By: Karen Hennington, MS, CCC-SLP, Past TSHA University Committee Co-Chair, and Ruth Crutchfield, SLPD, CCC-SLP, Current TSHA University Committee Chair

Every graduate student begins their program with a pressing question: “Where will I be placed for my externship?” That thought likely takes many of us back to our own time in graduate school, eagerly awaiting news of placement, imagining the possibilities, and hoping for the right fit.

The student perspective is filled with mixed emotions—excitement, nervousness, and anticipation. Graduate program coordinators often experience similar feelings though from a different angle. They must ask: Do we have enough qualified preceptors and clinical sites? Will our experienced preceptors return? Have we successfully recruited new partners?

For both students and program coordinators, the anticipation is palpable. And what about the preceptors themselves? They too may be feeling a combination of enthusiasm and uncertainty—excited to share their expertise and professional environment, nervous about their supervisory skills, and wondering how to balance their own workload while supporting a student’s learning journey.

Fortunately, the American Speech-Language-Hearing Association (ASHA) standards provide clear guidelines to help identify and support effective preceptors. These standards not only set expectations but also foster a shared understanding of the responsibilities and rewards that come with clinical supervision.

According to ASHA requirements, preceptors must meet the following guidelines to supervise clinical practicum hours for speech-language pathology certification:

• Hold a current Certificate of Clinical Competence (CCC) in speech-language pathology from ASHA
• Have at least nine months of full-time clinical experience after receiving the CCC
• Have completed at least two hours of continuing education in clinical instruction or supervision
• Hold any state credentials required for the practice setting
• Provide direct observation, guidance, and feedback to help the student develop clinical competence
• Ensure the student maintains confidentiality of client information
• Ensure the student documents client records and billing information accurately and in a timely manner

In addition, "The amount of supervision provided should be commensurate with the student's knowledge, experience, and competence. Direct supervision should be in real time, and the clinical educator should be available to consult with the student (ASHA, 2024).”

Beyond the minimum guidelines for supervision, the ASHA Ad Hoc Committee on Supervision (ASHA, 2013c) outlined the important knowledge and skills required for clinical education and supervision.

• Knowledge of clinical education and the supervisory process, including teaching techniques, adult learning styles, and collaborative models of supervision
• Skill in relationship development, including the creation of an environment that fosters learning
• Ability to communicate, including the ability to define expectations and engage in difficult conversations
• Ability to collaboratively establish and implement goals, give objective feedback, and adjust clinical education style when necessary
• Ability to analyze and evaluate the student clinician's performance, including gathering data, identifying areas for improvement, assisting with self-reflections, and determining if goals are being achieved
• Skill in modeling and nurturing clinical decision-making, including (a) using information to support clinical decisions and solve problems and (b) responding appropriately to ethical dilemmas
• Skill in fostering professional growth and development
• Skill in making performance decisions, including the ability to create and implement plans for improvement and to assess the student's response to these plans
• Ability to adhere to the principles of evidence-based practice and conveying research information to student clinicians
• Ability to connect academic knowledge and clinical application
• Ability to sequence the student's knowledge and skill development

The ASHA practice portal provides useful tools, such as the resource document “Tips for First-Time Supervisor of Graduate Student Clinicians” (https://www.asha.org/practice-portal/professional-issues/clinical-education-and-supervision).

Because of these guidelines, graduate students have the opportunity to complete their graduate school education under the supervision of experienced and dedicated speech-language pathologists (SLPs). These SLPs are giving back to their profession due to their professionalism and dedication. The TSHA University Issues Committee explored the motivators for our preceptors by completing an informal survey across randomly selected preceptors who received an email request to complete a survey. A total of 42 surveys were launched, and 12 surveys were completed in their entirety (28%). Our sample consisted of a representation of SLPs with varied years of experience in the profession. See Table 1.

Table 1. Demographics

These demographics communicate a couple of things. They tell us that there is no barrier to serving as a preceptor. You can be an early clinician, a mid-career clinician, or a seasoned clinician and still function as a preceptor. A systematic review by Loewen et al (2017) identified the key component for preceptorship effectiveness is experience in the field of choice. This data is an encouragement to those early career professionals who are hesitant to enter as preceptors. All that is needed is experience and the motivation to connect with graduate students.

Our surveyed sample was composed of individuals who have been active as preceptors for a number of years. There were 41.7% (n=5) who had more than 11 years of experience as preceptors. There were 41.7% (n=5) who had one to three years of experience as preceptors. Finally, there were 16.7% (n=2) who had four to seven years of experience as preceptors. Newman et al (2011) defined a preceptor as a master clinician. Master clinicians are shaped by their university education, their clinical experiences, and their continuing education. University graduate student preceptors follow ASHA continuing education guidelines and complete preceptor continuing education in addition to their own interests and specializations.

Preceptors in our survey were given the opportunity to respond to three questions:

1. What motivates you to be a student preceptor?

2. What are some challenges or barriers to taking students?

3. What is a favorite memory or something you have learned or benefited from by having a student?

These answers provided some great perspectives regarding both the challenges and rewards to being a preceptor. The insights we gained from these responses also can help to give university programs, preceptors, and students some things to consider so future placements can be positive and productive for all three of the stakeholders involved.

Responses regarding personal motivations for serving as a preceptor fit into three basic themes—intrinsic or personal gains (e.g., “It is a great way to keep up with the most current research that students are learning”), service back to the profession (e.g., “I had excellent preceptors, and I wanted to make sure I contributed back”), and recruitment (e.g., “Great on-site pre-interview process for potential employees”). Many responses contained elements across two or all three of these themes, such as a desire to give back to the profession along with acknowledgment of the things they receive through the process of being a preceptor.

The preceptors who responded to our questions all shared that they felt being a preceptor was an important service back to the profession but also acknowledged that this comes along with some challenges and barriers. Responses to our question regarding what challenges and/or barriers they face when taking students fit into three themes—workload/productivity demands, student performance or attitude, and time needed to train the student. The responses were almost equally split along those three themes, with some answers containing elements of two or all three of the themes. An example of an answer that contained all three themes included thoughts on workload/productivity (“It makes days longer at the beginning”) along with student performance/attitude (“Student expects the information to be given to them versus researching and then asking for confirmation”), and training time (“If the student isn’t open to guidance and corrective feedback, they keep making the same mistakes”).

Despite the inherent challenges of adding student training to their workload, respondents shared many positive anecdotes of their favorite memories or direct benefits received from the preceptor/student relationship. These responses included comments on things they had learned from a student (“I love observing the technology integration many students utilize”), examples of student initiative (“One student started an Autism support group”), and positive feelings regarding seeing student growth (“Witnessing the growth of a clinician who wants to learn”). Another response that showed the blending of learning from the student while also helping the student learn was encompassed in this quote: “Seeing the world from their perspective and seeing or reminding myself that I do have something to share or contribute that will make a difference.”

This survey provided valuable insights into the factors that motivate professionals to serve as preceptors as well as possible strategies university programs and students can implement to help mitigate the challenges and barriers preceptors may encounter. A shared understanding among all three stakeholders—preceptors, academic institutions, and students—is essential to fostering a productive and mutually beneficial preceptor/student relationship. The continued success of our fields relies on the availability and commitment of practicing professionals to serve in this crucial yet often undervalued role.

The authors extend their sincere appreciation to all survey participants for generously sharing their time, experiences, and perspectives.
 

References
American Speech-Language-Hearing Association. (n.d.). SLP graduate student supervision. Speech-Language Pathology Graduate Student Supervision. https://www.asha.org/practice/supervision/SLP-graduate-student-supervision/

American Speech-Language-Hearing Association Clinical education and supervision. (n.d.). https://www.asha.org/practice-portal/professional-issues/clinical-education-and-supervision/

Hallé, M. C., Bussières, A., Asseraf-Pasin, L., Storr, C., Mak, S., Root, K., & Thomas, A. (2021). Building evidence-based practice competencies among rehabilitation students: a qualitative exploration of faculty and preceptors’ perspectives. Advances in Health Sciences Education, 26, 1311-1338.

Loewen, P., Legal, M., Gamble, A., Shah, K., Tkachuk, S. and Zed, P. (2017), Learner: preceptor ratios for practice-based learning across health disciplines: a systematic review. Med Educ, 51: 146-157. https://doi.org/10.1111/medu.13144

Newman, Craig W. PhD; Sandridge, Sharon A. PhD; Lesner, Sharon A. PhD. Becoming a better preceptor: Part 1: The fundamentals. The Hearing Journal 64(5): p 20,22,24-27, May 2011. | DOI: 10.1097/01.HJ.0000398147.18626.6b