2008 Student Ethics Essay Award - 3rd Place

Professional Integrity of Student Clinicians

By Melinda J. Simon
Longwood University
Farmville, Virginia
NSSLHA Chapter Advisor: Peggy C. Agee

"Ethics is nothing else but reverence for life," was said by the Nobel Peace Prize winner Albert Schweitzer (1936). It is a true comment on why many of us decided to enter into the field of speech-language pathology. The "reverence for life" not only guides our career choice but also our ethical choices. The principal point of the Code of Ethics is to guide professionals in the ways to behave in the career of a speech-language pathologist or audiologist. Although graduate students have not yet achieved their certification from ASHA, they still must maintain the highest ethical standards as they practice as student clinicians. They too must "honor their responsibility to the public" (ASHA Code of Ethics , Principle III). To even arrive at the point of student clinician, the student must undergo rigorous academic training. The stringent 400 hours of preparation to practice on our own serves as a base where we can establish our ethical guiding principles. The student clinicians not only represent themselves as they practice, but they also represent the university and the professors that gave them the opportunity to practice.

The clients must be aware that they are being seen by graduate students that are still in training. To ensure that the clients are aware of this fact the practicing student clinician must have the client or parent/caregiver sign a notice addressing who will be providing service. Informing the client upholds the statement of, "Individuals shall not misrepresent their credentials, competence, education, training, experience" (ASHA Code of Ethics , Principle III, Rule A) is imperative to the integrity of the institution and ASHA. Of course, the graduate student clinician cannot provide services outside of the clinic or setting that he/she is being observed in. The student clinician is not prepared with the professional experience to practice on his/her own.

Also, a student clinician must make the client aware of the other options available to him/her. It is the clinician's ethical duty to inform the client that the setting where he/she practices is not alone in the area offering speech-language services. The clinician must follow the rule that "Individuals shall refer those served professionally solely on the basis of interest of those being referred" (ASHA Code of Ethics , Principle III, Rule C). By serving the best interest of the client the student clinician can refer with approval of his/her supervisor when the client's needs are beyond his/her scope of practice. In whatever situation, it is the ethical duty of the student clinician to place the needs of the client paramount even if it means losing the client from his/her caseload.

In addition to talking about the experience of the graduate student clinician, he/she must also be aware of what they are promising the clients and the public. There is no cure all in speech or swallowing therapy. Student clinicians must be straight forward in the services that can be provided and the possible progress that could be made. As stated under Principle III, Rule F, "Individuals shall not misrepresent diagnostic information, research, services rendered, or products dispensed." Each individual client will progress at his/her own rate, and the student clinicians must keep everyone involved informed on how the client does or does not proceed. To provide the best care the graduate student clinician needs to examine research to establish a knowledge base for the treatment. A sound evidence based practice makes certain that the treatment method has reasoning behind the management of the communication disorder.

The reverence for life continues as the graduate student clinician practices. The experience gained as a student clinician will have a direct bearing on how he/she performs in the future once the clinician is out of graduate school, through the Clinical Fellowship, and into the real world as a speech-language pathologist.

References

American Speech-Language-Hearing Association. (2003). Code of Ethics . Available from www.asha.org/policy .

Schweitzer, Albert (1936). "The Ethics of Reverence for Life." Christendom, Winter Issue, 1 (2). 225-239.