American Speech-Language-Hearing Association

When a Student Fails to Make the Grade

Ethics Roundtable: Case Study

Sarah is a graduate student clinician in speech-language pathology, assigned to an off-site placement in an acute care rehabilitation setting. She expects to complete her graduate program at the end of the current term and has accepted a CF position in a rehabilitation program. Throughout the 5-day/week, 10-week placement, Sarah has had a number of problems. Her on-site supervisor observes that Sarah is often late for appointments, fails to complete paperwork, shows poor documentation skills, has difficulty relating to patients and families, and struggles to make clinical decisions and to master clinical assessment tools. During conferences the supervisor has given Sarah constructive suggestions and they have agreed on specific goals, such as being on-time for all clients, completing daily paperwork before leaving the facility, and preparing for sessions ahead of time.

Over the past few weeks, Sarah has shown some improvement but continues to need direction to select therapy materials, to set daily goals for patients she has been managing for several weeks, and to administer familiar assessment tools accurately.

The supervisor consults with the university practicum coordinator to outline her concerns. The university coordinator notes that Sarah's performance has been uneven throughout her enrollment in the program and that other supervisors have expressed similar concerns. The university coordinator points out that Sarah is scheduled to graduate this term and that a less-than-satisfactory grade could create problems.

Questions to Consider

  • What is the appropriate action for the off-site supervisor? What is the appropriate action for the university coordinator? What guidance is available from ASHA's Code of Ethics?
  • What are the implications of passing or failing Sarah?
  • What options are available to the off-site supervisor? The university coordinator? To the student?

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