Guiding Principles

CAT Team Philosophy

The Schiefelbusch Speech-Language Hearing clinic operates in a team model of instruction. Each clinical educator has a team of students that they instruct over the course of the semester. The students have the ability to preference what team they want based on the clinical focus of the team and the supervisors expertise.

During my time as the GTA for the clinic, I served as a clinical supervisor for the Communication Advocacy Team (CAT). The CAT team's focus (developed my my supervisor Dr. Wegner) was on providing services to individuals with complex communication needs and their families. The clients served included individuals from various ages, but these principles guided service delivery for all clients:

1. All persons have communication potential and ability.

2. Improved communication is possible for all persons.

3. The only prerequisites to communication are in the area of communication opportunities.

4. Opportunities for interactions with peers without disabilities should be provided.

5. The focus of communication intervention should be functional communication through the use of daily activities in natural settings.

6. Interactions should serve as the content for intervention.

7. Communication intervention should be provided as an integrated services

With these principles, my supervisor and I strove to provide clinical learning experiences for SPLH students that provided opportunity for the students to collaborating and partnering with others (including family members and other providers) and provide services in the community to foster the long-term success of the clients. Other goals included a focus on literacy skills for all individuals.

We encouraged students on the CAT team to use resources available to them in the clinic and to always ask questions if they had them. If I was in my office, my door was always open for a student to ask a question about clinic. This was modeled to me by Dr. Wegner.

Personal Philosophy

Entering into the role as a clinical supervisor in a university setting, I drew heavily upon my experiences as a clinical SLP. I had many years of experience in various settings with diverse populations. Through these experiences, I developed knowledge on specific teaching strategies, assessment techniques, and family collaboration. Additionally, I had experiences supervising university students in field study and serving as a clinical fellowship supervisor to draw from. In my work as a clinical supervisor, I am committed to sharing information that I have learned with my students. I did this by making myself available for questions, demonstrating an openness to meeting with students, and providing frequent and specific feedback. I always explained the 'why' behind what I was asking of them, whether it was related to service delivery or billing.

As a clinical educator, I strove to create an environment with my students that was built on a foundation of trust. Because many of the clients served on the team used AAC systems, if student clinicians did not have prior experience with AAC, there was a steep learning curve at the start of the semester. A trusting relationship between student clinician and clinical supervisor was critical to ensure that an open dialogue for questions was present. I did this by communicating expectations clearly verbally and following up via email for their future reference, checking for questions, having office hours when they could drop in and ask questions, giving specific feedback frequently (see next page for more examples), and following up with resources.

Friday Team Meetings

One of my responsibilities as the GTA was to lead Friday CAT team meetings. The format of these meetings changed slightly each semester. Generally speaking, team meetings were at time for all members of the team to get together and share successes of the week, get ideas from other team members, discuss relevant assigned readings, and for students preparing for assessments to practice with peers. Dr. Wegner assigned the readings for the team. These changed slightly each semester. Team meetings were also a time for student reflections. By fostering a safe space for student reflections, students were able to think about experiences they had, identify successes and challenges, and direct their learning through collaboration with peers (i.e. asking a specific question in team meeting).

To foster deep reflections, Dr. Wegner and I developed a reflection form based on The Gibbs' Reflective Cycle (1988). Graham Gibbs developed the the Gibbs' Reflective Cycle as a way to learn from experiences. Its cyclical form allows for its use in repeated experiences. This made it an ideal tool to use in the clinical setting, as it allowed students to reflect not only what happened, and how it made them feel, but what could be done differently next time. With this tool, students were able to reflect on one session that occurred during the week deeply, share that reflection with the team, and use the reflection in session planning for the next week. If they chose to reflect on the same client the following week, they were able to dig deeper into this reflection.

The reflection form we developed is seen below. Students were asked to fill out the fourth page.

Theletherapy and Simucase

Due to the COVID-19 pandemic, the service delivery model within the clinic for clients and for student clinical hours shifted. During the time that campus shut down, we were unable to provide in-person intervention or assessments. We shifted to simulated learning experiences initially, and eventually added teletherapy. Though the initial shift to both of these modalities was difficult, the experience helped me to grow as a clinician educator and as a clinician. I expanded my skill set into the world of teletherapy, and through this helped students to see that everyone can benefit from teletherapy services.

Simucase

In the spring of 2020, we shifted entirely to simulated clinical experiences using Simucase. As a the GTA for Dr. Wegner, I assisted in planning the schedule of clinical experiences for the students to complete, researching the clinical experiences myself for topics for discussion, ensuring that each student completed the assignments each week to the level required, and leading the group discussions in the debriefing each week.

Weekly debriefing meetings took place via Zoom. I structured them all similarly in order to provide structure and set expectations. Each week began with debriefing that week's Simucase sessions. For each session, I included a slide that included the length of the video along with the required debriefing time for the case. For each client, I first asked for someone to briefly summarize the case. I then opened the floor to the group by asking "Did you learn anything new?" and "Do you have any questions?" I then let the students lead the discussion based on their questions or thoughts regarding the clinical case. It was important to me that the students direct their learning in these debriefings as much as possible, knowing that this is important for adult learners. If students didn't have any specific questions, I typically had a specific question planned based on the content of the case, such as "What do you look for when reviewing an IEP?" or "If you were doing this evaluation, what might you do in addition to the standardized test?" These questions were meant to help students extend the simulated experience to other clinical applications. Additionally, on some weeks, I led prompts for students to act out such as "Pretend you are summarizing the results of the assessment for the parent. What do you say?" This allowed students to practice verbally summarizing information for a parent or caregiver in a low-stakes environment, and to receive feedback from peers and myself on their summary.

I assisted with or led Simucase groups for students in spring 2020, summer 2020, and spring 2021.

Teletherapy

By the summer of 2020, the clinic had developed a plan to begin teletherapy with clients. Student members of the CAT team were intimidated by the prospect of providing AAC services through this modality. As I had never done teletherapy before either, I spent time attending online CEUs and developing and practicing new skills. In this modality, I continued to support students by making myself available through virtual office hours and sharing resources. In office hours, I helped students to figure out or set up ways to model AAC virtually through various options.

One unique way I supported students is by developing the "Virtual Resource Room" within Microsoft Teams. This was a folder that I placed resources (activities and visual supports) in that the student clinicians could have access to use. This folder included both links to websites that might be helpful in teletherapy sessions, activities developed in PowerPoint and shared by others, and tips. I encouraged students to add resources to the virtual resource room as they found them or created them. In this way, students had access to materials that a peer made or found. The virtual resource room grew each semester as clinicians learned and tried new activities in teletherapy.

One big difference that was experienced about teletherapy was the caregiver coaching component. Because we did not always know the context of what was going on in the home environment and were not always able to see what was going on on the screen of the AAC device. This meant an increased amount of communication between the student clinician and the e-helper (caregiver) was necessary. Student clinicians frequently brought up communication with e-helpers in their post session debriefing time with me. I had ongoing conversations with student clinicians about how to support caregivers. I also provided resources including information on coaching and guided video examples of caregiver coaching. For students who needed it, feedback surrounding coaching involved scripting potential conversations or conversations that had already happened to provide a real world context.