02-15-16

Dear Reviewers,

Please accept this letter as a response to CAPCSDs Content Matter Experts (CME) call to participate in a
module on Effective Student-Clinical Educator Relationships. Our interest is collegial; we propose to
collaborate with clinical educators (CE) at Gallaudets Hearing and Speech Center (GHSC) to demonstrate
supervision of masters SLP students (andto a lesser degree, doctoral students in AUD) in Auditory
(Re)Habilitation (AR) with clients who are deaf, Deaf, or hard of hearing (d/D/HH).We intend to identify,
coach, and capture through video (with voice-over and captions) different clinical educators
demonstrating different supervision styles (McCrae & Brasseur, 2003) involved indifferent supervision
tasks across the supervision continuum (Anderson, 1988). We are prepared to contributesix short video
samples that would likely resemble the followingscenarios:

Guided observations at a computer monitor, with a CEteaching a newly assigned graduate

student the nature of an AR session involving telephone skills with an older individual whose
acquired hearing loss makes telephoning difficult;
Shared intervention with a CE demonstrating and encouraginga graduate student, as she joins
hersession with a post-stroke aphasic Deaf patient who communicates in ASL;
Documentation of observations as written feedback from aCE at an observation window
observing an individual student working with a small group of toddlers;
Supportive monitoringof a CE as she checks on a tele-practice sessionof a student conducting AR
remotely, across computer monitors, with a cochlear implanted client;
An evaluation conference in which a student discusses her comparative self-assessment ratings
of AR competencies from the beginning of a semesters assignment working with a
speechreading group to the semesters end;
An interview between a CE and a new student intern using the same formative assessment of
the students previously acquired AR competencies to project new and continued AR skill
development at the new internship site.

These video clips would represent a variety of supervisionstyles (McRae & Brasseur, 2003). The first and
second sessions represent a High Direct/Low Indirect style marked by lots of telling, suggesting,and
directing by the CEs, and the later video sessions represent Low Direct/Low Indirect with more asking,
evaluating, and discussingdemonstrated by both the CEs and student clinicans. Taken altogether, the
CEs featured in the module would demonstrate how they teach specific skills, clarify concepts, assist
with critical thinking, conduct performance evaluations, mentor, advise, and model professional
behavior (ASHA &CAPCSD, 2013). We expect the supportive slides to address features of the CE-
student relationship, including interactive observations from the modules participants about the
physical environments facilitation, power differential, cultural differences, etc., as addressed in the
module goals.
Our own personal supervision styles tend to reflect another modelproposed for this module. This style,
commonly known as Give a man a fish/Teach a man to fish, is often supported in Early Intervention as
a model for working with parents. We have taken the same concept and adapted it for clinical
supervision, as shown in the table below, and as currently taught in HSL 893. Seminar in University
Teaching and Supervision, at Gallaudet University. This model is intended as a companion to, not a
replacement of, other models.

Give a Man a Fish, Adapted for Clinical Supervision

Student Clinical Educator Future SLPs Clinical Competence

Tell me what you know and Ill learn/retain 20%

Show me what you know and Ill learn/retain 40%

Show and tell me what you know and Ill learn/retain 60%

Let me show you what Ive learned 80%

Let me show and tell you what Ive earned 100%

________________________________________________________________________

This model aligns well with the videos we propose for the module.As we anticipate it, the first session
would show the CEdescribing her own video-recorded work with a client (hearing aid checks, Ling 6-
Sound Test, and auditory training via telephone) with a student newly assigned to her supervision. The
student watches as the supervisor explains (tells) what is occurring (shows). An observation-first session
follows ASHAs (2014) expectations that clinicians have already acquired (or are acquiring) their first 25
observation hours prior to direct contact with clients. The observation-first session is also consistent
with practices in the HSC at Gallaudet and at off-campus placements around the country, where
students are assigned to clients already being seen by the SLPs/CEs. (As a billing clinic, all CEs at GHSC
are also practicing SLPs.)

In the second proposed video session, the CE focuses on showing her graduate clinician how she works
with a stroke patient and her husband using augmentative communication strategies. This session
represents a period of phased dependenceto-co-dependence because of insurance demands; the
relationship shown here is also more common to internship and externship sites where SLPs maintain
more active involvement with their clients/patients until midterm or even closer to a semesters end.

In the third proposed video, the move to observation documentation represents the student at the Let
me show you point in the supervision continuum. At this point, the CE moves from a physically-seen-
and-available presence to an available-but-not-present role. Documentation of observations constitutes
a large part of the CEs responsibilities at this stage and we would expect various observation
instruments to be recommended as students move toward self-supervision and independence.

In the fourth video, we propose to show a CE who merely checks on her grad student conducting an AR
tele-practice session. In the training module, we will explain how the student conducting this session is
videotaping her session and is responsible for selecting clips from the session as she shows and tells
her CE what transpired. We will also promote routine video analysis as important to that goal of self-
supervision (Anderson, 1988). And in the final session, we will promote a practice that we believe is
critical for internship placements and Clinical Fellowship interviews, a beginning orientation or
contractual interview in which the clinican assumes responsibility for describing her clinical
competencies as they have been acquired over time. This critical stage is omitted in some training
programs where students are placed off campus with atabala rasaassumption and CEs takemuch of
the semester to determine the students competencies with clients common to that placement. We
propose that the student whos ready for an off-campus placement should arrive on day 1 ready to tell
her new CE about her competencies acquisition continuum (formative assessment)and to participate
with the CE in determining direction (and maybe style) of supervisionneeded to grow new
competencies.We allege that most CEs are comfortable with the early stages of supervision, but that
this important transition step is often missing and prevents each new placement from becoming a
starting over point, rather than a continued matriculation journey along that continuum.

We anticipate using at least $3000 for honorariums to the students and clinical educators who would
participate in the supervision activities (in ways that protect the anonymity of their clients) as an
addition to their typically assigned work week (for the CEs) or clinical-course assignments (for the
students). We would hope to use no more than $2000 to offset travel expenses to the 2017 CAPCSD
conference and/or 2017 ASHA conference,where we will propose a seminar presentation on this same
module.

Finally, we request to use the module at Gallaudet in three proprietarial ways:

1. In field-testing the module with CEs (possibly the reviewers of this CME proposal and those
involved in its development, along with some uninvolved, independent CEs) to collect data on its
validity, fidelity and reliability in meeting the CAPCSD goals (more on this below);
2. Once these three assessment metrics are satisfied by the authors and reviewers, we would
expect to use the completed module in training new CEs to supervise future SLP (and AUD)
Gallaudet students, focusing on the AR expertise as well as the supervision expertise;
3. We also would include the module as an assignment in the Ph.D. course, HSL 893, Seminar in
University Instruction and Supervision. This course is required of all Ph.D. students in the HSLS
Department (and taken by some doctoral students outside the HSLS program) and is a
prerequisite for another required Ph.D. course, HSL 895, Supervision Practicum.

The first of these three expectations would require the development or selection of instruments (if not
already available through CME or CAPCSD) that judge the effectiveness of the training module for its
validity (Does the module achieve the five CME goals called for in the proposal?), fidelity (Are the
supervision approaches and the AR activities demonstrated in the videos authenticated by individuals
with expertise in supervision?), and reliability (Do the validity and fidelity ratings/judgments show
consistency over different reviewers and across repeated viewings over time?). This intentional process
is also necessary for future research in clinical supervision, as recommended by ASHA (2008) in
determining the effectiveness and efficiency of technology in delivering supervision (p. 13).
We anticipate this project will bring favorable attention to the multiple ways AR is implemented across
multiple clients as a secondary outcome, but primarily contribute to the training of CE in an intervention
area that crosses both Audiology and Speech-Language Pathology. Gallaudets SLP CEs commonly
supervise partnered SLP and AuD doctoral students, particularly in group AR sessions (e.g., the
speechreading groups). The combined SLP-AUD relationship will also be captured in demonstrating and
nurturing inter-professional communication and inter-professional practices (IPC and IPP), not as unique
to Gallaudet, but as important to AR delivery and professional practicesin any clinical setting where any
clients, patients, and/or students are served by SLPs.

We look forward to hearing from you on our proposal; and, if awarded, we look forward to working with
you over the next year.

Sincerely,

Brenda C. Seal, Ph.D., CCC-SLP, ASHA-F Karen Garrido-Nag, Ph.D., CCC-SLP

Professor and Director of SLP Assistant Professor

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Note: In a spirit of professional openness, I should share that my retirement is eminent, possibly in July
2017, but most likely in December after a Ph.D. student defends her dissertation. I would love to leave
this completed project in Dr. Garrido-Nags hands to use in HSL 893, the instruction and supervision
course that I currently teach. She currently teaches the HSL 895 supervision practicum.

Attached: Bios, CVs

Support letter from Robin Goffen, GUHS SLP Clinical Coordinator

References:
AdHoc Committee on Clinical Supervision and Working Group of CAPCSD [aka Blue Ribbon Committee
on Supervision). (December 2013). Knowledge, Skills and Training Consideration for Individuals
Serving asSupervisors. Retrieved 02-06-16 from www.asha.org/uploadedFiles/Report-Ad-Hoc
-Committee-on-Supervision.pdf#search=%22CAPCSD%22
Anderson, J. (1988). The supervisory process in speech-language pathology and audiology. Austin, TX:
Pro-Ed.
ASHA. (2008). Clinical Supervision in Speech-Language Pathology. Technical Paper. Retrieved on 02-10-
16 from www.asha.org/policy/TR2008-00296.htm.
ASHA. (2014). ASHA 2014 SLP Standards for Clinical Certification. Retrieved on 02-12-16 from
www.asha.org/uploadedFiles/2014-SLP-CCC-Application-Standards.pdf#search=%222014%22
American Speech-Language-Hearing Association. (n.d.). Clinical Education and Supervision. (Practice
Portal). Retrieved 02-06-16 from www.asha.org/Practice-Portal/Professional-Issues/Clinical-
Education-and-Supervision/.
McCrea, E., & Brasseur, J. (2003) The Supervisory Process in Speech-Language Pathology and Audiology.
Pearson Education, Inc.
Biographies:

Brenda Seal is Professor and SLP Program Director at Gallaudet and Professor Emerita in CSD at James
Madison University, where much of her early career focused on improving clinical supervision. Refereed
publications and presentations in supervisors time management, electronic W-PACC, and observation
feedback are not available in the abbreviated CV.

Karen Garrido-Nag is Assistant Professor and Acting SLP Program Director at Gallaudet. Karens career
has spanned various settings and populations. She has supevised Gallaudet interns and students in the
GHSC. Karen teaches the required Counseling and MultiCultural Issues for masters students and the
required supervision practicum class for Ph.D. students.