultative Model, RCSLT Bulletin, 548 pp 12-14. Kolb D (1984) Experiential Learning as the Science Of learning and Development. Englewood

Cliffs, NJ: Prentice Hall Parker A, Kersner M., (1998) New Approaches to Learning on Clinical Placement, The International Journal of Language & Communication Disorders., 33:(supplement) 255-

260. RCSLT Position Paper (2003) The Provision of Clinical Placements: Stakeholder Roles &

Responsibilities (2007) National standards for practice based learning

Sharp P, Ainslie T, Hamphill A, Hobson S, Merriman C, Ong P and Roche J (2005) Mentoring. http://www.practicebasedlearning.org/resources/materials/docs/Brookes%20Final.pdf Singh G (2006) Assessment in Social Work. http://www.swap.ac.uk/learning/AssessSW1.asp Stengelhofen, J., (1993) Teaching Students in Clinical Settings. Chapman and Hall. Therapy Project Office

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Guidelines for Good Practice in Practice Education Therapy Project Office May 2008 Practice Educator Competencies Project Office May 2008 available for downloading from IASLT web site and the department website

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Please complete the course feedback form before you leave. Thank you for your attendance and participation in the clinical

education programme.

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