Issues in Ethics: Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology
About This Document
Published 2013. This Issues in Ethics statement is a revision of Responsibilities of Individuals Who Mentor Clinical Fellows (2007). This document applies to those mentoring clinical fellows in speech-language pathology. This Issues in Ethics statement addresses similar issues as a previous one (2004) with the title Clinical Fellowship Supervisor's Responsibilities.
Issues in Ethics: Definition
From time to time, the Board of Ethics determines that members and certificate holders can benefit from additional analysis and instruction concerning a specific issue of ethical conduct. Issues in Ethics statements are intended to heighten sensitivity and increase awareness. They are illustrative of the Code of Ethics and intended to promote thoughtful consideration of ethical issues. They may assist members and certificate holders in engaging in self-guided ethical decision making. These statements do not absolutely prohibit or require specified activity. The facts and circumstances surrounding a matter of concern will determine whether the activity is ethical.
The Clinical Fellowship (CF) mentor assesses the clinical fellow in the demonstration of the skills and knowledge appropriate for independent practice and provides professional support and personal guidance to the clinical fellow across the period of the CF. Mentors of a clinical fellow play a critical role in the preparation of speech-language pathologists (SLPs). The ASHA CCC-SLP certification standards and information for CF mentoring of SLPs on ASHA's website list supervisory functions; however, mentors should be aware that they also have ethical obligations to clinical fellows. They hold positions of power over clinical fellows—power to delay or deny the completion of a requirement for certification and, sometimes, power to affect an individual's immediate or subsequent employment. Moreover, individuals who mentor clinical fellows should recognize that they may at times encounter potential conflicts of interest in reconciling professional and workplace demands with the ethical duties they owe to employees who are in their CF.
Mentors of speech-language pathologists should be familiar with their obligations as described in the ASHA Code of Ethics and certification standards, as well as with all supervisory obligations in the pertinent sections of their respective state licensure laws. The CF mentor cannot assume that ASHA's supervisory requirements for the clinical fellow are the same as the supervisory requirements for an individual with the same level of education and training as mandated by the state's licensure law. Further, in those states where the requirements for licensure mirror and/or accept ASHA's clinical fellow requirements, the mentor must not jeopardize the state licensure of the clinical fellow (albeit separate and apart from ASHA's certification) by providing supervision without being licensed in that state.
The vast majority of clinical fellows report successful experiences under the appropriate mentoring and supervision of competent, dedicated professionals. Although the number of reports alleging detrimental supervisory practices is comparatively small, the fact that such incidents occur at all must be addressed. The consequences of the kinds of practices detailed above can be severe (e.g., clinical fellows have received no credit or only partial credit for the CF experience such that their certification has been delayed or employment opportunities have been lost).
Examples of situations that may give rise to ethical issues and/or misconduct include the following:
- arbitrary termination of the CF mentor-supervisory relationship
- failure to establish outcomes and performance levels or failure to do so in a timely fashion
- failure to complete and sign the CF report or failure to do so in a timely fashion
- withholding paperwork for the benefit of the employer and to the detriment of the clinical fellow
- failure to provide the required amount of supervision
- mentoring/supervisory responsibility for an excessive number of clinical fellows
- assignment of excessive nonclinical duties to the detriment of the clinical fellows' clinical experience
- recruitment of clinical fellows to function as independent practitioners without appropriate supervision
- failure to report a clinical fellow's noncompliance with the Code of Ethics or applicable law
- failure to fulfill the responsibilities of CF mentoring/supervision as agreed
The Board of Ethics acknowledges that clinical fellows may likewise be responsible for the occasional difficult situations that occur. Differing personal styles, cultural differences, and/or conflicting personalities may be at the root of some of the occurrences reported. It is suggested that the clinical fellow select his or her mentor carefully and follow the suggestions provided in Selecting a Clinical Fellowship (CF) Setting on the ASHA website.
Typically, the CF is the clinical fellow's first employment within the profession, bringing with it new challenges of time management, workplace dynamics, and employer expectations. Whether the employment setting is in the public or private sector, the recent graduate may not be aware of the realities of working within a professional practice. Mentors of speech-language pathologists should be mindful that these new challenges can give rise to ethical dilemmas for which the mentor has the opportunity to guide the fellow in his or her understanding of ethical decision making.
The mentoring speech-language pathologist is a role model for the beginning professional. Mentors have influence that lasts beyond the term of intensive contact, because new certificate holders may subsequently mentor and supervise others. Mentors are expected to adhere to standards of fairness. This requires, at a minimum, that mentoring speech-language pathologists understand their responsibilities, make good-faith efforts to carry them out, and immediately address issues of concern. It is also recommended that mentors advance their knowledge of supervisory techniques, practices, and principles through continuing education. Mentors are the key to a successful certification program and provide invaluable services to the public and the profession.
The Code of Ethics (2010) includes principles and rules with direct implications for the mentoring speech-language pathologist and the clinical fellow. They include, but are not limited to, the following.
Principle of Ethics I
Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a humane manner.
Under this principle, there are several rules which apply to mentoring responsibilities. These include:
Rule A. Individuals shall provide all services competently.
This rule applies because the mentor has the responsibility to assist the clinical fellow in the development of competent delivery of services, and ultimately has the responsibility to evaluate the clinical competence of the individual. It is wise to keep in mind that the successful completion of the CF is the final assessment for independent clinical practice.
Rule D. Individuals shall not misrepresent the credentials of assistants, technicians, support personnel, students, Clinical Fellows, or any others under their supervision, and they shall inform those they serve professionally of the name and professional credentials of persons providing services.
Rule Q. Individuals whose professional services are adversely affected by substance abuse or other health-related conditions shall seek professional assistance and, where appropriate, withdraw from the affected areas of practice.
Principle of Ethics II
Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence and performance.
Rule A. Individuals shall engage in the provision of clinical services only when they hold the appropriate Certificate of Clinical Competence or when they are in the certification process and are supervised by an individual who holds the appropriate Certificate of Clinical Competence.
Rule B. Individuals shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their level of education, training, and experience.
Rule D. Individuals shall not require or permit their professional staff to provide services or conduct research activities that exceed the staff member's competence, level of education, training, and experience.
Rules A and B apply to both the mentor and clinical fellow. In situations where the mentor becomes aware that the clinical fellow needs additional education, training, or experience in a particular practice area, it is the responsibility of the mentor to facilitate the fellow's acquisition of such education, training, or experience. Rule D may apply when both the mentor and the clinical fellow are employed within the same entity and the clinical fellow is considered a member of the professional staff.
Principle of Ethics III
Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including the dissemination of research findings and scholarly activities and the promotion, marketing, and advertising of products and services.
Rule A. Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly or research contributions.
Rule B. Individuals shall not participate in professional activities that constitute a conflict of interest.
Principle of Ethics IV
Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of other professions and disciplines.
Rule A. Individuals shall uphold the dignity and autonomy of the professions, maintain harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards.
Rule B. Individuals shall prohibit anyone under their supervision from engaging in any practice that violates the Code of Ethics.
Rule D. Individuals shall not engage in any form of unlawful harassment, including sexual harassment or power abuse.
Rules A, B, and D apply because the mentor has the responsibility to model appropriate patterns of intraprofessional and interprofessional relationships. The mentor has the responsibility to treat the clinical fellow with dignity and respect at all times, allowing the clinical fellow to develop professionally without intimidation and fear of reprisal. The mentor has the responsibility to complete all components of the CF experience within established guidelines.
Rule F. Individuals shall not engage in sexual activities with clients, students, or research participants over whom they exercise professional authority or power.
Rule K. Individuals shall not discriminate in their relationships with colleagues, students, and members of other professions and disciplines on the basis of race or ethnicity, gender, gender identity/gender expression, age, religion, national origin, sexual orientation, or disability.