Clinical Practicum Experiences Research Articles

Collaborative peer lyric writing during music therapy training: a tool for facilitating students' reflections about clinical practicum experiences

Self-reflection is integral to effective clinical practice and yet is a skill that many intelligent students struggle to develop. This paper reports on the findings of a pilot study where students shared both positive and challenging experiences with each other and co-wrote songs that captured their experiences. Four students attending clinical practicum engaged in collaborative songwriting experiences with peers from both the same and different universities in the US and Australia. These experiences utilized both face to face and online environments utilizing Skype communication software. Lyrics were reviewed by the researchers and were compared with themes and categories about music therapy clinical training found in the literature. Findings suggest that collaborative songwriting provides opportunities for students to engage in experiences of reflection with other peers.

Academic and Clinical Preparation for Cultural and Linguistic Diversity in Speech-Language Pathology: Program Director Perspectives

Purpose: This investigation surveyed program directors of speech-language pathology graduate programs in the United States to determine their views on the academic instruction and clinical practicum experiences that are provided to prepare students to work with culturally and linguistically diverse populations. Method: An online survey was administered to program directors of accredited programs in speech-language pathology throughout the United States. Results: Overall, program directors felt that their programs prepared students to provide speech-language pathology services to culturally and linguistically diverse populations. Two survey questions yielded statistically significant differ- ences across geographic regions of the United States. The first related to the amount of academic instruction provided in cultural and language diversity (CLD), and the second to the adequacy of numbers of individuals from culturally and linguistically diverse backgrounds to participate in clinic practica. Responses to an open-ended question also sug- gested that some directors perceived challenges related to

Relationships Between Students' Self-Perceived Supervisory Needs and End of Semester Outcomes

AbstractAccording to the 2008 Standards for Accreditation of Graduate Education Programs in Audiology and Speech-Language Pathology (American-Speech-Language-Hearing Association, 2008), pre-professional programs must demonstrate how the nature and amount of clinical supervision are adjusted to reflect the individual needs and skills of student clinicians. The purpose of this study was to analyze predictive relationships among student clinician responses to a modified version of Larson’s Supervisory Needs Rating Scale (1981) and variables including (a) current GPA, (b) whether the student was at the undergraduate or graduate level, (c) number of previous semesters of clinical practicum experience, (d) cumulative number of clinical clock hours obtained, (e) grade received for the clinical practicum experience during this study, and (f) score as calculated from the departmental clinical Knowledge and Skills Acquisition (KASA) form in an attempt to find early identification markers for student clinicians who require extra support in clinical practicum assignments. Based on student clinician responses to survey items, two factors were revealed: Supervisory Instructional Behaviors and Supervisory Communicative Behaviors. Correlations between these factors and the end of semester student variables were calculated. One significant relationship between Supervisory Instructional Behaviors and student Grade Point Average was found. Results and implications of this finding and the need for future research of effective supervisory practices are presented.

Facilitating undergraduate nurses clinical practicum: The lived experience of clinical facilitators

Clinical practicum experience for undergraduate nurses remains undisputed as an essential component of any program. Exposure to the reality of professional practice and its integration of explicit, with tacit knowledge, is invaluable in producing skilled clinicians. Currently there are many issues that have arisen regarding clinical practice education for undergraduate nurses in Australia including; ongoing financial support and resourcing of clinical placements. Developing an understanding of these issues is central to the provision of quality clinical education. The aim of this study is to reveal dimensions of the lived experience of being a clinical facilitator, a popular model of nursing clinical education, to come to an understanding of how facilitation actually takes place in the clinical environment. The Hermeneutic phenomenological approach used in this study has brought to light five essential themes that elucidate the phenomena of facilitation. Those themes have been identified as; knowing your own limitations, employing the notion of stepping in or stepping back, developing alliances, acknowledging the reciprocity of the learning experience, and identifying appropriate clinical buddies. The recommendations from this study will have an impact on current issues and will inturn, influence the quality of clinical education for all stakeholders.

Doctor of Audiology (AuD) Program at the University of South Florida

This article describes the doctor of audiology (AuD) program at the University of South Florida (USF). The USF AuD program has been operational since the fall of 1999 and, to date, 47 students have graduated from either the postbaccalaureate track or the post-master's track. The faculty consists of 9 full-time and 8 part-time adjunct members who provide a curriculum that covers the audiology scope of practice. Being located in a major metropolitan area allows for diverse clinical practicum experiences that result in students being prepared to become autonomous professional practitioners.

Doctor of Audiology program at the University of Florida.

The University of Florida on-campus AuD program is described. To date, 63 students have been enrolled in this program. Sixteen doctoral-level audiology faculty teach in this program, either in the classroom or clinically. Coursework spans all areas included in the audiology scope of practice. The curriculum also has classes taught by faculty in other related disciplines, such as medicine, neuroscience, pharmacology, and counseling. Clinical practicum experiences throughout the program occur in a major health science center on campus, along with a number of other clinical sites. With the support of a large faculty and the availability of a wide variety of clinical placements, the University of Florida AuD program provides the necessary knowledge and skills for students to become autonomous professionals.

Promoting Health and Well-Being of Students in a Marriage and Family Therapy Program: A Study of the Development and Utilization of Therapy Services for Future Therapists

A model program for providing therapy services for graduate marriage and family therapy students is presented. The utilization of therapy services by MFT students in the COAMFTE-approved Masters in Family Therapy Program of the Mercer University School of Medicine was evaluated. A survey assessing utilization of therapy services was administered. The survey evaluated student therapy utilization as correlated with multiple demographic variables. Descriptive data of the survey results are presented. Statistical treatment of the data indicated one significant correlation—the utilization of therapy services by MFT students increased significantly with the amount of time spent in the program, especially increasing at or around the time that clinical practicum experiences were begun. Recommendations for providing therapy services for graduate MFT students and for further studies on this issue are made.

Academic and clinical education in fluency disorders: an update

This paper presents a survey of the academic and clinical education in fluency disorders provided by American Speech–Language–Hearing Association (ASHA)-accredited training programs. Respondents were 159 programs (out of 256, return rate=67.4%) that completed a questionnaire seeking information about the courses and clinical experiences they require, the expertise of their faculty and supervisors, changes following the 1993 modification of training requirements for the ASHA certificate of clinical competence (CCC), and preliminary plans for changes in preparation for the 2005 standards. Results, which supplement findings from an earlier survey distributed in 1997 ( Yaruss, 1999), indicated that nearly one-quarter of programs allow students to graduate without coursework in fluency disorders, and nearly two-thirds allow students to graduate without clinical practicum experiences. Findings suggest a trend toward fewer required classes taught by less experienced faculty, fewer clinical hours guided by less experienced supervisors, and a greater likelihood that students will graduate without any academic or clinical education in fluency disorders. Given the repeated finding that many speech–language pathologists are uncomfortable working with people who stutter, as well as ASHA’s apparent de-emphasis of fluency disorders within the increasing scope of practice in the field of speech–language pathology, these results are a cause for concern about the future of fluency disorders. Educational objectives: The reader will learn about (1) the coursework and clinical practicum experiences that are currently required for students in ASHA-accredited training programs; (2) trends indicating a reduction in training requirements for fluency disorders; and (3) ways of improving these requirements.

Staffing of undergraduate clinical learning programs in Australia

Clinical practicum experience arguably forms a critical role in the undergraduate preparation for registration to practice as a professional nurse. Whilst there appears to be a consensus about the importance of practical experience in nursing education, there has been limited research exploring the nature of clinical learning within undergraduate programs and validity of current approaches. A national survey of undergraduate preregistration Bachelor of Nursing courses was conducted to determine the scope and focus of clinical learning programs in Australia. Selected case studies were conducted to develop an understanding of contextual issues influencing the delivery of the clinical learning programs. Findings reveal a range of clinical supervision models employed and the staffing mix used to support those models. Issues associated with the selection and preparation of staff to support clinical learning relate to geographical location and economic resources. There is little empirical evidence that any of the models currently in use lead to quality outcomes, rather an eclectic use of models arguably facilitates meeting short-term demands of a constantly changing educational environment.

Promoting Participation in the Health Science Professions: Summer Programs for Talented, Underrepresented Students in Science

Across the nation, there remains a critical shortage of health professionals and of students choosing to pursue health‐related careers. This problem is particularly pervasive in the state of Oklahoma. In response to this need, faculty, administrators, and health professionals on two campuses of the University of Oklahoma have, collaborated over the past 9 years to develop and deliver summer academy programs in the health sciences professions for talented students and primarily for students who are underrepresented in science. These summer academy programs feature classroom and hands‐on clinical practicum experiences to introduce students to the rigors of academic preparation required for the health profession careers and the opportunity to be involved in direct patient care and laboratory research experiences. The academies have the goal of ensuring that bright, talented young students are aware of career options in health care delivery, health care education, and health care research arenas. A secondary objective is to spark student interest in pursuing higher education in the health sciences and in pursuing health‐related careers. The academy goals complement the state and national ongoing efforts to attract top scholars and meet health work force needs.

Current status of academic and clinical education in fluency disorders at asha-accredited training programs

Numerous studies have indicated that speech-language pathologists do not feel comfortable with their ability to diagnose and treat individuals who stutter. It is often suggested that this is the result of inadequate training; however, there has been relatively little examination of the academic and clinical education in fluency disorders that is currently provided by ASHA-accredited graduate programs. This study surveyed programs about their graduate training in fluency disorders, assessing factors such as the number and nature of courses that are offered and the clinical practicum experiences that are available. Analyses revealed that the majority of surveyed programs do require coursework on stuttering, though nearly one-fifth allow students to graduate without a class on stuttering and more than one-half of programs allow students to graduate without clinical experience in stuttering. Furthermore, one-half of responding programs reduced their academic or clinical requirements following ASHA's elimination of training requirements in fluency disorders in 1993. Results provide one likely explanation for the finding that clinicians feel less confident working with people who stutter. Analysis also revealed a bias toward greater representation of programs with a faculty member belonging to ASHA's Special Interest Division for Fluency Disorders. As a result, present results may overestimate the training that is actually provided in the field as a whole. Findings emphasize the need for far-reaching discussion about appropriate academic and clinical education in fluency disorders and provide a strong argument for the reinstatement of credible, meaningful education requirements in ASHA-accredited training programs.

Undergraduate Clinical Practicum and the opportunity to practice skills in preparation for the graduate year: A review of the literature

Clinical Practicum is an important component of undergraduate nursing education, in order to prepare the graduates for their role as Registered Nurses. it is argued by some that in reality the Clinical Practicum experiences do not adequately provide graduates with the skills they need during the graduate year.

Knowledge and Experiences with Older Adults of Undergraduate Dietetic Students in a Coordinated Program.

Methodology:To prepare students to work with an increasingly aging population, junior dietetic students in an coordinated undergraduate program receive 14 hours of instruction in geriatrics and complete 32 hours of clinical practicum experience in geriatric settings. To assess students’ knowledge of and actual experiences with older adults prior to instruction and practice, a two part survey was administered to 20 students on the first day of the geriatrics class. The first part of the survey included demographic information: age, relationships to grandparents, general experience with older people; perceived strengths and abilities as well as perceived fears, concerns and anxieties about working with older adults. The second part consisted of the Palmore Facts on Aging, a 25 question true-false test.Results: Results indicated that the class mean age is 28yrs. (range: 20–40yrs). Although older students were more likely to have greater exposure to and report less concerns about working with older adults, 55% of the class reported very limited exposure to older adults (i.e. < 4 adults) and 80% expressed at least one concern. Students reported closest relationships with grandmothers (75%), maternal more than paternal (50% vs. 25%). 25% of the students presently have a close relationship with a grandparent who is alive and living in the same city. 75% of students reported that grandparents were either deceased (35%), lived in another country (20%) or in a different area (25%). Experiences with grandparents were more likely to be positive than negative (85% vs. 15%). Students expressed concerns about being able to relate to and communicate with older adults, dealing with illness and death, being perceived as too young or inexperienced, becoming too attached or emotionally involved. 11 of the 25 questions on the Palmore test were answered correctly by at least 75% of the class. Three-fourths of the class overestimated the percentage of senior adults in the population, and the number in long-stay institutions. They underestimated income status, and incorrectly judged the majority of old people to be bored. At least 50% of the class incorrectly judged the majority of older adults to be set in their ways and unable to change, to be socially isolated and lonely, to become more religious as they age and to be seldom irritated or angry. Despite positive experiences with grandparents, dietetic students are likely to have misconceptions about older adults which could impact their performance in practice settings.(This research was supported by the US Department of Health and Human Services grant #1-376000511A-7)

"Should Canadian psychologists follow the APA trend and seek prescription privileges?: Of course they should!" An invited critical commentary of Dozois and Dobson.

Critics are biased, and so are readers. But intelligent readers soon discover how to allow for the windage of their own and a critic's prejudices. Whitney Balliett, Dinosaurs in the Morning, 1962.The issue of drug for psychologists is probably one of the most critical and timely issues now facing Canadian psychologists (Pagliaro & Pagliaro, 1995a). In this regard, Dozois and Dobson (see current issue) should be acknowledged for stimulating the discussion of this issue here in Canada. However, after careful, thorough, and thoughtful review of their arguments, I find their conclusion, that psychologists in Canada not seek drug privileges,(f.1) to be intellectually naive and wanting, professionally untenable, and, in relation to some of the recent writings of one of the authors (i.e., Dobson), philosophically inconsistent. In the following pages, I will present a brief critical commentary of Dozois and Dobson's specious arguments against drug for Canadian psychologists.Before presenting my critical commentary,I believe that it may be of some assistance to readers to know my own personal beliefs in regard to drug for psychologists. In this regard, I have previously and consistently (e.g., Pagliaro, 1989, 1994) endorsed the concept of granting drug to psychologists. This endorsement has not been as a carte blanche enfranchisement for the entire profession, but rather for those psychologists in Canada and other countries, who, having recognized a need for this additional form of therapeutic intervention and desiring to be better able to provide more comprehensive mental health services for their patients, attain appropriate and sufficient education and clinical practicum experience in order to competently prescribe psychotropics as an adjunct to psychotherapy. Even for these psychologists, I would emphasize the caveat that their should apply only to those cases where their patients are also receiving psychotherapy.(f.2) Further to my support of psychotropic for psychologists, I have, over the past several years, co - developed and taught a hierarchical series of graduate courses in pharmacopsychology(f.3) at the University of Alberta. This series was specifically designed to provide psychologists with the knowledge and skills required to competently and ethically prescribe thepsychotropics as an adjunct to their psychotherapy (Pagliaro, 1993; Pagliaro & Pagliaro, 1995a). These courses have been well received by graduate students in master degree and doctoral programs and also have attracted several post - doctoral chartered psychologists who are engaged in active clinical practice. Let us now turn to a critical commentary of the several arguments presented by Dozois and Dobson against prescription privileges for Canadian psychologists.Dozois and Dobson's ArgumentsThe following critical commentary of Dozois and Dobson's arguments is organized according to their headings of: of Care; Marketability; Practical Impediments; and Canadian Implications.QUALITY OF CAREUnder their heading of Quality of Care the following arguments were noted: lack of need; lack of public pressure; and inability to prescribe competently.Lack of need. ...only 20% of the patients seen by psychologists between 1980 and 1987 were referred to other professionals for part of their outpatient mental health services... In addition, many psychologists report that they have functionally prescribed for years by collaborating with physicians (p. ms 16 - 17).I do not know what level of significance Dozois and Dobson were using in considering the figure of 20% referrals to be less relevant, but according to every psychological research study that I have been involved in, and my own knowledge of basic statistics, a difference in one out of every five patients would be considered significant and relevant. …

Essential clinical experience for subspecialty development in geropsychiatric nursing.

1. Subspecialization in geropsychiatric nursing builds on the specialist preparation obtained in graduate level psychiatric/mental health or gerontologic nursing education. 2. Development of a subspecialty requires a base of substantive knowledge gained in the classroom, supplemented by a series of supervised clinical experiences. 3. Clinical practicum experiences with specific role options for the geropsychiatric clinical nurse specialist and experiences with special populations are essential to the further development of geropsychiatric nursing as a subspecialty.