1. Student Supervision and Ethics
Andrea Vaughan, MS, CCC-SLP
Assistant Clinical Professor
Saint Louis University
MACDG Presentation
March 6, 2019

2. Supervision in Medical Setting
10 years as acute care therapist
Multiple students from various institutions
2 students at a time
Student unprepared for medical internships
Anatomy/Physiology
Bedside Swallow Evaluations
FEES/MBS

3. Solution? New role at SLU Developed clinical labs for 1st years
4 labs – 2 weeks each for 8 hours
Hearing
Social Communication
AAC
Swallow/Voice
Students rotated through each lab every 2 weeks
10 students in each lab

4. Swallow and Voice Lab Focus on normal through the lifespan
Anatomy and physiology
Cranial nerves
Bedside swallow evaluation (MASA)
Hands on experience
FEES and Videostroboscopy
Observation (Flexible and Rigid)
Anatomy identification
Procedure protocol
Evaluation Report

7. Lab Requirements
Complete bedside swallow evaluations on 5 normal “patients”
Anatomy identification on endoscopy/MBS
Identify differences between FEES/MBS
When to recommend FEES vs MBS
Simucase patient
Journal article review
Evaluation

8. Lab Feedback Overwhelmingly positive Some review, some new information
Most wanted more
“Made the idea of having an adult client less terrifying.”
“I feel prepared to complete a swallowing evaluation.”
“Great review of anatomy, but I loved the charts/handouts.”

9. Future of Clinical Labs
12 hours instead of 8 per week
All students rotate through each lab every 2 weeks
Lecture to all 40 students at once and break up into small groups for hands on activities
Prevent presenting the same lecture 4 times!
Add observation component
Acute care hospital
Rehab hospital
SNF
Reinforce those who want to intern at intense medical placements
Confirm those who do not

11. Graduate Student Supervision
Speech-Language-Hearing Clinic
Initial Preparation
Anderson Model
Evaluation-Feedback Stage
Supervisor takes lead and supervisee takes direction
Answer questions and provide thorough detail
Transitional Stage
Supervisee takes lead and evaluation/treatment is joint project
Ask questions with questions
Self-supervision stage
Supervisor serves as consultant
You tell me

13. Feedback Debrief after each session (at least initially)
4 Quadrant Feedback Form
Continue
Begin/Do More
Consider
Stop or Do Less

16. References
Anderson, J. L. (1988) The supervisory process in speech language pathology and audiology. Austin, TX: Pro-Ed
Butler, S., et al, “Penetration and aspiration in healthy older adults as assessed during endoscopic evaluation of swallowing”, Annals of Otology Rhinology and Laryngology,118(3), , 2009.
Mann, G. (2002) The Mann assessment of swallowing ability. Albany, New York: Delmar Thomason Learning.
Murray, J., Langmore, S.E., Ginsberg, S., & Dostie, A. (1996). The Significance of Accumulated Oropharyngeal Secretions and Swallowing Frequency in Predicting Aspiration. Dysphagia (11):
Neubauer, P.D., Hersey, D.P., & Leder, S.B. (2016). Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A systematic review. Dysphagia (3)
Poburka, B.J., Patel, R.R., & Bless, D.M. (2017). Voice-Vibratory Assessment with laryngeal Imaging (VALI) Form: Reliability of Rating Stroboscopy and High-speed Videoendoscopy. Journal of Voice, 31(4); 513.e1-513.e14.
Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration-aspiration scale. Dysphagia 11(4):225–233.