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Issues in Ethics

American Speech-Language-Hearing Association (ASHA) Practice Policy

Responsibilities of Individuals Who Mentor Clinical Fellows

Board of Ethics


About this Document

This Issues in Ethics statement replaces the previous one (2004) with the title Clinical Fellowship Supervisor's Responsibilities. The spirit of this Issues in Ethics statement also applies to those individuals completing clinical fellowships in audiology while in the process of obtaining certification under the 1993 guidelines. This is allowable until January 1, 2008, after which the clinical fellowship will no longer exist as a requirement for certification in audiology.



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.

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Introduction

This Issues in Ethics Statement replaces the previous version, Clinical Fellowship Supervisor's Responsibilities (2004). The 2005 Standards for the Certificate of Clinical Competence in Speech-Language Pathology require a change in the relationship between the clinical fellow and the individual providing oversight to the clinical fellowship (CF) experience. The relationship is redefined in the new standards as that of a mentor rather than a supervisor. While the CF mentor will continue to assess the clinical fellow in the demonstration of the skills and knowledge appropriate for independent practice, there is an additional expectation that the mentor will provide personal guidance and professional support 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. The ASHA certification and membership handbooks and the Background Information and Standards and Implementation for the Certificate of Clinical Competence in Speech-Language Pathology list specific supervisory functions, but mentors should be aware that they also have ethical obligations to the clinical fellow. 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 the fellows' 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.

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Discussion

Examples of situations that may give rise to ethical issues and/or misconduct include the following:

Mentors of speech-language pathologists should be familiar with their obligations as described in the ASHA Code of Ethics and ASHA's certification and membership handbooks, as well as with all supervisory obligations in the pertinent sections of their respective state licensure laws. The fellowship 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 by our professions. 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).

The Board of Ethics acknowledges that clinical fellows may likewise be responsible for the occasional difficult situations that occur. Differing personal styles and/or conflicting personalities may be at the root of some of the occurrences reported. Also, the CF may be some clinical fellows' first employment experience, 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 the business world or the practical considerations of running a proprietary establishment. Therefore, it is equally important for mentors of speech-language pathologists to be mindful that the clinical fellow's conduct within the CF experience may give rise to issues that implicate the Code of Ethics and invoke 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 CCC-holders subsequently mentor and supervise others. Thus, mentors are the key to a successful certification program and provide invaluable services to the public and the professions. Mentors are expected to adhere to elemental standards of fairness. This requires, at a minimum, that the mentoring speech-language pathologists understand their responsibilities, make good-faith efforts to carry them out, and immediately address issues of concern to meet the obligations they agree to assume when they supervise a clinical fellow. It is also recommended that mentors advance their knowledge of supervisory techniques, practices, and principles through continuing education.

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Guidance

The Code of Ethics is permeated with provisions having implications for the mentoring speech-language pathologist and the clinical fellow. The general principles and rules bearing relevance to the CF supervisory relationship include, but are not limited to, the following.

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Principle of Ethics I

Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or participants in research and scholarly activities and shall treat animals involved in research in a humane manner.

  • Rule A. Individuals shall provide all services competently.

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Principle of Ethics II

Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence.

  • 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 competence, considering their level of education, training, and experience.

  • Rule D. Individuals shall delegate the provision of clinical services only to: (1) persons who hold the appropriate Certificate of Clinical Competence; (2) persons in the education or certification process who are appropriately supervised by an individual who holds the appropriate Certificate of Clinical Competence; or (3) assistants, technicians, or support personnel who are adequately supervised by an individual who holds the appropriate Certificate of Clinical Competence.

  • Rule E. 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.

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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 dissemination of research findings and scholarly activities.

  • 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.

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Principle of Ethics IV

Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of allied professions. Individuals shall uphold the dignity and autonomy of the professions, maintain harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards.

  • Rule A. Individuals shall prohibit anyone under their supervision from engaging in any practice that violates the Code of Ethics.

  • Rule H. Individuals shall not discriminate in their relationships with colleagues, students, and members of allied professions on the basis of race or ethnicity, gender, age, religion, national origin, sexual orientation, or disability.

  • Rule I. Individuals who have reason to believe that the Code of Ethics has been violated shall inform the Board of Ethics.

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Index terms: ethics, clinical fellowship, supervision, mentoring

Reference this material as: American Speech-Language-Hearing Association. (2007). Responsibilities of Individuals Who Mentor Clinical Fellows [Issues in Ethics]. Available from www.asha.org/policy.

© Copyright 2007 American Speech-Language-Hearing Association. All rights reserved.

Disclaimer: The American Speech-Language-Hearing Association disclaims any liability to any party for the accuracy, completeness, or availability of these documents, or for any damages arising out of the use of the documents and any information they contain.

doi:10.1044/policy.ET2007-00279