Issue III- The New Standards: Impact on Practicum in Speech- Language Pathology and Audiology Elena M. Kleifges, MA CCC-A Clinic Director Gallaudet University Audiology and Speech-Language Pathology Department

Hearing and Speech Center Year-round clinic serving members of the Gallaudet Community and the members of the D.C. metropolitan area (and more) All ages: birth to … Speech and language services: therapy, diagnostic evaluations, screenings Audiology services: audiological evaluations, hearing aid dispensing program (evaluation, fitting, orientation), OAE, ABR and cochlear implant mapping (under construction) Aural Rehabilitation services: communication therapy, speech reading classes, pronunciation classes, undergraduate courses

Clinic Supervisors Four audiologists - diagnostic Two audiologists– aural rehabilitation Four speech-language pathologist – also do some aural rehabilitation

Clinical Experiences Practicum - four semesters of diagnostics and three semesters of aural rehabilitation in our clinic Internship - three semesters in outside placements (one of these may be an aural rehabilitation experience) Externship - fourth year experience

Clinic Practicum First year One diagnostic slot for an hour and a half – AA Walk-in service – one hour Clinic lab Staffing Second year Two diagnostic slots for an hour and a half each – AA, HAE, HAC, HAF, ALD Walk-in service – one hour Clinic lab Supervisory meeting

New Standards – What Weve Done So Far… Analyzed Knowledge and Skill areas listed in the new standards Compared the knowledge and skills in new standards to the knowledge and skills in our clinical practicum evaluations Formative assessment - ?

What we found… Not many holes in our curriculum Clinically, all of the skill areas seem to be covered, but not necessarily evaluated We have an appropriate formative evaluation system in place for clinic practicum for the first two years

The New Standards … do they match up with ours? Most of the standards are fairly general Our evaluation forms are much more detailed

For Example : Standard IV – D3 Obtain case history Skills we evaluate Diagnostic plan includes discussion of questions that will need to be asked Initial interview preparation reflects flexibility based on possible outcomes of responses Interview is comprehensive, systematic and structured Questions are clear and concise Level of language modified based on needs/abilities of client Client-clinician interaction facilitates interview

Another Example: Standard IV-E7 Perform assistive listening device assessment Skills we evaluate Recognize need for assistive and/or alerting devices Conduct communication needs assessment Plan and prepare, based on communications needs, appropriate devices to be considered Determine best coupling methods between hearing aid and ALD Conduct assistive device assessment Communicate impressions, recommendation and provide appropriate resources for obtaining assistive devices

The New Standards … do they match up with ours? Most of the standards are fairly general Our evaluation forms are much more detailed Competency of the skills listed – What does competent mean?

Competencies Need to have clear understanding of what constitutes competent Skills on our forms divided into two types: Competency: student not aware to well developed (5 point scale) Level of independence: requires constant supervision to knowledgeable on all phases and works independently (5 point scale)

Pending Issues Keeping track of skills and knowledge - documentation Whose responsibility is it? Students? Faculty and Staff? Outside placement supervisors? All? Continuity of formative assessment throughout the fours years Setting competency levels

What we need to do: Ideas Add specific skills and knowledge areas for experiences not obtained in our clinic (but somewhat in their classes) to the evaluation forms used by internships and externships

Experiences Obtained in Our Clinic: Basics of audiology Case history* Routine evaluation – pure tone air and bone conduction testing, speech audiometry, immittance, OAE Counseling and recommendations* Amplification - evaluation, fitting and orientation Aural rehabilitation Assistive devices technology* Experience with deafness and sign language

Experiences Expected During Internships and Externships Basic audiological skills Amplification experience Specific pediatric experience Special testing: ABR, EcOG, etc Vestibular testing and treatment Other – intra-operative monitoring, etc.

What we need to do: Some Ideas Add specific skills and knowledge areas for experiences not obtained in our clinic (but somewhat in their classes) to the evaluation forms used by internships and externships Develop a formative evaluation system that provides continuity through out the fours years – for outside placement supervisors Develop form that reflects clinical progress (and academic) for achieving knowledge and skill areas Decide what we consider competent

Review board – Audiology program members review all students each semester to monitor student progress and and provide feedback Portfolio – currently developing for aural rehabilitation Practical evaluation before internship – to have explicit criteria for entry into internships and externships Have students set goals for themselves before internships and externships Elaborate knowledge and skill areas to include strengths specific to our program

After the Fourth Year Experience… We want our graduates to be able to do or to be…what?