Graduate Student Clinicians Research Articles

The Effectiveness of Training Clinical Supervisors in Conducting the Supervisory Conference

ABSTRACT The clinical supervisor plays an important role in the training of clinicians seeking certification in speech-language pathology and audiology. However, clinical supervisors typically receive little if any preparation for their role as supervisor. In this study, one group of clinical supervisors receiving training in the execution of the supervisory process were compared to a group of supervisors who did not receive training. Conference interactions between supervisors and their assigned graduate student clinicians were examined along a continuum of behaviors ranging from direct to indirect supervisory styles. Significant differences between groups of supervisors in regard to the trained supervisors relinquishing control and allowing their students clinicians to be more active participants in the supervisory process were noted. This study supports the position that training in the supervisory process helps to accomplish the goals of clinical supervision and improves the interactional style of the clinical supervisor.

Clinical Supervisors...Are You Immediate?

Graduate student clinicians and clinical supervisors completed a Likert Scale regarding the importance of selected variables in student clinician/supervisor interaction. An independent means t-test was computed for each of the 25 items. A one-way ANOVA combining both groups was computed to establish values in an Scheffe test for multiple comparisons. Respondents also rank-ordered five dimension of clinician/supervisor interaction: nonverbal, verbal, accessibility, respect/attention and competency/professionalism.

Changes in maternal attitudes and perceptions and children's communication skills.

The present investigation had two purposes: (a) to assess significant changes in the attitudes and perceptions of mothers of young children who were enrolled in 15 wk. of individual speech-language therapy and (b) to compare changes in mothers' attitudes and perceptions with university supervisors' ratings of children's over-all communication skills and speech intelligibility. 17 children, ages 2;10 to 5;8, and their mothers were participants. Mothers received speech-language services and counseling from graduate-student clinicians and university clinical supervisors but no special counseling was provided to alter their attitudes and perceptions concerning the intervention process. The typical child in the intervention program received 24 individual speech and language therapy sessions. Mothers and supervisors completed questionnaires before and after the 15-wk. intervention. Neither group was made aware of the purpose of the investigation. Analysis showed a pattern of significant changes in mothers' pre- and postrankings of questionnaire items and significant changes in the total communication and speech intelligibility rankings made by supervisors. Significant relationships were found for changes in attitudes and perceptions of mothers and changes in the children's communication skills. The results bolster the need for use of family-based therapy approaches in intervention programs for young children's communication disorders.

A Comparison of Two Graduate Student Clinical Performance Instruments in Speech-Language Pathology

This study compared perceptions of 16 graduate student clinicians and eight supervisors on the desirabilily and usefulness of a subjective versus objective measure of students' clinical performance in speech-language pathology. Students who had the same supervisor for two consecutive semesters were administered an objective and subjective evaluation instrument, and at the end of the second semester, students and supervisors were asked their opinion about both instruments. The results indicate that most of the graduate student clinicians and the supervisors preferred the objective instrument, and all participants helieved the objective instrument was more helpful in assessing clinical perfomance. These results support the theoretical literature in supervision in speech-language pathology and audiology that encourages accountability and objectivity.

Facilitating Changes in Supervisees' Clinical Behaviors

This research was conducted to determine whether supervisees altered their clinical behaviors as a consequence of a joint data-analysis method of clinical supervision. Four beginning graduate student clinicians assigned to articulation clients were supervised in accordance with tenets of Cogan's Clinical Supervision Model and Anderson's Continuum of Supervision. Supervision focused on the targeted dependent variables of clinician "explanations," "informative feedback," and "directive responses to off-task utterances." Visual inspection of multiple baseline data indicated that target behaviors improved after they became the focus of supervision. The supervisory procedures implemented in this study effected positive changes in the supervisees' clinical behaviors. Qualitative discoveries that relate to the practicalities of daily supervision are discussed.

Different clinical perspectives of good and poor therapy sessions.

This study investigated differences in causal attributions made by student clinicians taking actor and observer roles in good and poor therapy sessions. One hundred thirty-four graduate student clinicians in speech-language pathology were asked to imagine a hypothetical good or poor therapy session in which they took either the role of a clinician working with a client in a session or that of a clinician observing the session. To account for the session's hypothesized outcomes, clinicians taking the actor role cited client causes more frequently than other causes while clinicians taking the observer role cited clinician causes. These results are consistent with the actor-observer bias documented extensively in the psychological and educational literatures. Clinicians' causal attributions also differed for good and poor therapy sessions. Implications are discussed in terms of possible impact on the clinical training process in speech-language pathology.

Observed differences between direct, indirect, and direct/indirect videotaped supervisory conferences.

The purpose of the study was to determine whether supervisors and supervisees were able to observe differences in supervisory styles and whether or not the subjects' experience levels were related to the differences they observed. It investigated whether speech-language pathology supervisors, graduate student clinicians, and undergraduates rated differently their observations of direct, indirect, and direct/indirect supervisory behaviors in videotaped supervisory conferences. A modification of Smith's Individual Supervisory Conference Rating Scale served as the dependent measure. Under counterbalanced conditions, 30 supervisors, 30 graduates, and 30 undergraduates from six different universities each viewed one of the three videotapes and rated the level of occurrence of direct and indirect supervisory behaviors. Factor analysis results indicated that 14 of the 18 rating scale items could be used reliably to assess direct and indirect supervisory behaviors in the videotaped conferences. ANOVA results demonstrated that regardless of level of experience, subjects did observe differences between the direct, indirect, and direct/indirect conferences. Results of Tukey tests demonstrated that the direct conference observers' mean score accounted for the significant conference-style main effect 75% of the time.

The use of time-expanded speech in the identification of part-word repetitions of stutterers

Abstract The purpose of this investigation was to explore the possibility of using time-expanded speech to aid clinicians in the identification of one-, two-, and three-unit repetitions of stutterers. Tape-recorded samples of nine stutterers (five adults and four children) were time-expanded to 0%, 150%, and 200% of original time. Thirty graduate student clinicians listened individually to the speech samples under the three listening conditions. The three conditions were presented in a counterbalanced order. Clinicians were asked to indicate each occurrence of one-, two-, or three-unit part-word repetitions on a response sheet. Results indicated that time expansion of the stutterers' speech by 150% or 200% of the original time resulted in significantly ( P < 0.05) more accurate identification of one-unit part-word repetitions. Time expansion did not, however, provide a perceptual advantage for the identification of two- and three-unit part-word repetitions. Implications for clinical application and further investigation are discussed.

Therapist habituation and purported client progress in articulation therapy

Ten graduate student clinicians, in their final year of training, evaluated the tape recorded pretherapy performances of 10/s/-defective children on the 68/s/ items of the McDonald Deep Test of Articulation (1964). Five of the 10 clinicians were randomly selected and assigned one of these /s/-defective children as part of their regular case load. The children were seen for 1 hr per week for a 5-week period. The clinicians were not informed as to the nature of the study or that the composition of their case load was in any way connected with the tapes that they had previously evaluated. The five remaining clinicians and children did not participate in therapy during this 5-week period. Immediately following this 5-week period, an additional tape recording was made of all 10 children's responses to the /s/ items of the McDonald Deep Test (1964). Both pre- and posttreatment tapes were then evaluated by all 10 clinicians in independent listening sessions. Significant between-tape differences, indicative of both habituation and sensitization to client errors within the in-therapy clinicians only, are discussed in terms of their clinical applications.

Clinician Bias in Evaluating Speech Proficiency

Summary The effect of clinician bias in evaluating the speech of children was studied. Case presentations were made to 30 clinicians by means of videotape. Prior to evaluation, graduate-student clinicians were exposed to fabricated case-histories containing positive-bias or negative-bias factors, or to no case-history information. The clinicians generated phonetic inventories, scaled judgments of articulatory proficiency, scaled prognoses, and scaled therapeutic judgments. The case-history preconditions had little effect on the measured behaviour of the clinicians. Implications for clinical evaluative procedures are discussed.

Client-clinician relationships and concomitant factors in stuttering therapy.

Interrelationships among client progress in stuttering therapy, the nature of the affect interchange between client and clinician, and certain personality characteristics of both client and clinician were studied. Sixteen young adult male stutterers and their 11 graduate student clinicians served as subjects. Results support observations that the clinicians' and clients' personalities are significant variables in the stuttering therapy situation, support observations that important similarities exist between stuttering therapy and psychotherapy, and suggest that it is more accurate to note stages in the therapeutic relationship, rather than to characterize the relationship as if it were the same throughout therapy.