Assistant Professor Gannon University Saint Petersburg, Florida, United States
Disclosure(s):
Deborah T. Scheble, SLPD: Gannon University and ISHA: Financial - Speaking Fee (Ongoing), Travel Stipend (Ongoing). No non-financial relationships to disclose
Abstract Speech-Language Pathologists are required to complete clinical practicum hours during graduate school and a Clinical Fellowship post-graduate school. However, limited research exists regarding the efficacy of supervisory and mentoring strategies resulting in the use of arbitrarily determined methods. A scoping review of supervisory models for post-graduate healthcare professionals revealed that mentorship was positively associated with retention, decreased burnout, career success, and research involvement. While both mentees and mentors found value in mentorship programs, certain program characteristics, styles, topics, and traits had a greater impact than others. Likewise, preliminary results of a scoping review focused on clinical instruction found that graduate clinicians reported an increase in knowledge, skills, and confidence as a result of specific supervisory elements. Summary of Presentation The American Speech-Language-Hearing Association (ASHA, 2019b) requires all Speech-Language Pathologists (SLPs) to participate in a post-graduate school, nine-month, temporary credentialing experience known as a Clinical Fellowship (CF). ASHA describes the CF experience as a transitional time between graduate school and practicing independently as an SLP. It is unclear if evidence-based practices (EBP) for mentoring CFs exist, and there is limited research regarding the efficacy of CF mentoring strategies or methods that add value to the CF mentor/mentee relationship. Furthermore, there are few resources to guide the CF mentor in the development of supervisory skills or the provision of feedback.
Two relevant resources provided by ASHA include the ASHA Ad Hoc Committee on Supervision Training (AHCST) Final Report and the 2020 Clinical Fellowship Skills Inventory (CFSI) (ASHA, 2019a; McCready et al., 2016). ASHA states that a CF mentor is required to “improve the clinical effectiveness of the Clinical Fellow through meaningful mentoring and feedback, and assists the Clinical Fellow in developing independent clinical skills” (ASHA, 2019b); however, each CF mentor determines how this is accomplished. The Self-Assessment of Competencies in Supervision guides the mentor in reflecting on their strengths and areas for improvement. However, each CF mentor arbitrarily determines effective strategies for developing the minimum level of competency for independent practice when the CF is and is not meeting the expectations per the CFSI (McCready et al., 2016).
The implementation of research-based supervisory models aligns with ASHA’s objective for the CF experience, which is to develop effective and independent SLP practitioners (2019b). The findings may also be advantageous to the ASHA AHCST as a six-year plan for obligatory professional development training in the area of supervision unfolds (McCready et al., 2016). The report outlines “A Plan for Establishing ASHA Resources and Training Opportunities,” and as of January 2020, all CF mentors are required to complete two hours of professional development in the area of supervision (McCready et al., 2016). Many CF mentors report feeling unprepared for this supervisory role and may benefit from researched-based models (Beckley, 2017). Finally, clinically effective and independent SLPs are valuable to organizations, administrators, and other healthcare professionals as they are capable of making significant contributions to interdisciplinary teams. The goal of the National Center for Interprofessional Practice and Education (2018) is to create “team-based and collaborative care models - starting with students and continuing into professional settings – to ensure the highest quality of care and lowest cost in all settings and professions…high-functioning teams can improve the experience, outcomes, and costs of health care.”
It is necessary to determine if effective supervisory models used by other healthcare professions are applicable to the CF experience. The purpose of this scoping review was to determine the efficacy of supervisory models for post-graduate healthcare professionals. This review can guide CF mentors as they strive to scaffold CFs from new graduates to independent practitioners.
The scoping review included 78 studies involving mentorship programs for post-graduate entry-level healthcare professionals published between 1999 and 2019. The studies comprised 7,709 mentees and 823 mentors. Codes were established from recurring themes within the studies, and broader categories were created to group similar concepts to describe the research findings across studies. This review focused on program characteristics and outcomes such as matching method, frequency and duration, mentoring style and topics, program satisfaction, successful aspects, and areas in need of improvement.
Research related to this topic nearly tripled from 2015-2019 and increased fivefold in the last decade compared to the previous one. Eighty-seven percent of the studies included qualitative data examining mentees’ and mentors’ perceptions. The duration of the relationships varied from one day to five years, with the most frequent duration of one to two years. Seventy percent of the mentorship programs included synchronous instruction, e.g., conferences, workshops, and CEUs, and only 30% conducted onsite observations. Seventy-four percent of mentees and 88% of mentors rated their mentorship program as good or excellent. According to mentees, the most valued mentor traits were approachability, honesty, and credibility. Mentors and mentees discussed well-being, such as psychological and physical wellness, personal growth, financial issues, and work-life balance more than any other topic.
Mentorship was positively associated with retention, decreased burnout, career success, and research involvement. Quantitative research remains minimal, and details about participant characteristics were lacking. Only seven studies specified minority status of mentees, and none of the studies provided it for mentors. Although programs administratively matched mentees with mentors 81% of the time, the findings revealed that 48% of mentees preferred to self-select mentors. A prevalent theme identified by both mentees and mentors is the need for protected time.
Qualitative analysis demonstrated that mentees and mentors find value in mentorship programs primarily related to the mentees’ professional development and well-being. Future programs can benefit from improving the matching process, establishing protected mentoring time, and providing training concerning the mentorship relationship. While qualitative studies provide significant insight regarding preferences for the development of mentorship programs, further research is needed to determine if program characteristics also impact patient safety and outcomes. Like the CF experience, clinical practicum guidelines are defined by ASHA (2022) and require students to complete a minimum of 325 hours. A minimum of 25% of a student’s total contact with each client must be supervised periodically, throughout the practicum, by an ASHA-certified SLP. The same requirements outlined by the AHCST apply to clinical instruction, yet there remains a lack of evidence regarding best practices or graduate clinician preferences for supervision (Carter et al., 2017; McCready et al., 2016). Although key outcomes of the above findings may generalize to the supervision of graduate clinicians, an independent scoping review was initiated. This scoping review aims to determine if specific methods or strategies support the development of SLP graduate clinicians or if patterns exist to inform current and future clinical instructors. Additionally, similarities and differences in supervisory elements between scoping reviews will be compared. The preliminary scoping review includes 24 articles related to the clinical instruction of SLP graduate students published between January 2017 and November 2022. The studies comprise 625 SLP graduate students and 209 clinical instructors. This review evaluates instructional methods, activities, positive outcomes, and findings. Emerging themes within and across articles will be discussed.
References American Speech-Language-Hearing Association. (2016). 2015 Work life survey. CCC-SLP survey summary report: Number and type of responses. https://www.asha.org/Research/memberdata/Membership-Survey/
American Speech-Language-Hearing Association. (2018a). 2017 CCCs, jobs, & careers mini-survey. Summary report: Numbers and types of responses. https://www.asha.org/research/memberdata/membership-survey/ American Speech-Language-Hearing Association. (2018b). Communication sciences and disorders education trend data: 2010-2011 to 2017-2018. https://www.asha.org/Academic/HES/CSD-Education-Survey-Data-Reports/
American Speech-Language-Hearing Association. (2019a). 2020 Clinical fellowship skills inventory. https://www.asha.org/certification/Clinical-Fellowship/#qual-mentor/
American Speech-Language-Hearing Association. (2019b). A guide to the ASHA clinical fellowship experience. https://www.asha.org/certification/ClinicalFellowship/#qual-mentor American Speech-Language-Hearing Association. (2022, November 28). Certification standards for speech-language pathology frequently asked questions: Clinical practicum. https://www.asha.org/certification/certification-standards-for-slp-clinical-practicum/
Carter, M. D., Carter, M., Randolph, C., Backes, L., Noll, K., & Cole, L. (2017). Graduate student perceptions regarding common speech-language pathology supervisory practices. Perspectives of the ASHA Special Interest Groups, 2(2). https://pubs.asha.org/doi/abs/10.1044/persp2.SIG11.48
McCready, V., Nunez, L., Adamovich, S., Cheung, K. C., Dudding, C., Lenzen, N., & Williams, L. (2016). Final report: A plan for developing resources and training opportunities in clinical supervision. American Speech-Language-Hearing Association, Ad Hoc Committee on Supervision Training. https://www.asha.org/About/governance/committees/Completed-Ad-Hoc Committees/
