Outline of the Clinical Education Programme

Transcription

1 Outline of the Clinical Education Programme Roinn an Staidéir Chliniciúil ar Urlabhra agus Teangacha, Scoil na neolaíochtaí Teangeolaíochta, Urlabhra agus Cumarsáide, Coláiste na Tríonóide, Baile Átha Cliath Clinical Speech and Language Studies, School of Linguistic, Speech & Communication Sciences, Trinity College, Dublin 2, Ireland

2

3 Course outline...5 Clinical education...6 Outline of the clinical education programme...9 Undergraduate education programme in feeding, eating, drinking and swallowing Clinical schedule Clinical workshops and practice placements Placement types Continuing Professional Development Clinical education Annual Clinical Educators Meeting Introduction to Clinical Education... 28

4

5 Course outline The Department of Clinical Speech and Language Studies at Trinity College, Dublin, provides an undergraduate educational programme to students who wish to join the speech and language therapy profession. The department provides a course which reflects the current knowledge and skill base in the discipline of speech and language pathology and therapy. The structure of the programme aims to develop and enhance the ability of students to learn independently, to learn, select and integrate information from disparate disciplines to the framework of communication disorders. It is hoped that graduates will be creative, critical thinkers who will be able to evaluate and apply theoretical knowledge to develop solutions to clinical problems. The end goal is to educate graduates who demonstrate a commitment to their clients and the profession by the provision of effective and efficient clinical services. A variety of teaching approaches are used including problem-based learning, casebased learning, self-directed learning and direct teaching to foster the development of a scientific approach to assessment, intervention and service provision. 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 JF Strands Foundation Introduction to Speech and SLT Professional Language Role, clinical Pathology context and content Clinical Education Speech Language & FEDS Observation, Foundation clinical skills CONNECT Audiology Baby study Preschool study FEDS Introduction to Language Studies Language acquisition SF Novice Assessment Principles: Profiling communication and feeding eating drinking and swallowing Assessment, diagnosis, & case management Clinical workshops and practice placements 1.1 Weekly 1.2 Block Assessment and diagnosis communication and feeding, eating JS Transition Intervention Principles: Communication and feeding eating drinking and swallowing Intervention: Clinical intervention workshops Case management Placements 2.1 Weekly 2.2 Block Sociolinguistics Bilingualism Discourse analysis SS Entry Management Communication and feeding eating drinking and swallowing disorders Intellectual impairment Ethics, administration and reflection on practice Caseload and case management Placements 3.1 Weekly 3.2 Block Seminars Specialist topics General Psychology Research Phonetics Speech & hearing Anatomy Physiology Normal swallow Social and lifespan psychology Introduction, Cross subject input Library courses Speech Sciences Linguistics Neuroanatomy Cognitive-neuropsychology Neurology & Psychiatry Learning Memory & Cognition Research methods Principles and methods of empirical research Seminars Specialist topics Counselling principles and practice Research project

6 Clinical education The clinical education of speech and language therapists operates as a joint undertaking between colleges and members of the profession. The college provides structured learning and research opportunities for students to develop the knowledge base that will enable them to use the clinical placements provided by the profession to develop the skills and competencies necessary to become a speech and language therapist. Therapists in their role as practice educators are vital to the development and delivery of the clinical education programme. The role and responsibilities of the therapist as practice educator has been written into all HSE job descriptions and is outlined in Practice Educator Competencies and Guidelines for Good Practice in Practice Education (2008,Therapy Project Office). The Therapy Project Office also clarified the roles of those involved in practice education and identified the following key roles: Practice educators Practice educators are therapists who undertake the key role in clinical education of providing practice placements in direct clinical work in a range of settings. They assist in the education of students by providing them with the clinical learning opportunities in community, school and hospital programmes that facilitate the linking of theory to practice and foster the development of clinical competencies. The role of practice educator involves the therapist in instructing, demonstrating, educating, supervising, mentoring and monitoring students as they progress through the clinical education programme. Practice educators provide opportunities for students to Observe clients with a range of different communication and swallowing impairments. Observe therapists utilising the wide range of clinical skills and models that characterise the profession. Observe and participate in clinical administration and record keeping procedures. Observe and participate in client related team work. They also provide opportunities for students to develop specific skills and competencies by providing opportunities to Administer, score and evaluate assessments of a range of clients variety of communication and feeding eating, drinking and swallowing impairments Sample transcribes and analyse communication and swallowing behaviours. Evaluate and integrate assessment results with the professional knowledge base to formulate diagnosis and determine clinical pathways Prepare, present and discuss clinical findings in a professional manner.

7 Plan and implement and evaluate therapy programmes with guidance and consultation. Report and discuss assessment findings and therapy programmes in with clients, carers, co-workers and clinical educators both orally and in writing Discuss and evaluate general models and principals and evidence underlying intervention with clients and their carers Develop self-evaluation and professional monitoring skills The following posts have been developed to support therapists in their roles as practice educators Practice Tutors These posts are funded by the HSE and based in health service agencies. The posts are at senior grade level with responsibilities for the provision of direct clinical education to students along with the provision of support to therapists in their role as practice educators. The posts associated with Trinity College all part time (i.e..5 FTE or below) Practice tutors currently in post in the Eastern area Ciara Murphy Mater Hospital Lindsay Harrison Enable Ireland (Ballsbridge / Bray). lharrison@enableireland.ie Marie Cox National Rehabilitation Hospital Marie.Cox@NRH.IE Fiona Walsh Central Remedial Clinic fwalsh@crc.ie Caroline Jagoe Beaumount Hospital, carolinejagoe@beaumont.ie Katie Walsh St. James's Hospital, KWalsh@STJAMES.IE Regional Placement Facilitators These posts are funded by the HSE and may be based either in the HSE services or in the university. The posts are at senior grade level with responsibilities in supporting practice educators across service locations as well as in the provision of clinical teaching and supervision. Regional Placement Facilitators currently in post Aoife Mhic Mhathúna, Ballinteer aoife.mhicmhathuna@hse.ie Sarah Scott Swords, sarah.scott@hse.ie The Regional Placement Facilitator placement post in Tallaght is currently vacant Practice Education Co-ordinators These posts are funded by the HSE and based in the university. The post has responsibility for overall co-ordination of placements for the university and for sourcing and allocating student placements. Clothra Ní Cholmáin is the practice education coordinator in the department in Trinity College (ccholmin@tcd.ie). The

8 practice education coordinator provides clinical educators with clinical information packs at the start of each academic year and informs regional facilitators, tutors and practice educators of the general learning objectives of the students assigned to their clinics. Placement mentors The department aims to offer as much support as is possible to clinical educators in their work with students. Members of the academic staff undertake the role of placement mentor to students in the final year placements. Practice educators are welcome to discuss any aspect of student work with the mentor and to consult with them on related areas. Practice education is supported on a national level by the National Implementation Group (NIG) for Clinical Placement Provision for Occupational Therapy, Physiotherapy and Speech & Language Therapy.which was established in 2005, to oversee the provision of quality practice-based learning in occupational therapy, speech and language therapy and physiotherapy. The membership of this group is drawn from a cross-section of those with a direct involvement in practice education including the DoHC, the HSE, the Universities, the Professional Bodies and the Therapy Managers. The NIG has four Local Implementation Groups (LIGs) in the regions of Galway, Limerick, Cork and Dublin which have representatives from both the local universities and the therapy managers. Clinical Steering Committee The clinical steering committee is convened when matters relating to changes in the education programme or the clinical placement structures arise. The head of department, practice education coordinator, regional facilitators and tutors are represented or attend all meetings. The following client groups and service areas are represented through the facilitators and tutors: acute hospitals, rehabilitation hospital, physical impairment and community care. Representative of the other client groups / service areas are invited to attend as the need for additional expertise arises.

9 Outline of the clinical education programme The clinical component of the course aims to provide the students with opportunities to obtain, integrate and apply professional knowledge and skills to a range of clients with a variety of communication and feeding eating, drinking and swallowing impairments. Clinical learning opportunities in college and health service clinics foster the development of the full range of competencies that will enable students to become members of the speech and language therapy profession. Year 1 Foundation / Preclinical The Junior Freshman year serves as a preclinical year during which students acquire the core knowledge and lay down the foundation skills on which professional competencies can be based. They acquire basic knowledge in anatomy, language acquisition, linguistics, phonetics, physiology and psychology and are introduced to the professional role in modules covering service types, clinical contexts and practice. Foundation skills in the observation and assessment of general communication skills and in assessment of fluency, hearing, speech, swallowing and voice are studied and are actuated in preclinical practice in observation of infants and preschool children and by participation in the CONNECT project. The clinical learning goals for the Junior Freshman year are to Obtain knowledge of the profession and of general client groups Develop professional interaction, observation and reporting skills Develop clinical problem solving processes and skills Develop knowledge and skills in the assessment of fluency, hearing, speech, swallowing and voice Develop skills in identifying clinical learning goals and setting and achieving personal objectives During the academic year students participate in the CONNECT project which enables them to meet many of these learning objectives. General Client Group Experience Junior Freshman students are encouraged to gain experience of working with potential future client groups in a general way (i.e. not direct speech and language therapy) during the long vacation. The objective of this experience is to broaden knowledge of individuals with differing needs on a personal basis and to develop awareness of the impact of special needs on daily life. The experience gained should develop transferable competencies in time management

10 observation of workplace procedures in areas such as general health and safety acknowledging and respecting the beliefs and rights of others recognising and respecting the personal, social and emotional needs of self and others using a range of interpersonal relationships styles observation and recording skills as well as enabling students to integrate and apply the theoretical knowledge gained from their studies in speech and language pathology psychology, linguistics and human biomedical sciences. Students who feel that they require further experience may organise placements in schools, day centre/hospitals, etc., independently. They are requested not to contact Speech and Language Therapists to facilitate such placements. The learning goals do not require the expertise and supervisory skills of speech and language therapists and are best met in a broader context with the student usually working as a volunteer in a service agency or on a specific project.

11 Senior Freshman Novice clinicians Academic course work is linked to clinical practice throughout the Senior Freshman year by the use of problem-based learning, lectures, video observation and discussions. Clinical assessment skills are targeted in general and area specific workshops during the first term. These workshops focus on integrating academic knowledge to clinical practise in the following areas: observation, transcription, recording and analyses, use of formal and informal assessments, evaluating assessment findings and developing diagnostic and reporting skills. The weekly clinical placement (1.1) in second term provides the students with opportunities to develop practical assessment and client management skills under direction and supervision. During the week placement (1 day per week) students are expected to begin to apply knowledge and skills of assessment to direct work with clients under the supervision of the practice educator. As novice students they need support to identify problems and solutions within the clinical context guidance to develop a holistic approach to the client and clinical context time to focus on their own performance and reflect on developing competencies structured feedback on developing competencies from practice educators By the end of the second year students should be integrating knowledge from speech pathology, linguistics and psychology and applying this to clinical work and should have developed skills in Administering, scoring and evaluating formal and informal speech, language and feeding, eating, drinking and swallowing (FEDS) assessments with a range of clients and client groups formulating diagnostic hypotheses and discussing possible clinical pathways including onward referral, direct/ indirect intervention, etc. Reporting and discussion of client needs both informally in tutorials and formally in case reports and presentations. The 15-day block placement in September (1.2) allows students to consolidate skills while also providing them with experience of a wide range of professional models. This placement includes 3 research days when the students are required to become familiar with caseload and service planning and delivery in interdisciplinary contexts. Information gained from this research is shared with the class in a formal presentation during Michaelmas term. Students should be demonstrating competencies at level 1 (novice) on the majority of competencies rated on the Student Clinical Competency Evaluation form before they enter the Junior Sophister year.

12 Summary Senior Freshman placements 201 January 13 th -March 31 st Clinical practice 1.1 (10-12 days) Students attend clinics one day a week (Monday) to develop general clinical skills and specific competencies in the use of clinical assessments. At the start of the placement students should be able to administer, record and score a range of formal and informal assessments, to identify typical and atypical communication and swallowing profiles. Knowledge and skills in assessment should progress towards clinical competency in sampling, recording and evaluating behaviours as the placement progresses. Student learning is evaluated by continuous assessment, a written case report and a case presentation. September 1 st -19 th Clinical practice block 1.2 (12 clinical & 3 research days 1 ) The September block provides students with opportunities to generalize competencies developed in second year and to link assessment and diagnostic skills with intervention planning. It allows them to consolidate assessment skills while also providing them with experience of a wide range of professional models. The 3 research days are focused on service planning and delivery including inter disciplinary working where possible. Information gained from this research is shared with the class during Michaelmas term 1 Placement 1.2 and 2.1 SF/JS inter block and JS weekly may be combined if this fits with clinical practice

13 Junior Sophister Transition The application of theory to clinical diagnosis and case management is stressed throughout the third year. Students attend weekly clinics (Placement 2.1) where they are given increasing responsibilities for client management as the year progresses. Students in transition will require a moderate level of supervision, monitoring and feedback to assess and implement therapy programmes for clients with routine needs. They will also need support to identify significant factors for clients with complex needs and to recognize the effects of general and clinical environmental factors on client management. guidance in the evaluation of therapy programmes and their impact on the clients and environments. reflection time, structured feedback and guidance to develop self monitoring of professional competencies By the end of the JS year students should have developed professional knowledge and skills in: Diagnosis of communication and FEDS disorders in children and adults. Planning of therapy programmes both long and short term, with guidance. Therapy execution and evaluation of effectiveness. Maintaining case files, writing reports and keeping clinical records record in a professional manner appropriate to the placement. They should show knowledge of general principles in both theoretical and practical areas and should be able to identify their own learning needs in relation to clinical work in general and client specific issues. Students are examined towards the end of the placement (after a minimum of eight clinical days). The examination is carried out by the practice educator and a co therapist and covers evaluation of student record keeping, a short case presentation, observation of a clinical session and a short viva. The 20 day clinical block placement (2.2) in May / June allows students to integrate knowledge acquired during the academic year and apply knowledge and skills to a wide range of client groups and disorders. During the placement, students should be able to work with a small caseload under guidance with regular consultation with the supervising therapist. Students are assigned research days during the placement. During these days they are required to use an evidence based approach to explore assessment and therapy approaches, clinical pathways, and service delivery options for the client group with whom they are involved. Students should be developing competency in self-evaluation and moving towards a collaborative supervision structure during this placement. They will require regular

14 feedback on their performance from the practice educator to ensure that they are setting and achieving appropriate learning goals to enable them to take on the role and responsibilities of junior therapist in their final year. It is recommended that therapists schedule time for formal feedback sessions consultations on their block timetable. Students should be demonstrating evident or enhanced competencies at level 2 (transition) on the national Student Clinical Competency Evaluation form before they enter the Senior Sophister year. The students are required to submit 2 case reports following this placement to both the clinic and the department. The marks from these reports contribute to the final year clinical mark. October 3rd January 30th Clinical practice Placement 2.1 Thursdays This placement comprises one day per week clinics on Thursdays. Students are expected to spend at least 2.5 hours in direct client focused clinical work with the remainder of the day being devoted to learning from other aspects of SLT caseload and service work e.g. administration, EBP research, developing materials, etc. Student learning is evaluated by continuous assessment and a clinical examination. The placement is supported by weekly clinical workshops focused on intervention and case management with clients who present with difficulties in FEDS, fluency, language, speech and voice. Students are also encouraged to fill in gaps in their practice knowledge using interactive IT based programmes Christmas break between Dec. 12th and Jan.16th Placement 2.1 continues if necessary until 30th of January May 12 th June 20 th 201 Clinical Practice Block 2.2 (16 clinic & research days) During this placement students should be integrating knowledge acquired during the academic year and clinical competencies developed in previous placements to generalize competencies to a wider range of client and disorders groupings. They should be able to work with a small caseload under the guidance of practice educators. The research days are focused on establishing evidence based approaches to assessment, therapy, clinical pathways, and service delivery options for the client group with whom they are working

15 Senior Sophister Entry Students at this stage of the education programme are expected to have developed knowledge of the principles underlying the assessment, diagnosis and treatment of disorders of communication and of feeding, eating, drinking and swallowing. The final year placements provide students with opportunities to strengthen and generalise competencies in these areas across a range of client groups and health service settings. Students should be able to work independently with regular consultation with the practice educator during their final placements. Senior Sophister students begin their final year with a short block followed by six Monday or Friday clinics (Placement 3.1 September 16 th- -Nov. 29 th ). Students are expected to be responsible for a mini caseload during this placement and should be moving towards independence in assessment, planning, implementing and evaluating therapy. They should be able to evaluate their own performance objectively and set appropriate professional learning goals during the placement. Practice educators are requested to assist them in this by using formal formative feedback at mid block and end of block sessions. This placement is assessed by continuous assessment mark. The final clinical block placement is scheduled between 27 th January and 28 th of March. The 30 day placement comprises 2 clinic days, 6 research days. The student is assessed by continuous assessment and clinical examination. The clinical exam may take place after the student has completed 12 clinical days. The examination is conducted by the supervising therapist and a practice tutor / regional facilitator or college therapist. In a number of instances each year, the External Examiner may be present for this assessment in the role of moderator. Students should be demonstrating competencies at level 3 (entry) on the national Student Clinical Competency evaluation form as they complete the Senior Sophister programme. September 16 th- -Nov. 29 th Clinical practice 3.1 Mon.16 th College Briefing Tues Fri. Clinic day mini block followed by one day per week (Mon or Friday) for 6 weeks. Students are expected to have developed knowledge of the principles underlying the assessment, diagnosis and treatment of disorders of communication and of feeding, eating, drinking and swallowing. They should be able to take responsibility for a mini caseload and should be moving towards independence in assessment, intervention planning, therapy implementation and evaluation. Student learning is evaluated by continuous assessment in the placement and a college based case presentation. 201 January 27 th - March 28 th Clinical practice 3.2 (2 clinic & 6 research days) This placement provides students with opportunities to strengthen and generalize core clinical competencies across a range of client groups and service settings. Students are expected to be responsible for a small caseload during the placement and should be showing independence in assessment, planning, implementing and evaluating therapy. They should be able to work independently with regular consultation with the practice educator. Student learning is evaluated by continuous assessment and a clinical examination

16 Undergraduate education programme in feeding, eating, drinking and swallowing Speech and language therapists play a key role in the evaluation and treatment of infants, children and adults with feeding, eating, drinking and swallowing disorders /dysphagia. Graduates on entry to the profession from 2011 onwards have been expected to have developed basic competencies in the assessment, diagnosis and management of clients with routine presentations of feeding, eating, drinking and swallowing disorders. Entrants to the profession will not be deemed competent to conduct or interpret videofluoroscopies or FEES independently. Professional competence in dysphagia, as in other areas of practice, is on ongoing process combining further education and experience. Further information on competency levels are available in IASLT Standards of Practice for Speech and Language Therapists on the Management of Feeding, Eating, Drinking and Swallowing Disorders (Dysphagia)2012 which can be downloaded from It is expected that students will acquire the knowledge base for working with clients with feeding, eating, drinking and swallowing disorders /dysphagia by full participation in the range of academic and clinic based learning activities (table 2) offered by the college and practice placements and accredited by the IASLT Education board. Students also require learning opportunities to observe and practise skills and develop competencies, which can only be provided in a range of clinical settings. The colleges and the profession are dependent on speech and language therapists in their role as practice educators to provide this experience during practice placements. Table 2 Outline of modules and clinic based learning activities incorporating FEDS Knowledge base Year Academic Case based learning & Clinical workshops Anatomy and physiology of the head and neck Neurology and neurophysiology including the neurology of swallowing and the coordination of respiration, swallowing and phonation Oral motor functioning in relation to speech, feeding and swallowing skills The normal swallow and changes though out the lifespan 1 Anatomy and physiology Development of the normal swallow Self directed learning (SDL) Products for Professional development Log (PDL) / FEDS portfolio Developmental feeding checklist Completed for baby study Open wide tasks (PDL) 1-2 Lectures SDL Open wide tasks Completed oral examination records (PDL) 1-2 Lecture workshop 1 Assessment t of the normal swallow 2 Clinical Assessment SDL Experiential examinations feeding trials, laryngeal palpation, oral sensori motor examination, pharyngeal reflexes, etc. 1-2 Lectures SDL Open wide tasks 5 completed oral examination forms (PDL) Normal swallow and clinical signs

17 Atypical and disordered feeding, eating, drinking and swallowing patterns Professional terminology specific to the area of feeding, eating, drinking and swallowing disorders Knowledge of psychosocial impact of feeding, eating, drinking and swallowing disorders on the individual and carers Roles and scope of practice of multidisciplinary team members Risk management policies and procedures Ethical, legal and service influences on decision making Referral processes and typical clinical pathways Aetiology of dysphagia and implications for management Key factors to be indentified from case notes and history prior to and during assessment Commonly used subjective and objective assessments including oral motor examination, assessment of oral preparatory, oral and pharyngeal swallow stages and including trials of food consistencies Recognise indicators for instrumental assessment e.g. videofluoroscopy, FEES Differential diagnosis and management intervention processes for clients with FEDS disorders including awareness of needs of clients with complex conditions (neonates, people with tracheostomies, etc) and signs and symptoms of oesophageal dysphagia to assist in differential diagnosis with oropharyngeal dysphagia.) Prognostic indicators in common case presentations Complex presentations Caseload management and service delivery practices Carer and client roles in management plans/ intervention programmes Direct and indirect management programmes including oral motor and sensory treatment programmes Management strategies including rehabilitation and compensatory techniques e.g. physical positioning and modifying food and liquid consistencies 2 & 2,3, 2,3, 2,3, 1,2, 3, 2,3, 2,3, 2,3, 2,3, 2,3, 2,3, 2,3, Dysphagia module Complex presentations General course work and FEDS workshop Self directed learning Clinical practice Skills workshops Clinical placements of swallowing disorders (FP A) Summary sheet of key patterns and indicators (FP A) Summary sheet of key terminology in FEDS (FP A) Lectures SDL Objective and reflective mealtime report (PDL) Lecture SDL Service report SF/JS (PDL) Clinical briefings Lectures Clinical briefing Lectures Lectures Lectures workshops Lectures and video based exercises Lectures and video based exercises Lectures Workshops SDL Clinical placements SDL Clinical placements SDL Clinical placements SDL Clinical placements SDL Clinical placements SDL Clinical placements Workshops SDL Clinical placements Case based learning 2, 3 Workshops, lectures SDL Clinical placements 3, 3, Lecture SDL Clinical placements Lecture 2,3, 2 3, 2,3, Non-oral feeding options 2,3, Lecture workshop Lectures Lectures SDL Clinical placements Case management and SDL on clinical placements Workshops, lectures & CP SDL & Clinical placements Health and safety agreement (PDL) Risk assessment summary (FP) Service report SF/JS (PDL) Service report SF/JS (PDL) Normal swallow and clinical signs of swallowing disorders (FP A) Clinical assessment forms (FP B1) Completed oral examination sheets including 2 completed MASA (FP B) SDL Instrumental procedures checklist completion (FP F) Detailed FEDS assessment forms for paediatric and adult clients (FP C &D ) Diagnostic summary sheet including indicators for onward referral (FP) Detailed FEDS assessment forms for paediatric and adult clients Case reports Clinical reports MCQ Test Clinical exam Case reports Clinical placement Evaluation (FP D & F) (FP D &F)

18 Video recordings and access to PATSY are available to students who may not have the opportunity to work directly with clients with specific communication impairments /FEDS disorders or with specific client groups. The objective is that as broad a range as possible of communication impairments and feeding, eating, drinking and swallowing disorders be covered by students, with web based programmes, workshops, video observation and discussion augmenting clinical experience. The Department would welcome auditory and visual recordings illustrating typical and atypical presentations of clients with communication and FEDS disorders/ impairments and will abide by consent conditions agreed with the client and general data protection legislation.

19 Aug 26 Sep t Nov Dec. 2 9 Clinical schedule Michaelmas Term Year1 Year 2 Year 3 Year Clinic visit 26 th Clinic visit 3rd Clinic visit 10 th Clinic visit 17 th CONN ECT 3 CONN ECT CONN ECT CONN ECT CONN ECT CONN ECT Introduction to practice education Clinical policies and procedures 2- Practice based learning Formal and informal assessment Sampling and recording 11-1 Skills practice 2- Skills practice Formal and informal assessment comparing and evaluating 11-1 Audiology 2- Skills practice Formal and informal assessment Speech 11-1 Skills practice Informal assessment Profiling FEDS /Comm Skills practice 2- Clinical workshop Speech Clinical practice SF/JS Block clinical & 3 research days 2 Clinical briefing Clinical workshop Record keeping Service management report Thursday Clinical practice (CP) 2.1 starts Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Public holiday Thursday CP 2.1 Mon/Fri Clinical workshops Diagnosis Thursday CP Clinical workshop Mon/Fri Clinical workshops Voice Clinical tutorial Session planning Formal and informal assessments 11-1 Skills practice 2- Clinical workshop Report writing 11-1 Skills practice 2- Clinical workshop Formal and informal assessment 11-1 Skills practice 2- Clinical workshop Informal assessment presentations 2- Clinical workshop Clinical diagnosis 3-5 Clinical workshop Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshops Thursday CP 2.1 Mon/Fri Clinical workshop PE Course 12 th & 13 th SS 3.1 Clinical practice Mon.-Briefing Tues Fri. day block Clinical practice 3.1 Monday or Friday Clinical practice Monday or Friday Clinical practice Monday or Friday Clinical practice Monday or Friday Clinical tutorial Clinical practice Friday Clinical practice Monday or Friday Clinical practice Monday or Friday Clinical practice Monday or Friday Clinical practice Monday or Friday Clinical practice Monday or Friday 2 Placement 1.2 and 2.1 SF/JS inter block and JS weekly may be combined if this fits with clinical practice 3 Baby study visits as arranged Audiology clinics will be scheduled for Thursday/ Friday when available

20 201 Hilary and Trinity Terms 30 Jan PS 6 visits Feb Mar CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT CON NECT Monday Clinical Thursday CP 2.1 practice 1.1 starts Monday CP 1.1 Thursday CP 2.1 Clinical practice Monday CP 1.1 Thursday CP 2.1 finishes Monday CP 1.1 Clinical workshop Intervention FEDS Monday CP 1.1 Clinical workshops Intervention FEDS Monday CP 1.1 Clinical workshops Clinical tutorial Intervention Voice Monday CP 1.1 Clinical workshop Intervention Voice Monday CP 1.1 Clinical workshop Intervention fluency Monday CP 1.1 Clinical workshop Intervention fluency Public Holiday Clinical workshops x 2 Language Clinical briefing Clinical briefing Case Presentations Report writing 2 th 1- Meeting PE 3.2 Clinical briefing Case presentations Clinical practice days block 2 clinic days 6 research days between 27 th of Jan and 28 th of March 31 Ap7 Trinity Term exam period 1 21 Public Holiday 28 Exams exams exams May Public Holiday exams exams 5 12 Clinical Practice 2.2 exams 19 Block 20 days (16 days clinical & exams 26 Jun Public Holiday research days) between 12 th of May and 20 th of June e *Level 1 **Level 2 competency Level 3 Competency competency Placement Sept 201 Students should have an average of 2 hours per day direct client work during weekly placements and hours 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.

21 Clinical workshops and practice placements Year 2 Year 3 Year September 1 st- 19th 201 Clinical practice block 1.2 (12 clinical & 3 research days 5 ) The September block provides students with opportunities to generalize competencies developed in second year and to link assessment and diagnostic skills with intervention planning and possible clinical pathways. The placement allows students to consolidate assessment skills while also providing them with experience of a wide range of professional models. The 3 research days are focused on service planning and delivery including inter disciplinary working where possible. Information gained from this research is shared with the class in a formal presentation during Michaelmas term. Clinical briefing Clinical workshop Record keeping Setting, recording and evaluating objectives September -December Clinical briefing and on site workshops to develop knowledge of assessment formats and skills in administering, recording, analyzing and scoring routine clinical assessment procedures. Specific workshops are devoted to assessment of hearing, FEDS, fluency, language speech and voice. Students are required to develop their own informal assessment pack during the term. Christmas Vacation 13 th Dec Oct 3 rd January 30 th (break 12. Dec -16 Jan) Clinical practice Placement 2.1 This placement comprises one day per week clinics on Thursdays. Students are expected to spend at least 2.5. hours in direct client focused clinical work in the clinic with the remainder of the day being devoted to learning from other aspects of SLT caseload and service work e.g. administration, EBP research, developing materials, etc. Student learning is evaluated by continuous assessment and a clinical examination. Sept. 17 th to 20 th mini block followed by 6 Mondays or Fridays until 29 th of November. Clinical practice 3.1 Mon.-Briefing Tues Fri. day mini block followed by one day per week ( Mon or Friday) for 6 weeks. Students at this stage of the education programme are expected to have developed knowledge of the principles underlying the assessment, diagnosis and treatment of disorders of communication and of feeding, eating, drinking and swallowing. They are expected to be able to take responsibility for a mini caseload during the placement and should be moving towards independence in assessment, intervention planning, therapy implementation and evaluation They should be able to evaluate their own performance objectively and set appropriate professional learning goals during the placement. Student learning is evaluated by continuous assessment in the placement and a college based case presentation. 5 Placement 1.2 and 2.1 SF/JS inter block and JS weekly may be combined if this fits with clinical practice

22 January June 201 Clinical practice Placement 1.1. January 13 th - March 31 st (10-12 days) Students attend clinics one day a week (Monday) in order to develop general clinical skills and specific competencies in the use of clinical assessments. At the start of the placement students should be able to administer, record and score a range of formal and informal assessments, to identify typical and atypical communication and swallowing profiles. Knowledge and skills in assessment should progress towards clinical competency in sampling, recording and evaluating behaviours and in formulating diagnostic hypotheses as the placement progresses. Student learning is evaluated by continuous assessment, a written case report and a case presentation. Exams Clinical practice Placement 2.1 continues if necessary until 30 th of January Clinical workshops Clinical briefing and on site workshops to develop knowledge of widely used intervention approaches and therapy techniques. Specific workshops are devoted to intervention and case management with clients who present with difficulties in FEDS, fluency, language, speech and voice. Students are also encouraged to fill in gaps in their practice knowledge using interactive IT based programmes. Clinical briefing Learning review Report writing workshop Clinical Practice Block 2.2 May 12 th June 20 th 20 days (16 clinic & research days) During placement 2.2 students should be integrating knowledge acquired during the academic year and clinical competencies developed in previous placements to generalize competencies to a wider range of client and disorders groupings. Students should be able to work with a small caseload under the guidance of practice educators. The research days are focused on establishing evidence based approaches to assessment, therapy, clinical pathways, and service delivery options for the client group with whom they are working Case presentations Clinical briefing Clinical practice 3.2 Between 27 h of Jan & 28 th of March (2 clinic and 6 research days) The final placement provides students with opportunities to strengthen and generalize core clinical competencies across a range of client groups and health service settings. Students are expected to be responsible for a small caseload during the placement and should be showing independence in assessment, planning, implementing and evaluating therapy. Students should be able to work independently with regular consultation with the practice educator during their final placements.. Student learning is evaluated by continuous assessment and a clinical examination

23 Placement types The traditional practice placement relied on a one to one model of supervision but additional types of placement provision are currently developing across all professions in the health services. The department, along with members of the profession in health service agencies, have been exploring a range of placement types over the past number of years in order to identify efficient and effective ways to develop professional competencies while maximising gain to the clients and health service agencies. Paired placements The department has been encouraging the use of paired and group placements for students over the past 10 years. The aim of paired placements is to provide a learning environment for students that reduces pressure on individual performance and allows them to benefit from the knowledge and skills of their peers. These have been found to be efficient by practice educator and students. Practice educators report reduced demands on their time as the students provide learning and social support for each other. The students also problem solve together, resulting in discussion time with placement educator being more focused. Paired work also serves to prepare students for future professional work by encouraging development of the ability to share knowledge and skills necessary for professional team working. professional reporting and discussion skills problem solving skills, the 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 as Co-therapist, i.e. direct delivery, e.g., partner in activities, role model, demonstrator, etc. Observer/ recorder during therapy e.g. peer provides 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. Paired students must schedule time for peer discussion and feedback during each placement.

24 Group placements Group placements involving -10 students have been used for specific clinical projects and programmes by both on-site clinical educators and by therapists in Health Service clinics. These have involved groups of -8 second, third and final year students in clinical work with particular client groups. They have provided students with a wide range of experience and enabled therapists to undertake specific service delivery or therapy projects. These projects have included initiatives to reduce waiting lists for assessment and to provide therapy for clients with specific disorders / impairments such as voice and fluency. Please contact the department if you are interested in working with students in this way. Long arm placements/ joint supervision The use of group placements has contributed to the development of shared supervision between on site and health service clinical educators involved in second and third year case management placements. Shared supervision involves the speech and language therapist in the clinic supervising and mentoring students in service delivery to clients with support provided through tutorials and occasional clinical visits by a practice tutor, regional placement facilitator or member of the academic staff.

25 Placement roles and responsibilities guidelines Therapists are referred to the Guidelines for Good Practice in Practice Education (Therapy Project Office, 2008 available at for more detailed explanation of the roles and responsibilities of all involved in student education. Pre-placement College Student Practice educator 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 the student is aware of the placement learning goals Ensure that the student is aware of the supports and resources available to them in the department and in college to meet their learning needs Attend pre placement clinical briefings Read materials from relevant the professional knowledge to prepare for the application of theory to therapy. Practise the specific skills required for their placement with peers i.e. practice use of assessment tools, IT systems, etc. Conduct a learning review and identify learning goals for the placement Prepare and post a clinical CV to the practice educator when placement confirmed Contact the practice educator to confirm stating details Forward an information pack to student Design and implement placement procedures to ensure that quality of client care and service management are maintained Select student caseload and service delivery options During the placement College Have links available to support placement educator and students should the need arise e.g. PEC college mentors. Student Respect the professional ethical code and conduct guidelines Show respect for the clients and the host agency service by observing written and unwritten codes of dress and conduct. Act within the guidelines laid down by their practice educator in client and caseload management and in administration and record keeping. 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 practice educator Accept feedback from practice educators and modify behaviour if requested Use reflective practice and independent learning to further develop knowledge and skill base Practice 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 being entrusted to them and of the limitations placed on these by the clinician. Establish schedule of direct and indirect supervision* Establish evaluation and feedback schedule. 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

26 Post placement College Student Practice educator Collect evaluation form and add to student profile Collect general placement feedback from students Collect feedback from practice educators Attend pre and post placement clinical briefings Complete and return placement evaluation form Reflect on learning, complete learning review form and set new learning goals Return hours form to the school Sign student hours form Return student evaluation form Provide general i.e. non student specific feedback to school if warranted. Conduct long term and short term cost/ benefits analysis of student placement New resource for Practice educators The Health & Social Care Professions Education & Development unit of the HSE has supported the development of on line resources for practice educators. These are now available online. The modules cover Professional Practice Competencies Education Supervision Assessment/Evaluation Management & Administration Competencies To access the modules go to and login. Go to Practice Development Hubs and select Health & Social Care Professionals Hub. Open hub and select Practice Education. The online course can be accessed on the dropdown menu. It consists of 5 modules covering general practice educator competencies and contains many useful links to related websites. It is hoped that the modules will be approved for CPD credit by the professional bodies /CORU in the near future