ASSESSMENT TOOL FOR CMD 562 ‑ SCHOOLS PRACTICUM AND CMD 569

NUROPATHOLOGIES PRACTICUM

 


 

 

Southern Connecticut State University

Department of Communication Disorders

 

Competency-Based Evaluation for Off-Site Clinical Practica

 

Student: __________________________________                           Dates of Placement:      /       / 20_____        to        /        / 20_____

Supervisor: _______________________________                             Placement Location: _____________________________________

 

Competency Indicators

Related ASHA SLP Standard(s)

Midterm Rating

Final Rating

Interaction and Personal Qualities

 

 

 

Adheres to all aspects of the ASHA Code of Ethics.

 

Standards III E; IV G3-d

 

 

Exhibits interest and enthusiasm in all aspects of clinical assignment.

 

Standards IV G 3-d

 

 

Respects cultural beliefs and linguistic diversity of  clients, families and significant others,, caregivers, co-workers and relevant others.

Standards IV F; IV G 3a

 

 

Demonstrates appropriate professional dress, appearance, and demeanor. 

 

Standards IV G3-d

 

 

Demonstrates prompt and regular attendance.

 

Standards III E; IV G 3-d

 

 

Completes all assignments within the required time frame.

 

Standards III E; IV G 3-d

 

 

Demonstrates effective organizational and time management skills.

 

Standards IV G 3-d

 

 

Engages in effective oral and written communication, recognizing the needs, values, preferred mode of communication, and cultural/linguistic background of the client, family, caregivers, and relevant others.

Standards IV B; IV G 3-a

 

 

Demonstrates flexibility and problem solving when presented with changes in assignment or routine.

Standards IV G 3-d

 

 

Evaluation:

 

 

 

Reviews available background information and identifies key diagnostic issues.

 

Standards III B, C, D, F; IV G 1-c

 

 

Chooses tests and assessment procedures related to identified diagnostic issues.

 

Standards III B, C, D, F, G;

IV E 1a,c

 

 

Administers evaluation procedures, such as behavioral observations, non-standardized and standardized tests, instrumental procedures.

Standards IV D, III D; IV G 1-c

 

 


 

 

Competency Indicators

Related ASHA SLP Standard(s)

Midterm Rating

Final Rating

Adapts evaluation procedures to meet client’s needs.

 

Standards III D; IV G 1-d, 3-a

 

 

Interprets standardized and non-standardized results accurately; draws logical diagnostic conclusions.

Standards IV B III A, B, C, F;

IV G 1-e

 

 

Documents all assessment findings in a cohesive manner in the required format(s).

 

Standards IV B; III G; IV G 1-f

 

 

Makes appropriate recommendations and  referrals, based on evaluation outcomes.

 

Standards IV B; III A, B, C, G;

IV G 1-f,g

 

 

Intervention

 

 

 

Accurately interprets baseline and/or ongoing assessment data and uses it appropriately to establish and modify treatment goals and objectives.

Standards III D; IV G-2a

 

 

Develops and implements effective and appropriate goals and  objectives.

 

Standards IV B III A, B, C; IV G-2b

 

 

Integrates academic information/research into clinical practice; provides rationale for selection of specific therapy methods.

Standards III A, B, C, D, F; IV G-2a

 

 

Uses level of language and instruction to optimize client’s responses.

 

Standards IV B; III C, D; IV G-2b, 3a

 

 

Selects and employs appropriate stimuli to elicit type and level of response required.

 

Standards III D; IV G-2c

 

 

Develops a variety of functional and appropriate tasks to support objectives.

 

Standards III D; IV G-2b

 

 

Demonstrates flexibility within session, modifying intervention plan as necessary.

 

Standards III D; IV G-2b

 

 

Sequences and paces activities within the treatment session to facilitate intervention outcome.

Standard  III D; IV G-2b

 

 

Uses appropriate reinforcement and feedback strategies.

 

Standard III D; IV G-2b

 

 

Collects and records quantitative and qualitative data in an accurate, efficient and unobtrusive manner.

Standard III D; IV G-2d

 

 

Uses qualitative and quantitative data to adjust client’s program as necessary.

 

Standard III D; IV G-2d, 2e

 

 

Provides appropriate information regarding skill generalization, family/caregiver training, and home-based activities.

Standards III D; IV G-3a, 3b

 

 


 

 

 

Competency Indicators

Related ASHA SLP Standard(s)

Midterm Rating

Final Rating

Counseling, Conferencing and Team Participation

 

 

 

Provides counseling regarding communication and swallowing disorders as needed to clients, family, caregivers, and relevant others.

Standards III A, B, C, D, E, F, G, ; IV B; IV G 3-a,b,c

 

 

Collaborates effectively and appropriately with other professionals to facilitate case management.

Standards III  E, G; IV B; IV G 3-a,b

 

 

Participates in and contributes to client centered team meetings in an appropriate manner.

 

Standards III E, G; IV B;  IV G 3-a,b

 

 

Reacts appropriately and professionally when conflicting viewpoints are expressed.

 

Standards III E; IV G  3-a,b

 

 

Supervisory Process

 

 

 

Interacts cooperatively and collaboratively with supervising clinician.

 

Standards IV B; IV G 3-d

 

 

Initiates and uses self-evaluation process to refine clinical skills.

 

Standards IV B; IV G 3-d

 

 

Actively and cooperatively engages in and contributes to the supervisory process.

 

Standards IV B; IV G 3-d

 

 

Uses supervisory feedback to refine clinical performance.

 

Standards  IV B; IV G 3-d

 

 

 

Competency Rating Code:  Rate the student’s progress in mastering each competency indicator using the following “Level of Support” codes:                                         

I = Demonstrates behavior independently 

M = Demonstrates behavior with minimal guidance from supervisor.

S = Demonstrates behavior with specific guidance from supervisor.

R = Demonstrates behavior with excessive and repeated instruction from supervisor.

F = Fails to demonstrate behavior regardless of amount of supervision.

 

~~~~~PLEASE DO NOT ASSIGN A LETTER GRADE ~~~~~

Midterm Review:

 

Supervisor’s Signature: _____________________ Date: _______    Student Clinician’s Signature: _____________________ Date: ________               

 

Final Review: 

 

Supervisor’s Signature: _____________________ Date: _______    Student Clinician’s Signature: _____________________ Date: ________                                


 

Southern Connecticut State University, Department of Communication Disorders

Summary of Clinical Performance

Midterm Review

 

Student:                                    Supervisor:                                     Practicum:           Term & Year:

 

Areas of Strength / Emerging Competencies:

 

 

 

 

 

 

 

 

 

 

 

Mid‑term Formative Assessment: Goal Setting (use any of the following areas that apply)

 

Personal and Professional Competencies: Goal(s):

 

 

 

Foundation Knowledge: Goal(s):

 

 

 

Evaluation Skills: Goal(s):

 

 

 

Intervention Skills: Goal(s):

 

 

 

Oral Communication: Goal(s):

 

 

 

Written Communication: Goal(s):

 

 

 

 

__________________________           _________  ____________________________    ________________

Supervisor Signature                              Date            Student Clinician Signature                   Date

                                                                                

 


 

Southern Connecticut State University, Department of Communication Disorders

Summary of Clinical Performance

                                                          Semester End Review

Student:                                     Supervisor:                                     Practicum;           Term & Year:

 

Review of Midterm Goals and Emerging Competencies:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suggestions for Continued Competency Refinement:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

______________________________      _________  ______________________________    ______________

Supervisor Signature                                   Date              Student Clinician Signature                        Date