Aileen Patterson is Course Director of the Speech and Language Therapy programme at The University of Ulster and is also involved in clinical education for clinical teachers in speech and language physio and occupational therapy As is often the case the best resources identified by students and clinicians are not necessarily expensive pieces of equipment but are often human Success in learning to be a good clinician results from commitment of a university in partnership with clinical supervisors to the development of students as active participants with responsibility for their own learning
1. Pre-placement pack Information about the area, Trust, service and caseload can allay anxieties, facilitate more focused preparation, and prompt discussion. A welcome booklet with names, roles and photographs of the team provides key information such as health & safety, child protection, ethics, confidentiality, administration, dress codes, facilities, tea/coffee payments and other policies. Knowing in advance about management strategies and materials and tests available allows the student to plan what to bring, particularly for block placements away from their university base.

2. Induction pack and handbook Students value clinicians showing a positive approach, indicating how they will facilitate deep learning, for example through goal setting, learning contracts, logs, feedback, video recording and role play. Students and clinicians have reported it useful to complete analysis of their learning styles and provide information on their placement expectations. These can then be used in goal setting to improve learning and encourage problem solving and can allow more effective use of valuable clinic time. Honey P. and Mumford M. (1992) The Manual of Learning Styles. Berks: Peter Honey. Yeung, E., Jones, A. and Webb, C. (2001) “The Use of Learning Contracts” in Kember, D. et al. Reflective Teaching and Learning in the Health Professions. Oxford: Blackwell Science. 4. The ‘unseen’ box of tricks Students usually put together their own informal assessments, particularly for the assessment of their ability to observe, act and think clinically with an unknown client. Success depends largely upon being observant, well organised and flexible, though attractive materials make interesting stimuli. A ‘child unseen’ kit might include lists of areas to be assessed and a card index box, sectioned for sets of pictures for eliciting samples of phonology and language graded in complexity (clear verb pictures are particularly worth storing); set of graded commands; bag of objects and matching pictures; sequenced pictures for narrative and picture/ story books suited to a range of ages; writing/ drawing materials, glove puppet, posting box and reward stickers - which have all withstood the test of time and may be supplemented by whatever toy is in fashion. 7. A sound knowledge base - and access to more The application of theory to practice becomes more apparent and meaningful in the clinical context. Case-based approaches to learning encourage students to research problems and their solutions in relation to specific examples. Students rate highly having access to knowledge through literature and web-based resources while on placement. Helpful sites include the American SpeechLanguage-Hearing Association, and our own professional body’s developing where links to other reputable sites can be found. For specific information and queries on autistic spectrum disorder, the on-line discussions at and the National Autistic Society are informative. Of course, the Speech and Language Therapy in Practice site is also a must! 10. Clinical supervisors/ teachers/ educators Whatever we choose to call them, possibly the most important resource in student learning - as are the clients. Like all of us, students learn best in an atmosphere where they feel welcome and where their confidence can be built up. Students do entail additional work and skilled handling but passing on knowledge and experience can be a satisfying part of our job. One of our local clinicians wrote to a student, “my expectations are that we can work together and learn together so that your placement will be both enjoyable and successful in developing your professional skills and knowledge.”

3. Student’s Clinical Information file A loose leaf file containing the specific guidelines for the placement, treatment plan and feedback forms and basic key facts, often subdivided for specific client groups, usually includes: developmental norms; International Phonetic Alphabet chart; phonological processes with ages; case history outlines for different client groups (some clinicians have provided mock case studies within the Induction pack which focus observations and raise clinical questions specific to their clients); clinical audit forms (checklists devised for each client group to ensure that the student does not omit key areas of enquiry when taking histories and writing up case studies); notes from applied neurology with structure, function and effect of damage; psycholinguistic, cognitive neuropsychological frameworks for assessment of developmental and acquired speech and language disorders; list of abbreviations used in case notes; summaries of tests (age groups and what they test). Some useful checklists are also in Shipley, K. and McAfee, J. (1992) Communicative Disorders. Chapman Hall. 5. The right tools for the job - and a large pocket Our answer to “lights, camera, action”- torch, mirror and tissues / straws, still as useful today as when they were essentially the only equipment some of us had to work with. Often an oral assessment will be appropriate as part of the initial informal assessment. After ‘rapport has been established’, much can be discovered using these basic tools - along with good observation and listening skills, pencil, notepad and prepared checklists of oral structures / functions and DDK tasks. Children still like to ‘blow out the torch’ or suck/ blow bits of tissue cut to look like butterflies or fish, and the clouding in the mirror strategically placed can still help determine airstreams/nasal emission.

6. Interpersonal skills: video recording and playback facilities Students see an essential clinical resource to be interpersonal skills (including skilful questioning, listening, explaining, problem solving and counselling strategies) as well as observational and organisational skills. ‘Weak’ students may have more problems with interpersonal and therapeutic skills than with basic knowledge. Skills training is important in undergraduate education, and students study the theory of interpersonal skills and learn to analyse their own behaviour through the use of CCTV. Video playback facilities in some clinics also assist the learning process. Clinical supervisors too have found it helpful to examine their interactions with students and practise role playing scenarios such as giving feedback. McAllister, L., Lincoln. M., McLeod, S. & Maloney, D. (eds) (1997) Facilitating Learning in Clinical Settings. Nelson-Thornes. Hargie, O., Saunders C. & Dickson, D. (1994) 3rd ed Social Skills in Interpersonal Communication. London: Routledge.

8. Peer and tutor support: in person, through telephone contact and email Modern technology assists contact with their assigned tutor and also peers which students generally find important, with specific guidelines for peer support. Acknowledging the value of this some clinicians have suggested they build in time for students to make purposeful contact with each other, not only in paired placements, but also when geographically separated. Most students have personal mobile phones and email and well developed informal peer support mechanisms. But clinicians also need the support of colleagues and the university tutor - it is not only the student who values and needs support through clinical placement!

9. Time: a top resource in short supply Students are generally very appreciative of a clinician’s time spent in providing guidance and feedback. Induction at the beginning can result in reduced anxiety, and provide an opportunity to discuss and clarify goals, run through policies and procedures on caseload management etc. During the placement, time built in for feedback encourages the student to develop and respect time management. Written feedback and questions following observed sessions provides focus for evaluations and self-appraisal. Time to think is important. The use of a reflective log is advocated to encourage the student to become a reflective practitioner and as a key resource for tutorials. Some supervisors also wish to be actively involved in reviewing these with students, while acknowledging rights to privacy. Kember, David ( ed.) (2001) Reflective Teaching and Learning in the Health Professions. Oxford: Blackwell Science.

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