Supervision and the Professions: Scenarios for Consideration

Scenario One

You are the supervisor of a graduate student in SLP who will be with you for one semester as his first off-campus externship placement. During his first week with patients/clients, you begin to plan for the supervisee to assume treatment for a nine year old child with an articulation problem. The supervisee indicates that he is having difficulty knowing what to target with the child. He indicates that he only has worked with an articulation problem one time and that child was working on generalization of correct productions to conversational speech.

Comment: The supervisee is in the evaluation-feedback stage of the supervisory continuum. The supervisor may say to the student to probe to determine the child's current success levels on production of target phonemes at the levels established. The supervisor may tell the student to gather this data and if the child evidences performance at 80% or above, the child will be moved to a more difficult target. The supervisor may also tell the supervisee to provide verbal cues for the child and reinforce responses with a tangible reinforcer like stickers. The feedback is direct/active and the supervisee has little responsibility for planning for the client.

Scenario Two

You are the supervisor of a graduate student in SLP who is completing the last semester of clinical externship. You are working with the supervisee in an adult facility where the student has just completed an evaluation of a 75 year old patient who has suffered a TBI. The supervisee indicates that she has had quite a bit of experience in working with geriatric patients who have dysphagia and aphasia but has not worked with a patient who has had a TBI. She indicates that receptive and expressive skills are judged to be adequate based on formal and informal assessment. Pragmatic issues seem to be a presenting problem. The patient is having difficulty in organization skills and in monitoring talk time with others. The student indicates that her materials for the assessment were well selected, however, she adds that the patient was allowed to control too much of the available time for the assessment.

Comment: The supervisee in this scenario is probably at the transitional stage of the supervisory continuum. She is evidencing beginning ability to self-evaluate and she is applying some information from prior experiences to new patients. You may ask the student to consider aspects of patient management when working with individuals with dysphagia and/or aphasia that may generalize to the management of this patient. You may ask about specific problems that the patient is evidencing and suggest an intervention strategy for consideration and ask the student what she thinks might be another strategy to assist the patient. In addition, you may ask the student to reflect on the evaluation and identify additional strengths of the assessment and things the supervisee might wish to do differently in a subsequent diagnostic. You provide feedback/support in a collaborative manner as the student begins to evidence some independence.

Scenario Three

You are the supervisor of a clinical fellow in SLP who is completing the last three months of the clinical fellowship experience. You visit the supervisee at her site in a public school. You observe the supervisee with a variety of children and in some inclusion work in a kindergarten class. In a conference with the clinical fellow following the observations, you discuss a presenting issue with a classroom teacher who objects to the child being pulled from the class for individual work. You problem solve with the clinical fellow and develop a solution strategy where the child will be seen in the class for one session per week and will be pulled for individual work only one time per week. The clinical fellow also expresses concern about the number of children on her caseload. You discuss some advocacy strategies with the fellow and suggest that she meet with her school supervisor with a plan to consider relative to the growing caseload. You provide feedback in a consultative manner as the clinical fellow is working well independently and is demonstrating clinical and professional skill consistent with the completion of a clinical fellowship experience.

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