Issues in Ethics: Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology
About This Document
Published 2025. This Issues in Ethics statement was originally published in 2004 and was last revised in 2017. It has been updated to make any references to the Code of Ethics consistent with the Code of Ethics (2023) (hereinafter, "Code of Ethics"). The Board of Ethics (hereinafter, the "BOE") reviews Issues in Ethics statements periodically to ensure that they reflect current practices and the current Code of Ethics.
Issues in Ethics: Definition
From time to time, the BOE 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 are 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.
Introduction
The Clinical Fellowship (CF) mentor (a) assesses the Clinical Fellow by determining whether that individual is able to demonstrate the skills and knowledge appropriate for independent practice and (b) provides professional support and personal guidance to the Clinical Fellow across the period of the CF experience. The mentors of a Clinical Fellow play a critical role in the preparation of speech-language pathologists (SLPs) for clinical practice. ASHA's speech-language pathology certification standards and the information for SLPs who mentor Clinical Fellows on the Association's website list supervisory functions; however, mentors should be aware that they also have ethical obligations to Clinical Fellows.
CF mentors hold positions of power over Clinical Fellows—that is, the power to delay or deny the completion of a requirement for certification and, sometimes, the 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 that they owe to employees who are in their CF experience.
Mentoring Clinical Fellows requires an extraordinary commitment of time and talent. Mentors share in the responsibility of preparing future professionals for a lifetime of ethical conduct. Although the BOE does not have the jurisdiction to review complaints against Clinical Fellows until they are applicants for ASHA certification, the fundamental Principles and Rules of the Code of Ethics are an essential part of the CF experience. As such, the CF mentor must model the Code of Ethics and teach its significance.
Discussion
Mentors of SLPs should be familiar with their obligations as described in the Code of Ethics and the 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 those 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. The consequences of inappropriate mentoring/supervision can be severe for the Clinical Fellow and the CF mentor. For example, there have been instances where Clinical Fellows (1) have reported receiving no credit or only partial credit for the CF experience such that their certification was delayed or employment opportunities were lost; and (2) have filed an ethics complaint against the CF mentor whose negligence or unprofessional behavior rose to the level of a violation of the Code of Ethics.
Examples of situations that may give rise to ethical issues and/or misconduct include but are not limited to the following:
- arbitrary termination of the CF mentor–Clinical Fellow relationship
- termination of the CF mentor–Clinical Fellow relationship such that client abandonment occurs
- 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 and types 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 (if they've applied for ASHA certification) or with applicable law
- failure to fulfill the responsibilities of CF mentoring/supervision as agreed
- acceptance of compensation for the CF mentorship or supervision from the Clinical Fellow being mentored or supervised, except reasonable reimbursement for direct expenses, which does not include paying the mentor's ASHA certification dues/fees
- delegation of tasks for which the Clinical Fellow is inadequately prepared
The BOE acknowledges that Clinical Fellows may also bear some responsibility 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 their CF mentor carefully and follow the suggestions provided in A Guide to the ASHA CF Experience on the ASHA website.
Typically, the CF experience 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. CF mentors of SLPs should be mindful that these new challenges may create ethical dilemmas for which the mentor has the opportunity to guide the Clinical Fellow in their understanding of ethical decision making.
Guidance
The Code of Ethics includes Principles and Rules with direct implications for the SLP who is mentoring the Clinical Fellow. They include the following.
Principle 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."
Under this Principle, the following Rules apply to mentoring responsibilities.
Rule A: "Individuals shall provide all clinical services and scientific activities competently."
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The CF 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 important to keep in mind that the successful completion of the CF experience is the final assessment for independent clinical practice.
Rule D: "Individuals shall not misrepresent the credentials of aides, assistants, technicians, students, research assistants, Clinical Fellows, or any others under their supervision, and they shall inform those they serve professionally of the name, role, and professional credentials of persons providing services."
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It is important for the CF mentor to demonstrate that they have appropriately communicated the Clinical Fellow's credentials to the consumer.
Rule E: "Individuals who hold the Certificate of Clinical Competence may delegate tasks related to the provision of clinical services to aides, assistants, technicians, or any other persons only if those persons are adequately prepared and are appropriately supervised. The responsibility for the welfare of those being served remains with the certified audiologist or speech-language pathologist."
Principle II
"Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence and performance."
Under this Principle, the following Rules apply to mentoring responsibilities.
Rule C: "Individuals shall enhance and refine their professional competence and expertise through engagement in lifelong learning applicable to their professional activities and skills."
- Given the 2020 ASHA standards and ceritification requirements, those intending to become or act as CF mentors must confirm that they have met the continuing education requirements to supervise a Clinical Fellow.
Rule E: "Individuals in administrative or supervisory roles shall not require or permit their professional staff to provide services or conduct research activities that exceed the staff member's certification status, competence, education, training, and experience."
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In situations where the CF mentor becomes aware that a Clinical Fellow needs additional education, training, or experience in a particular practice area, it is the responsibility of the CF mentor to facilitate the Clinical Fellow's acquisition of such. Rule E may apply when both the CF mentor and the Clinical Fellow are employed within the same entity and the Clinical Fellow is considered a member of the professional staff.
Principle III
"In their professional role, individuals shall act with honesty and integrity when engaging with the public and shall provide accurate information involving any aspect of the professions."
Under this Principle, the following Rules apply to mentoring responsibilities.
Rule A: "Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly contributions."
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It is the ethical responsibility of the CF mentor to maintain professional credentials throughout the supervision of all Clinical Fellows. The CF mentor must also prohibit the Clinical Fellow from providing services for which they are not qualified and ensure they do not misrepresent their professional services to the public.
Rule B: "Individuals shall avoid engaging in conflicts of interest whereby a personal, professional, financial, or other interest or relationship could influence their objectivity, competence, or effectiveness in performing professional responsibilities. If such conflicts of interest cannot be avoided, proper disclosure and management is required."
Rule C: "Individuals shall not misrepresent diagnostic information, services provided, results of services provided, products dispensed, effects of products dispensed, or research and scholarly activities."
- The CF mentor needs to provide ethical guidance to ensure that the Clinical Fellow understands how to identify a conflict of interest and does not engage in inappropriate activities. The CF mentor must also avoid engaging in conflicts of interest themselves; if such conflict cannot be avoided, they must understand proper disclosure and/or management procedures.
Principle IV
"Individuals shall uphold the dignity and autonomy of the professions, maintain collaborative and harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards."
Under this Principle, the following Rules apply to mentoring responsibilities.
Rule F: "Individuals who mentor Clinical Fellows, act as a preceptor to audiology externs, or supervise undergraduate or graduate students, assistants, or other staff shall provide appropriate supervision and shall comply—fully and in a timely manner—with all ASHA certification and supervisory requirements."
- It is the responsibility of the CF mentor to provide (1) appropriate supervision based on the knowledge and skills of the Clinical Fellow and (2) mentoring and supervision that align with the standards set forth by ASHA for certification.
Rule H: "Individuals shall not engage in any form of harassment or power abuse."
Rule M: "Individuals shall not discriminate in their relationships with colleagues, members of other professions, or individuals under their supervision on the basis of age; citizenship; disability; ethnicity; gender; gender expression; gender identity; genetic information; national origin, including culture, language, dialect, and accent; race; religion; sex; sexual orientation; socioeconomic status; or veteran status."
- According to Rules H and M, the CF 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, harassment, or fear of reprisal.
Rule S: "Individuals shall comply with local, state, and federal laws and regulations applicable to professional practice and to the responsible conduct of research."
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A CF mentor who allows a Clinical Fellow to provide clinical services under their supervision when the Clinical Fellow is not properly licensed as required by the applicable state, aids in the misrepresentation of services provided as well as the misrepresentation of the Clinical Fellow's credentials.
Summary
The CF mentor is a role model for the beginning professional. A CF mentor has influence that lasts beyond the term of intensive contact, because new certificate holders may later mentor and supervise others. CF mentors are expected to adhere to standards of fairness; doing so requires, at a minimum, that they understand their responsibilities, make good-faith efforts to carry them out, and immediately address issues of concern. It is also highly recommended that CF mentors continue to advance their knowledge of supervisory techniques, practices, and principles through professional development. Likewise, CF mentors must know whether their state licensure requires continuing education specific to supervision. CF mentors are the key to ASHA's certification program, and they provide invaluable services to the public and the speech-lanuage profession.
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