CLINICAL HANDBOOK FOR STUDENTS

MSc SPEECH AND LANGUAGE THERAPY

2017-2019

School of Psychology and Clinical Language

Sciences

DISCLAIMER

This is an informal guide for the convenience of students and staff. While accurate at the time of publication,

aspects of the clinical programme and evaluation of students’ work may be subject to modification and

revision. Information provided by the Department of Clinical Language Sciences at later stages of the course

should be regarded, where appropriate, as superseding the information contained in this handbook.

CONTENTS

Introduction.................................................................................................................................................................4

Summary of Clinical Sessions.................................................................................................................................5

General Overview of Clinical Practice 1 and 2....................................................................................................6

Preparation for Placements....................................................................................................................................9

University Staff and Support for Clinical Placements....................................................................................10

Assessment Library and Therapy Materials.....................................................................................................11

Clinical Placement Policies and Procedures....................................................................................................11

Professionalism...................................................................................................................................................11

Infection Prevention and Control...................................................................................................................12

Health and Safety................................................................................................................................................13

Personal Clinical Aims.............................................................................................................................................15

Personal Clinical Profile..........................................................................................................................................16

First day of placement:...........................................................................................................................................16

Assessment and Monitoring of Placement......................................................................................................16

NHS Funding for Travelling Expenses – NHS Bursary...................................................................................17

Clinical Placements – General Guidelines.........................................................................................................17

Notes on Paediatric Placements.........................................................................................................................18

Community Clinics..............................................................................................................................................20

Children’s Centres and other Early Years Settings....................................................................................21

Child Development Centres............................................................................................................................21

Drop-In Clinics.....................................................................................................................................................22

Mainstream Schools..........................................................................................................................................23

Resource Bases...................................................................................................................................................23

Special Schools (day / residential)..................................................................................................................24

Specific Client Groups.......................................................................................................................................26

Notes on Adult Placements..................................................................................................................................27

Acute Wards.........................................................................................................................................................28

Outpatient Settings...........................................................................................................................................29

Adults with Learning Difficulties......................................................................................................................29

Rehabilitation Hospital or Day Hospital.........................................................................................................29

Domiciliary Service.............................................................................................................................................30

Group Therapy.....................................................................................................................................................30

Types of Placement................................................................................................................................................31

Preparation Clinic Placements........................................................................................................................31

Weekly Placement..............................................................................................................................................32

Elderly Care Setting............................................................................................................................................32

Block Placements...............................................................................................................................................33

First Year MSc Clinical Learning Outcomes.....................................................................................................34

Second Year MSc Clinical Learning Outcomes...............................................................................................34

Clinical Skills...............................................................................................................................................................35

Clinical Experiences................................................................................................................................................36

Clinical Activities......................................................................................................................................................37

Placement Evaluation.............................................................................................................................................38

Linguistic Assessment Clinic (LAC)....................................................................................................................39

Case Report..............................................................................................................................................................39

Clinical reasoning seminars..................................................................................................................................39

Clinical Practicum Examination............................................................................................................................40

Failure of the Clinical Practice 2 Module............................................................................................................40

Appendices...............................................................................................................................................................41

Personal Profile...............................................................................................................................................42

PERSONAL PLACEMENT AIMS.................................................................................................................43

First day placement checklist......................................................................................................................46

Record of Telephone Contact with Supervising Clinician...................................................................47

Actions to be taken when concerned about a student’s progress..................................................48

Statement of Confidentiality.......................................................................................................................49

Session plan –assessment..........................................................................................................................50

Assessment Session Plan - Evidence of clinical reasoning................................................................50

Session Plan – intervention..........................................................................................................................52

Placement Evaluation form.........................................................................................................................54

Guidelines for Clinical Diary..........................................................................................................................57

Five Moments for Hand Hygiene at the point of care...........................................................................59

Remote Supervision to a Placement Student............................................................................................60

Student Guidance Notes for Clinical Tutor Visits.....................................................................................61

Dysphagia clinical experience and clinical learning opportunities on placement.........................64

Summary of Clinical Placements.................................................................................................................67

Video Consent Form..........................................................................................................................................68

IntroductionThe purpose of this handbook is to guide you through the various clinical placements you will attend at different stages in the programme, and to give you information on how the clinical components are assessed.

You should keep this handbook in a safe place, and bring it to all introductory meetings (at the start of each term), clinical placement briefings, case study briefings and clinical tutorials. You should also have it available for reference when you go to new placements.

Your clinical placements are an integral part of the Clinical Practice modules. Over the two years, these clinical placements will enable you to develop your clinical skills and integrate theoretical aspects from all modules into your clinical practice.

We are given high quality placements by local placement providers offering you an excellent environment in which to develop your clinical skills. Your clinical placements will be varied over the two years and although you may not see all client groups you will have broad experience with which to begin your clinical career.

Please read this handbook in conjunction with your academic handbook.

Mrs. Carol A. Fairfield MA; BSc; MRCSLT; RegHPC

Director of Clinical Studies/Lecturer in Clinical Practice/ Speech and Language Therapist

c.a.fairfield@reading.ac.uk

Mrs. Allison L. Biddle MSc; BSc; MRCSLT; RegHPC

Clinical Coordinator and Highly Specialist Speech and Language Therapist

a.biddle@reading.ac.uk

Summary of Clinical SessionsThroughout the clinical programme you will attend clinical placement briefings and clinical seminars. You will also engage in professional Blackboard discussions forums. These forums are monitored by the clinical staff for accuracy and professionalism.

Year Autumn Spring Easter/May Summer Summer Vacationblock placement

1 10 sessions paediatric (University Clinic)

OBSERVATION and PARTICIPATION

Child Development Visits

10 sessions adult (University Clinic)

OBSERVATION and PARTICIPATION

Child Development Visits

TUES; WEDS: THURS: FRI

8 daysAdult/Paediatric

(external)

PARTICIPATION

5 days Elderly Care setting

4 weeks (20 days)

Adult/Paediatric

(external)

PARTICIPATION

*2 TUES, WEDS,

10 or 20 days

Adult/Paediatric(external)

PARTICIPATION

TUES, WEDS,

10 or 20 days

Adult/Paediatric(external)

PARTICIPATION

Block Placement

2 weeks (10 days)Adult/Paediatric

(external) PARTICIPATION

Clinical exams

*Students complete 3 placements across the Autumn and Spring terms. Each student must complete one adult and one paediatric placement at MSc 2 level. The other weekly placement and the block placement will be determined by their overall placement profile

A session is half a day.

Additional Clinical Activities

TERM ACTIVITY No. of sessions

Pre Sessional week, Autumn 1 Introduction to clinics 1

Autumn, Spring, Summer 1 CDA visits 5

Autumn 2, Spring 2 Clinical seminars 4

Autumn OR Spring 2 Linguistic Assessment Clinic 4

Summer 2 Dissertation contact 3

The above is a guide, as there are a range of placement models made available to us. Each student will have their own individual placement portfolio across a range of settings, client groups, and models of service delivery.

General Overview of Clinical Practice 1 and 2The aims of the clinical component are:

To introduce students to principles and practice of speech and language therapy To provide opportunities to observe a range of clients and speech and language therapists To provide experience in assessment, treatment and evaluation of therapy with a wide

range of clients To enable students to integrate their theoretical knowledge in structured and coherent

models of treatment to enable students to develop into reflective practitioners

The emphasis of this programme will be on the assessment/treatment and management of communication and swallowing disorders across the lifespan. This will be achieved by utilising your linguistic, medical, psychological, psycho-social knowledge and applying this within an individuals’ sociocultural environment as well as within the education system and the modern NHS.

Students will achieve some experience of each major communication disorder and more extensive experience with the more common disorders. From the Easter of year 1 each student has an individual placement profile collated for them. Selection of clinical experience for each student will be arranged to allow students contact with a wide variety of client groups including disorders of voice; fluency; articulation; language and disorders of eating, drinking and swallowing.

Assessment comprises termly clinical reports from your placement educator, oral presentations,

written case studies and a final clinical examinations in the Summer Term year 2. You will also have

a tutorial visit to one of your placements by a Clinical Tutor.

Programme Learning outcomes

When you have completed this programme you should be able to:

1. Plan appropriate assessment procedures for a wide range of clients based on sound theoretical principles

2. Plan intervention/clinical management programmes tailored for each client’s needs3. Base the programmes on thorough and appropriate assessments the analysis of which will

result in hypotheses4. Base your hypotheses on a firm theoretical knowledge of normal and abnormal speech and

language as well as the individual communication needs of each client within their communicative context demonstrating clear skills in clinical reasoning and clinical decision making

5. Be aware of the limitations of your knowledge and expertise and understand how to seek further knowledge, help and guidance as needed

6. Maintain clinical records, statistics and other relevant administration7. Demonstrate time management skills appropriate to your level of experience8. Take professional responsibility for your work in accordance with your level of experience9. Show an understanding of the need to work with statutory and voluntary bodies,

educational, health and social service providers10. Demonstrate awareness of the professional standards of the profession and those of

employing authorities;11. Understand and be committed to the need to maintain your knowledge and skills through

continued professional development

12. Demonstrate professional awareness of issues such as confidentiality and ethics, including understanding and adherence to the relevant HPC standards of ethics, conduct and performance and standards of proficiency

Your clinical learning experience includes:

1. Structured observation of a range of cases seen in the University Speech and Language Therapy Clinic; these sessions include tutorials before and/or after each session

2. Observation and participation in the regular service clinics held within the University Speech and Language Therapy Clinic; with tutorials

3. Attending weekly sessions in SLT services4. Some sessions in schools or centres for specialist client groups5. Weekly sessions with adults in hospitals/community centres and/or rehabilitation centres.6. Home visits7. Block placements 8. Attending clinical reasoning sessions 9. Learning via electronic access to information and clinical discussion boards, monitored and

contributed to by clinical tutors and academic staff

Clinical Placements - General Comments

You will have a number of different types of clinical placements over the two years of your degree course. The placements will vary in length, location, service delivery and client group. Placements will also vary between those that are attended weekly throughout term-time and the block placements during vacations. The placement administrator and clinical co-ordinator arrange all weekly and vacation placements.

Client contact in placements will vary, but you will always be learning from observing your supervising placement educator. You will see detailed in this handbook a comprehensive range of suggested activities whilst on placement encompassing direct client contact, multidisciplinary working and administration.

Clinical Placement Details

You will be given contact details for your placement educator at the end of the term prior to the placement term if they have been made available to the University. The University reserves the right to change placements at short notice in accordance with placement availability. You will be given full details of your clinical placements at the clinical briefing session. It is essential that you make contact with your placement educator prior to the first session. If you have any further questions or difficulties in contacting your clinic, please talk to the Clinical Administrator (Justine Nicholls) or Clinical Placement Co-ordinator (Allie Biddle) as soon as possible – you MUST be able to attend the first clinic of term.

Attendance and Punctuality

Before the start of the placement, contact the placement educator to agree a starting time and to exchange contact details

Please always arrive promptly at the agreed time Ensure that your placement educator has a telephone number where you may be

contacted or a message may be left for you in the event of last minute cancellation of a clinic

If you are unable to attend clinic for any reason, you must notify your placement educator and your placement educator tutor at the University.

You should keep a record of each clinic visit, noting the initials and diagnosis of each client seen, with a brief outline of assessments and treatment carried out, together with any personal observations. Later this logbook must be brought to clinical tutorials.

Case Reports

You will be required to submit a case report at a specified time whilst on placement (please refer to your academic handbook). It is your responsibility to inform your placement educator about this at the start of the placement.

Video Recordings

You will be required to make a recording for your final clinical exam whilst on placement. It is your responsibility to:

inform your placement educator at the start of the placement of any recordings you need to make for the purpose of the clinical exams

gain informed consent from the client and the placement educator and the client will need to complete a consent form. (The University will provide consent forms but you may also be required to gain consent on a form specific to your placement location). Informed consent means explaining clearly to the client the purpose of the recording

Ensure that the recording is kept safe and that only the client’s first name can be ascertained from the recording

You will need to follow the guidelines for making and storing video given separately

Clinical briefing sessions are given at the beginning of each term. You attend clinical tutorials in the first and second years.

The following two documents need to be read and adhered to:

HCPC Guidance on Conduct and Ethics for Students

http://www.hcpc-uk.org/assets/documents/10002C16Guidanceonconductandethicsforstudents.pdf

NHS Constitution for England (March 2013)

http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx

13.

Preparation for PlacementsThese guidelines apply to all placements during your degree programme.

Pre Placement Preparation

Prior to each placement we expect you do the following as minimum professional preparation:

To have read the relevant parts of your clinical handbook relating to your current year of study and placement

To be familiar with the clinical learning outcomes for your year as identified in this handbook

To have considered types of clinical activities in order to meet the placement aims (this is also looked at in seminars as a group activity)

To have completed your personal aims form and student profile and sent them to your placement educator before the start of the placement

To have carried out pre placement reading as requested by the placement educator To have made contact with the placement educator prior to the start of the placement

and provided him/her with a contact phone number. To identify a phone number for your educator for someone to contact in case of

emergency and who could collect your from placement To be regular and punctual in attendance To inform the placement educator of expected absence in a timely fashion To dress appropriately for the placement To adhere to confidentiality regulations Students are not permitted to take case notes off the premises All confidential information must be deleted from photocopies of

reports/assessments/correspondence Respect client confidentiality in discussion away from the placement Adhere to the confidentiality statement given by the department To remember that the welfare of clients comes first To wear your University photo ID badge at all times in clinic To adhere to the HCPC standards of conduct, ethics and performance.

Responsibility for your Own Learning

It is your responsibility to manage your learning and professional relationships. This includes alerting your Placement Educator and The University of Reading via your Clinical Tutor in a timely manner to any problems with the placement which might prevent progress or satisfactory completion of the placement.

It is expected that you will take responsibility for understanding the assessment process and criteria for the placement, and will use that knowledge when seeking guidance on progress and self-reflection.

It is your responsibility to make your Placement Educator aware of your individual learning outcomes and for negotiating how these might best be achieved during the placement

It is expected that you will take responsibility for reflecting on your anticipated learning outcomes for the placement, using previous feedback, personal reflection, and the course’s expectations for the stage you are at on the programme.

It is expected that you will engage actively in learning in order to develop your integration of theory to practice

It is expected that you will be responsible at all times for your own and your patients/clients’ health and safety within the placement and should not compromise the health and safety of the patients/clients.

It is expected that you will recognise that the needs of the patient/client will take priority at all times

It is expected that you will arrange a “mid placement” and “end of placement” review with your Placement Educator(s) to review the learning and assess future learning needs.

It is expected that you will take responsibility for alerting the Placement Educator and your clinical tutor if the agreed feedback and monitoring does not take place.

It is expected that you will be familiar with and adhere to the RCSLT speech and language therapy professional standards

University Staff and Support for Clinical PlacementsClinical Tutors

The role of your identified clinical tutor is to support students and their placement educators, to ensure that the best learning opportunities are offered from the placements. If you have any worries or concerns about your clinic placements, please come and talk in confidence as soon as possible to your identified clinical tutor-details below. The clinical tutors also run daily drop-ins for placement support and ideas. These are scheduled on your academic timetables.

NAME TELEPHONE EMAIL AVAILABILTY

Allison Biddle (Allie)

Clinical Coordinator

0118 3784687

a.biddle@reading.ac.uk All week

Fiona Baillie f.baillie@reading.ac.uk Tuesday

Wednesday

Linda Chitty l.a.chitty@reading.ac.uk Monday

Alison Cox a.cox@reading.ac.uk All week

Sarah Fincham-Majumdar s.c.finchammajumdar@reading.ac.uk Monday

Tuesday

Wednesday

Helen Marlow h.marlow@reading.ac.uk Tuesday

Thursday

Kate Munro c.a.munro@reading.ac.uk Monday,

Tuesday

Wednesday pm

Emma Pilkington(maternity

cover for Melissa Loucas)

emma.pilkington@reading.ac.uk Monday am

Wednesday - Friday all day

Katherine Pritchard k.a.pritchard@reading.ac.ukf Monday

Wednesday

Thursday am

Theo Read t.e.read@reading.ac.uk Monday

Tuesday

Friday

Placement Administrator’s Contact Details and Availability

Justine Nicholls 0118 378 3784696 j.nicholls@reading.ac.uk All week

Assessment Library and Therapy MaterialsNext to the undergraduate common room (room 157 Psychology Building) is a reference library. The library contains a wide range of assessments used in speech and language therapy. Throughout your degree you will be accessing the assessment library on a regular basis to complete your assessment logs and to prepare for clinical placements. Assessment library rules are on display in the assessment library.

The library has a range of therapy materials which you can photocopy for use in clinic. There are also additional printable therapy materials on the computers in the speech research lab (room 144 Psychology Building)

Clinical Placement Policies and ProceduresDetails about your placement will be emailed to you from the clinical placements’ database two weeks prior to the start of the placement. The University reserves the right to change placements at short notice in accordance with placement availability. It is essential that you make contact with your placement educator prior to the first session. If you have any further questions or difficulties in contacting your placement educator, please talk to the Clinical Administrator (Justine Nicholls) or the Clinical Placement Co-ordinator (Allie Biddle) as soon as possible.

Professionalism

Attendance and Punctuality

Attendance at all clinical placements is compulsory. Before the start of the placement, contact the placement educator to agree a

starting time and to exchange contact details Please always arrive promptly at the agreed time If you are unable to attend clinic for any reason, you must notify your placement

educator and your clinical tutor at the University You must wear your photo ID badge (your library card in a badge holder)

Clothing and General Appearance

Please check the placement dress code with your placement educator, prior to your first visit. Jeans are not usually acceptable, although casual wear is often worn in children’s clinics and schools for children with special educational needs. Ensure long hair is tied back and avoid dangly jewellery

Confidentiality

It is essential that you refer to the Confidentiality Statement in the appendices. Any breach of this in any form of verbal or written course work will incur a 10% point penalty and may lead to disciplinary action.

As a student therapist, you will have access to confidential medical and therapy notes, in both paper and electronic medium.

Under no circumstances remove confidential notes from the clinic Never talk about clients by name in public where you may be overheard, such as in shops,

student bars or on public transport. You must ensure that any photocopies or handwritten notes adhere to the confidentiality

statement

Course Work

Your academic handbook will advise you when you will be required to submit coursework that is directly linked to clients from your clinical placements. It is your responsibility to inform your placement educator about this at the start of the placement.

Infection Prevention and Control

In accordance with NHS Trusts policies on hand washing and infection control you must adhere to the following:

Bare below the elbows No rings ,wrist watches or bracelets Removal of facial piercings Removal of false and gel nails, and nail varnish Short nails

NHS trusts must legally comply with and strictly adhere to the Department of Health standards contained in ‘Uniforms and Workwear: An evidence base for developing local policy relating to workwear and uniform policies’ (2007). In 2010 the DoH published a revision of this document. The legislation requires that when you are involved in direct patient care activity, all healthcare professionals need to be bare below the elbow. Any sleeve must be able to be rolled or pulled back and kept securely in place during hand-washing and direct patient care activity. THERE ARE NO EXCEPTIONS TO THIS RULE

Local variations in dress code

The Health and Social Care Act (2008) allows for NHS trusts to set their own dress code with reference to the legislation. Therefore, you need to be aware that dress codes may vary between placements. All students are given prior warning of the infection control policy before undertaking placements. It is therefore reasonable to expect all students to comply. It is the student’s responsibility to contact the placement educator for information regarding local dress code and any additional steps that may need to be taken (e.g. disposable sleeves are available).

Religious Considerations

The NHS expects all staff, trainees and students to adhere to the infection control policy. The Department of Health (2007) Uniforms & Workwear legislation was revised in 2010 and incorporated further information regarding religious considerations. Religious leaders were consulted) and it was agreed that patient safety outweighs the need to comply with religious dress when working or participating in a clinical area with patients.

Items of religious clothing are permitted provided that they do not affect health and safety, and that bare below elbows rules are adhered to in clinical areas and the face is visible to staff and patients.

Student Adherence to the Infection Control Policy

Students may query any aspects of the infection control policy they do not understand prior to undertaking their placement. Failure to comply with the policy may result in patient harm, or personal illness. Failure to comply with the policy will be seen as unprofessional and may result in you being unable to return to the placement setting.

Bare Below Elbows Rules

All students are expected to abide by bare below elbows rules when in clinical areas. Bare below elbows rules are in place so that hands can be cleaned effectively by hand washing and by the use of alcohol based hand rubs. The absence of clothing on the forearm also helps to minimise the transmission of bacteria from surface to surface and patient to patient.

Definition of ‘bare below the elbow’

Remove wristwatches, all bracelets, and rings (a plain wedding band is permitted). Keep nails short and clean, no nail varnish (including clear nail varnish) or false nails. Short sleeved clothing should be worn or long sleeves should be able to be rolled up and

held secure past the elbow.

Good Hand Hygiene

Good hand hygiene is required to protect patients, staff and the public. The basic principles of good hand hygiene are:

Wash hands using the correct handwashing technique after removal of gloves or if soiled by any possible contaminants.

Clean hands with alcohol gel between every patient contact Use moisturiser to hands to prevent drying (pots of hand cream etc. must not be shared

with others).

Hand hygiene during direct patient care activity requires washing/disinfection:

before patient contact; before aseptic tasks; after risk of body fluid exposure after patient contact after contact with a patient’s surroundings (e.g. lockers at bedside, toys in clinic, home

surroundings in community work) See www.who.int/gpsc/5may/background/5moments/en/index.html for correct

handwashing technique

Be aware that you may be challenged by staff or patients if they do not see you wash/decontaminate your hands.

Health and Safety

Health and safety issues need to be considered within clinical placements in a number of ways. All placements will have their own Health and Safety policy, so you must ensure you discuss this with

your placement educator. Wards and other hospital departments may have separate procedures so ensure you are aware of these.

Vaccinations and DBS

You are expected to have the relevant vaccinations as an occupational health requirement and a completed enhanced DBS check prior to attending placements (International students will also be asked to provide a police check or statement of good conduct) It is your responsibility to tell us if there might be a change to the status of your original DBS check and we will ask you to attest to this on a yearly basis.

At the time of writing your DBS will need reissuing in the summer term of year 3.

Details of these procedures will be given at the commencement of the programme.

Health and Disability Status

Your current health or disability status may mean that you require reasonable adjustments for your clinical placements. You will need to register with the disability service in order to discuss with them any reasonable adjustments for clinical placements (linked to health and/or disability). Students who need to register with disability will be managed by Allie Biddle.

If you are uncertain if you may require consideration for reasonable adjustments, please contact Allie Biddle.

Pregnancy and Maternity

If you become pregnant at any point during your course please consult the Student Maternity Policy to find out where to seek advice about your health, the health of your child and the management of your course of study. This is available at: http://www.reading.ac.uk/internal/student/rules-and-regulations/stdserv-maternity-policy.aspx

It is very important that you let your personal tutor or the Programme Director know that you are pregnant as soon as possible. A Risk Assessment will be completed with you to identify any relevant risks associated with your study programme and to manage these risks for your protection. Health and Safety advice can also be found at www.hse.gov.uk/mothers

If you will be attending any type of clinical placement (including CDA, education visits and elderly care visit) at any point during your pregnancy this must be specifically addressed in the Risk Assessment completed by the School. Please contact Allie Biddle as soon as possible to discuss this.

Clinic Procedures

Attending a variety of clinics provides opportunities to encounter different styles of therapy and types of clients. It also enables you to observe the administration of clinics. Try to learn as much as possible about each clinic e.g. the name of its Health Authority/PCT/Trust, the client population concerned, referral procedures, appointment systems and record keeping. You should also familiarise yourself with health and safety regulations, and emergency procedures for your particular clinic.

If you should find yourself temporarily in charge of a clinic, make sure that you know who to contact in an emergency and take any messages carefully (i.e. time of call, caller’s name and telephone number) and transmit them quickly. Be particularly careful to refer any queries about clients’ attendance, treatment or discharge to the placement educator, unless you have otherwise been

given specific instructions. Before you are left in this position, it is your supervising placement educator’s responsibility to make sure you know what you are required to do. However, you should ensure that you have been given sufficient instructions to carry out the tasks expected of you.

Environment

You will need to know the fire alerting and evacuation procedures.

If you see anything that may cause risk to anyone in your environment you must either deal with this yourself, or (and) alert your placement educator. For example, if a chair is broken you need to alert the placement educator to put procedures into action to deal with this. If you spill water on the floor in the corridor then it is your responsibility to ensure that you either clear this up properly or alert someone to do this, but never leave spilt water on the floor.

Ensure blinds are shut, doors locked etc. at the end of the day. Ensure no valuables are on view when you are in clinic and so on.

Client Safety

You must ensure that your actions do not endanger a client or put them at risk. For example: giving an adult/child a drink before ensuring they do not have any swallowing difficulty; or if you are in a situation where you know an adult/child has difficulty walking, ensure you have checked whether it is appropriate for you to help with this (ensure you are aware of what your role is in this situation as a SLT student). All the issues around environment need to be included in this. A further example may be to ensure toys are of appropriate age for each individual child (i.e. does the child still put toys into his/her mouth even if beyond the age of expecting this).

Ensure that you follow the correct hygiene procedures for your placement i.e. hand washing, cleaning of equipment.

Personal Safety

Consider your personal safety when travelling to and from a placement. If you feel there any issues with this, contact the University placement coordinator immediately.

Dress appropriately and safely for the placement. Consider the safety of ‘dangly’ earrings/pendants and so on. Consider the cultural implications of your dress and manner and if they may cause distress, for example, exposing your tummy may not be culturally acceptable (or professional). Ensure you know the infection control procedures that have to be followed in different environments. This includes washing your hands between each client.

On your first day of placement you need to give your placement educator a contact number of someone to contact if you fall ill on placement (i.e. someone who could come and collect you or look after you). Ensure you know who and how to contact someone (especially if you are on your own in clinic) if there are any problems. Consider whether you need to share information about any illness or disability you may have, to ensure the safety of both yourself and the clients/placement educator. If you are not sure about this please see Carol Fairfield regarding this.

The health and safety of yourself and the clients you may see are your responsibility. To do this effectively you need to ensure you are aware of relevant health and safety procedures at each of your placements. You must take the relevant action or report the incident to an appropriate person. These notes are to increase your awareness of these issues and part of your professional development.

Personal Clinical Aims

You will establish new personal clinical aims for each placement you attend (see appendices). These will need to be discussed and agreed with your placement educators wherever possible on the first placement session. These can then be reviewed midway through and at the end of the placement. The information from this and from your report form will help you establish aims for your next placement. It is essential therefore that you complete one of these for each of your clinical placements.

Personal Clinical ProfileYou will be expected to fill in a personal clinical profile (see appendices) to send to your placement prior to the start of the placement. This details your clinical experience and any personal issues, such as a disability, that may be relevant. It will enable the placement educator to ensure you gain the most possible from your placement.

No placement educator will expect you to be fully experienced or to know everything. Ask for help when you need it. Everyone has to learn and placement educators and tutors also gain experience and learn from students. We learn from each other. Share your knowledge! Discussing techniques with other students can also be very helpful.

First day of placement:Prior to or at the beginning of each placement you need to provide your placement educator with the following:

Contact details for yourself and an emergency contact number Your personal aims for the placement (sent prior to placement) Your personal profile (sent prior to placement) Name and contact details of your clinical tutor

You need to ensure that your placement educator has accessed the:

Report form Placement educator’s Handbook

Assessment and Monitoring of PlacementReport Forms

There is a report form for each placement. Your placement educator is asked to discuss their comments (and mark for 4BSc students) with you when they complete it towards the end of term. Evaluation will inevitably involve some constructive criticism. This is done solely with the view of helping you to develop clinically, and is very much an integral part of your training. Use this to determine some personal aims for the next term or placement.

You are required to complete a professionalism sheet for each clinical placement you attend

Telephone Contact

During your placement your clinical tutor will contact your therapist by telephone to discuss your progress. In order to do this you need to ensure your placement educator has completed the ‘contact form’ on the database. A record of the telephone contact will be kept in your personal file.

Clinical Tutor Visits

Reasons for visiting are diverse, and may include any of the following:

You are in your final year. All BSc students will be visited once by a clinical tutor in either their third or final year. See information in appendix re: preparation for these visits.

The placement educator has not had Reading students placed with them before. The placement educator is unsure how best to help you gain the maximum experience

from the placement. This may apply when the placement is unusual or highly specialised. It is felt that you would benefit from feedback on your clinical work, over and above that

given routinely by your placement educator.

NHS Funding for Travelling Expenses – NHS Bursary You should have received information from the NHS about making travel expense claims. If you are receiving an NHS bursary, you may be eligible to reclaim some or all of your travel expenses and also accommodation expenses for block placements. You must retain all receipts and attach them to your claim form, which can be downloaded from your BOSS account. This form then needs to be handed in to Justine Nicholls with all receipts. Please do this on a placement by placement basis as claims are only valid for 6 months. You will not be allowed to claim for petrol unless you have informed Justine Nicholls that you are using a car or motor vehicle to attend your clinical placements.

Each year all home and EU students must apply for the Bursary, even if you know you are not eligible.

Clinical Placements – General GuidelinesYou will attend preparation clinics observing both paediatric and adult clients in the University Speech and Language Clinic the Autumn and Spring terms of year one. You will have external placements from the Summer term of year one. These are usually off-campus although the University Clinic provides both adult and paediatric placements for some students. See previous notes for timings of placements. More specific briefings about each type of placement are given later in this handbook; however please refer to earlier notes regarding general guidelines and also note the following:

1. ALL PLACEMENTS are arranged through university staff. Placement details will be provided via the clinical placements database. The details on this database are supplied by the placement provider. If you feel there is insufficient information to help you plan for your placement, please contact the placement educator in the first instance

2. Placements normally take precedence over any other activities and are timetabled so that they will not conflict with university classes. If you must miss a clinic for any reason, you must first obtain permission from your clinical tutor and the agreement of your supervising placement educator. Each request will be considered on an individual basis

3. It is essential that you maintain an ongoing record of the clients you see during clinical placements, with brief details of their communication/swallowing disorder and the therapy/assessment carried out, plus any useful therapy ideas and reflections on these. Use your clinical diaries for this. You should keep this information in your clinical portfolio (this will be discussed in seminars)

4. Your weekly placements will be in a variety of geographical locations which will be accessible by public transport if you do not have a car. It is your responsibility to alert Allie Biddle of any special circumstances that might affect the location of your placements

5. It is not possible to guarantee placements at any particular location or time

6. During your first year, you will be asked for information that will help us to organise block placements. We will be seeking confirmation of your home area, and also other locations where you have friends or relatives you could stay with. Please note that placements are always arranged by University staff

During the Placement

We have a professional expectation that throughout the placement you will:

treat all staff, clients and carers with respect and behave professionally advise their educator where appropriate, if there is anything which may be affecting their

work act in line with the appropriate placement policies and procedures notify their placement educator if they see anything hazardous or suspicious be self-motivated and organised be adequately prepared for clinical placement ask if unsure about anything be punctual or make contact if delayed/unable to attend placement

The following sections cover more specific guidelines for each type of placement you are likely to encounter, whether these are external placements or within the University Clinic.

Notes on Paediatric Placements During your degree course you will attend a wide range of paediatric placements. This reflects the wide age range that paediatric service locations can cover: from birth in a Hospital Special Care Baby Unit, to a young person in a Secondary Special School.

Every placement will provide opportunities to develop clinical skills in observation, assessment, intervention and management.

Paediatric placements will provide the opportunity to see widely ranging severity of needs, in the areas of: speech, language, communication and eating, drinking and swallowing difficulties.

Placements may be set in health settings, educational settings or integrated settings. All placements provide the opportunity to liaise and work with a wide range of professionals and agencies. The structure and titles of services / teams will vary across different geographical areas.

To ensure you make the most of your paediatric placements, consider the following points:

Be aware of and be sensitive to your environment The place you will be visiting will have its own systems and processes. Find out about:

administration forms, referral and discharge processes, and photocopying/post facilities used in your setting.

You will always need to be aware of confidentiality and issues surrounding information sharing. Ensure you are aware of security measures in your placement.

Always check with your placement educator the procedures for Child Protection matters in your setting.

Find out from your placement educator what the procedures are in an emergency, for example a fire, or if a child suddenly becomes ill when with you.

Do check in your placement what is the most appropriate way for children to address you when they are working with you. For example, in school settings it may be more formal such as “Sir” or “Miss....”. Also check the form of address for adults to use when in front of the children.

Always bear in mind that parents and carers may still be coming to terms with their child having a difficulty with their communication skills, or coming to terms with a life-long diagnosis such as a Development Delay or Autistic Spectrum Disorder. Always check with your placement educator whether any diagnostic label has formally been shared with the parents.

Collaborate with colleagues in other professions. Be sensitive to the fact that many may also have expertise in areas that overlap with a Speech and Language Therapist’s knowledge, skills and expertise.

Learning from a wider context and group of people

Your placement will provide you with opportunities to increase your understanding of the roles and responsibilities of other professionals and agencies. You will have extensive opportunities to work with a variety of professionals, in particular: Child Minders, Nursery Nurses, Teaching Assistants, Class Teachers, School Inclusion Managers (sometimes known as SENCOs), LEA Specialist Teachers, Educational Psychologists, Social Workers, Paediatricians, Audiologists, Occupational Therapists and Physiotherapists.

Use your paediatric placement to consider how the child’s profile will be affected by communication opportunities in other environments from that you are seeing the child in e.g. at home / school. Also consider the impact on accessing the educational curriculum now and in the future.

Finding out new information

Dealing with new and unusual situations is an important part of being a Speech and Language Therapist. If you are presented with an unusual medical diagnosis, ask your therapist to guide you towards relevant reading. Share these resources and information sources whenever possible with your fellow students via Blackboard.

Take the opportunity to find out about the organisation of Nurseries, Children’s Centres and Schools. The Government has Websites for: OFSTED School Reports, Children’s Centres, the National Curriculum and the Department for Education.

Core Skills

Any paediatric placement will provide the opportunity for core skills:

Collecting background information and taking a case history. This may be directly from carers, but could also be from another professional or the client’s case notes.

Developing your communication skills with adults and children. Completing informal and formal observations and assessments. Using your findings to draw up a management plan. Planning and/or providing intervention. Evaluation of intervention. Report writing Development of multi-professional team working.

There will also be many specific skills that may be transferable, for example: Alternative and Augmentative Communication (AAC) and knowledge and use of ICT software

Community Clinics

Community Clinics provide a local speech and language therapy service. Children are typically referred by a variety of referrers including their: GP, Health Visitor, Nursery, School, Paediatricians, as well as the child’s parent. A Community Clinic aims to provide assessment and intervention. Community Clinic Speech and Language Therapists may make onward referrals for specialist assessments e.g. to a Paediatrician or to Audiology.

Community Clinics can see children covering a wide age range from pre-schoolers to adolescents. Often the majority of the caseload will be pre-school. Home visits or assessment at the child’s nursery or school setting may also be part of the assessment process, if appropriate.

Community Clinic Speech and Language Therapists will also provide advice to parents/carers, educational staff and other agencies e.g. Social Services. This may be through providing training for carers or other professionals.

When preparing for this kind of placement, be familiar with the kind of information available to parents on well-regarded UK-based websites such as:

www.talkingpoint.org.uk • Information about the stages of speech, language and communication development• Dedicated sections for parents, young people, EY workers, teachers, health visitors,

GPs, SLTs

www.ICAN.org.uk • Resources available to order• Sections for parents and carers, practitioners and commissioners

www.wordsforlife.org.uk • Information on the stages of development for parents• ‘Fun stuff’ for different age groups• Tips, further information, leaflets, articles, videos for the different age groups• Recommended books for children

www.literacytrust.org.uk/talk_to_your_baby • Information for practitioners• Lots of downloadable free resources / leaflets• Information on key topics (e.g. play, listening)

Knowledge of developmental norms for language, phonology and play is essential in all placements so devise your own checklists for each age to refer to.

Opportunities in Community Clinics

Community Clinic Placements will provide opportunities to develop the following clinical skills in particular:

Working closely with parents / carers Use of informal and formal assessments for pre-school and school-aged children. Experience of the diverse range and frequently co-occurring clinical diagnoses. Opportunity to undertake a detailed case history. Opportunities to devise management plans for individual clients, pairs of clients or groups.

Opportunity to provide therapy on a regular, intensive, block basis; or re-assessment / review appointments.

Opportunity to set programmes, write reports and to liaise with a wide range of colleagues in health, social services and education settings (including nurseries and playgroups).

Children’s Centres and other Early Years Settings

These ‘early years’ placements may take place in nurseries or Children’s Centres, and may also involve some domiciliary visits. Sure Start is a Government initiative aimed at reducing child poverty and social exclusion for families in local communities. Sure Start Children Centre’s were initially targeted at the most disadvantaged areas of the country, including rural areas and pockets of deprivation. Now most communities will have a Children’s Centre.

http://www.direct.gov.uk/en/Parents/Preschooldevelopmentandlearning/NurseriesPlaygroupsReceptionClasses/DG_173054

Children’s Centres are where children under 5 years old and their families can receive integrated services and information. Services are provided by a wide range of multi-disciplinary professionals from health, social services and education. They also bring together voluntary, private and community organisations, for example, childminders, Job Centre Plus. A key aim is to work with parents-to-be, parents, carers and young children, so that they can flourish at home and when they enter school. The way in which Speech Therapy services are provided in Children’s Centres will vary in different areas.

When preparing for a placement in an early years setting, be familiar with the kind of information available to Early Years workers and parents on well-regarded UK-based websites such as: www.talkingpoint.org.uk/en/EY-worker.aspx Knowledge of developmental norms for language, phonology and play is essential in these placements – you may find it useful before you start to devise your own checklists for each age to refer to. You should also be familiar with the Early Years Foundation Stage:

http://www.foundationyears.org.uk/early-years-foundation-stage-2012/

Opportunities in Children’s Centres and other Early Years Settings

To assess early speech, language and communication skills, including eating and drinking skills

To provide early intervention To undertake home visits To run joint sessions, for example, with Early Years teaching staff To provide training sessions for parents and carers on a wide range of topics, such as, early

speech, language and communication development To work with a diverse variety of professionals To liaise with local playgroups, nurseries and schools

Child Development Centres

A Child Development Centre (CDC) aims to provide a detailed specialist assessment and diagnostic service for children with a wide range of paediatric difficulties which will include communication, and also eating, drinking and swallowing difficulties. Referrals to Child Development Centres are typically made by the Paediatrician, but SLTs may also refer, as well as education staff and other health professionals.

The assessment is typically undertaken by a multi-disciplinary team. Some centres offer an assessment-only service, whilst others provide assessment and on-going intervention. Intervention may be provided individually or in groups jointly run with other professionals e.g. an Occupational Therapist. Referral meetings take place where a multi-disciplinary panel agrees who may attend.

Multi-Professional Team members play a central role in supporting carers with any diagnoses. Voluntary groups may also provide a role in this at the centre.

CDC team members will liaise closely with each other and attend case conferences and team meetings. Speech and Language Therapists based in Child Development Centres will liaise with other Speech and Language Therapists in the community and special schools.

Opportunities in Child Development Centres

To undertake joint assessments with Paediatricians, Occupational Therapists, Physiotherapists or Clinical Psychologists.

Opportunity to undertake a detailed case history. Use of informal and formal observations and assessments for children, including pre-

verbal children. Experience of the diverse range and frequently co-occurring clinical diagnoses. Experience of assessment and management of eating, drinking and swallowing disorders. Opportunity to observe and use some forms of AAC (e.g. Makaton, or possibly some

technological aids) Opportunities to devise management plans for individual clients. Opportunity to set programmes and liaise with a wide range of colleagues in health, social

services and education settings (including nurseries and playgroups). There may be the opportunity to observe acute in-patient work as well as out-patient

work, depending on the location and service offered by the Child Development Centre.

You may find it useful to take a look at: www.ace-centre.org.uk

Drop-In Clinics

These clinics are for families to turn up to without an appointment to discuss their concerns about their child and to have a screening assessment. The locations of such clinics are varied, including children’s centres and health centres.

Opportunities in drop-in clinics

To observe or participate in case history/information gathering To assess a child through observation and participation in play related activities To see children and families with a wide range of concerns To access a range of written support materials for families

Mainstream Schools

Frequency and level of input provided to children in mainstream settings varies according to the model of service delivery and the needs of the child. Some children will have a Statement of Special Educational Needs, which entitles them to this service. However, Speech Therapy Services in mainstream schools are also sometimes supporting children at the School Action Plus stage of the SEN code of practice. It will be important for you to have a good understanding of the National Curriculum and the statementing process. You will find some useful basic information on the Code of Practice and the kind of provision available on this website written for parents:

http://www.direct.gov.uk/en/Parents/Schoolslearninganddevelopment/SpecialEducationalNeeds/DG_4008600

SLT Services to the mainstream settings are often purchased from NHS providers by the Local Authority, but it is important to understand the political environment and any changes affecting the work place, so ask your clinician about how the service has been commissioned.

Clinicians working in mainstream schools will often be working in an advisory capacity. You may like to familiarise yourself with the kinds of information that are often relevant to teaching staff with children in their class with SLCN. These websites may be useful:

http://thecommunicationtrust.org.uk/schools/resources.aspx

http://www.talkingpoint.org.uk/Teachers.aspx

Opportunities in Mainstream Schools

To increase subject knowledge of the Foundation Stage Curriculum (Early Learning Goals) and the National Curriculum used in England and Wales.

Use of informal and formal observations and assessments for school-aged children. Experience of the diverse range and frequently co-occurring clinical diagnoses. Opportunity to undertake a detailed assessment. Opportunities to devise and evaluate management plans for individual clients, pairs of

clients or groups which are linked into the child’s Individual Education Plan. Opportunities to write Annual Review reports and attend Annual Review meetings. Opportunity to provide regular and intensive therapy on 1:1 or group basis. Opportunities to be involved in liaising with and providing In-Service Training for School

Staff. Opportunities to devise and demonstrate intervention programmes to be continued by

school staff Opportunities to liaise with parents and other members of the MDT e.g. Educational

Psychologists Opportunities for observation of children in a range of school environments

Resource Bases

Resource Bases are attached to a mainstream school and provide educational provision to pre-school and school aged children for a wide range of special educational needs. This may include: Hearing Impairment, Physical Disability, Learning Difficulties and Autistic Spectrum Disorder. Children have statements of SEN and there is likely to be a range of professionals and assistants involved in the multi-disciplinary Resource team e.g. physios, OTs, teaches of the deaf (see further list below). Speech and Language Therapists work as part of the Resource team, which is usually

headed up by a Specialist Teacher. Familiarity with the National Curriculum will help in your preparation for these placements, and ‘P levels’ may also be relevant, depending on the level of the children within the resource:

http://www.education.gov.uk/schools/teachingandlearning/assessment/a00203453/about-the-p-scales

However, some of the children may be included within mainstream classes for some of the school day. Some of the web links given above for ‘mainstream schools’ may also be relevant to these placements.

Language Resources / Units

These are resources which specialise in children with complex and specific speech and language disorders. However, some language resources adhere more rigidly than others to these entry criteria. The immediate team within the resource base may be smaller than in other resources, but will always include a specialist teacher and usually teaching assistants specifically to support the children within the resource. Provision of Language Resources beyond the primary school years is very limited.

Opportunities in Resource Bases (incl. language resources)

To increase subject knowledge of the National Curriculum and the Early Years Foundation Stage used in England and Wales.

Use of informal and formal observations and assessments for school-aged children. Experience of the diverse range of frequently co-occurring clinical diagnoses. Opportunity to observe specific client groups / communication disorders in detail. Opportunity to undertake a detailed assessment. Opportunities to devise and evaluate detailed management plans for individual clients,

pairs of clients or groups which are linked into the child’s Individual Education Plan. Opportunities to write Annual Review reports and attend annual review meetings. Opportunity to provide regular and intensive therapy on a 1:1 and group basis. Opportunity to support the child in the resource base and in mainstream classes. Opportunities to be involved liaising with school staff and providing In-Service Training to

mainstream teachers / assistants. Peripatetic visits to other nurseries or schools to see children and increase expertise of

educational staff. Experience working with Local Education Authority or Children Services SEN Advisors and

Specialist SEN staff e.g. Teacher of the Deaf, Specialist Speech and Language Teachers, Specialist Autism Teachers, Portage Staff etc.

Special Schools (day / residential)

There still remains a wide range of designated special school placements across the country. Special School placements typically offer education places to those children and young people with the severest and most complex special educational needs. Some operate around the typical school day, while others offer after-school care or are residential. Some extend beyond the typical age for school leaving, allowing their students the opportunity for a ‘seamless transition’ to adult

care services – discuss how this is managed and how effective it is, with those working at the school. The school placements for such children and young people may include:

Moderate Learning Difficulties (MLD) Complex Learning Difficulties (CLD) Severe Learning Difficulties (SLD) Profound and Multiple Learning Difficulties (PMLD) Hearing Impairments or Schools for the Deaf (HI) Visual Impairment (VI) Physical Disability (PD) Emotional and Behavioural Difficulties (EBD) Speech, Language and Communication (SLCN) Specific Learning Difficulties (Dyslexia) (SpLD) Autistic Spectrum Disorders (ASD)

Placement in special educational provision is normally dependent on a Statement of Educational Needs being issued by the Local Authority. Special Schools can be Local Authority Maintained, or Independent. Some are run in conjunction with national charities, for example the ICAN schools for children with Speech, Language and Communication Needs.

All parents have the right to choose whether to have their child educated in a mainstream school or a special placement. This is part of the Government’s ‘inclusion agenda’. The final decision is made between the parents and the Local Educational Authority.

Familiarity with the National Curriculum’s ‘P levels’ may help in your preparation for these placements:

http://www.education.gov.uk/schools/teachingandlearning/assessment/a00203453/about-the-p-scales

Opportunities in Special Schools

To increase subject knowledge of National Curriculum and the Early Years Foundation Stage used in England and Wales.

Use of informal and formal assessments for school-aged children. Experience of the diverse range and frequently co-occurring clinical diagnoses. Opportunity to undertake a detailed assessment. Opportunities to devise detailed management plans for individual clients, pairs of clients or

groups which are linked into the child’s Individual Education Plan. Opportunities to write Annual Review Reports and attend annual review meetings. Opportunity to provide: consultation and/or regular therapy. Opportunities to be involved in liaison with and providing In-Service Training for School

Staff. Opportunities to contribute to School Policies e.g. English, Personal, Social and Health

Education (PSHE). Opportunities to experience a range of communication modalities and AAC systems Opportunities to work alongside specialist teachers, teaching assistants and

Speech and Language Therapy Assistants. Opportunities to liaise with the wider MDT e.g. Occupational Therapist,

Physiotherapist, Counsellors, and efforts to involve families/carers in the MDT. Opportunities for observation of children in a range of school environments

To understand some of the challenges of families with children attending these schools e.g. the practicalities of taxis to and from school.

To observe the impact on children, their families and their education of extended visits to hospital and respite care.

Specific Client Groups

Your paediatric placement may be for one specific client group, such as children with cleft lip and palate, hearing impairment, ASD or dysfluency, and the age of the clients may vary widely. These client groups may be seen in a variety of locations according to individual trusts’ models of service delivery. SLTs may work as part of a MDT and local service provision will determine whether they primarily offer specialist assessment / also direct therapeutic input. The same learning opportunities detailed above for the relevant clinical settings are applicable for these specialist client groups. When preparing for these placements it will be important for you to become familiar with the specific client group and some of these websites may be useful places to start your background research:

Cleft lip and palate

www.clapa.com

Hearing impairment

http://www.deafnessatbirth.org.uk/ – lots of useful info/articles

www.nhsp.info – Newborn Hearing Screening Programme

www.ndcs.org.uk – National Deaf Children’s Society

www.rnid.org.uk – Royal National Institute for the Deaf

www.ForestBooks.com – good resources for deaf children

Autistic Spectrum Disorders

www.autism.org.uk

Dysfluency

www.stammering.org

www.stammeringcentre.org

Speech Sounds Disorders

http://www.speech-language-therapy.com/

Other (resources)

http://www.sparklebox.co.uk/

http://www.bbc.co.uk/cbeebies/shows/something-special

Notes on Adult PlacementsThe variety of adult Clinical Placements available illustrates the breadth of speech and language therapy input to clients aged 16 years upwards and the exciting opportunities available to therapists working with adults. Therefore the environment you will be visiting could range from a day hospital, outpatient clinic, acute ward, stroke unit, rehabilitation hospital, college, a client’s home or group. Consider the following in order to make the most of your adult placement:

Being aware of and sensitive to your environment

The place you are visiting will have systems, which you need to be aware of regarding confidentiality and security including filing of notes and ID badges.

Individual departments will vary in terms of dress code and etiquette e.g. asking clients how they wish to be addressed, reporting to the nurse in charge of a ward.

Finding out about administration and practical arrangements such as arranging transport are part of the learning process.

Learning from a wider context and group of people

Create opportunities to increase your awareness of the wider organisation e.g. special clinics (videofluoroscopy, Voice Clinic) and multi-disciplinary working (observe other health care professionals, case conferences, joint goal setting meetings).

The setting for your placement will influence your caseload and the style of input. For example you may observe your placement therapist using a consultative approach as she/he provides interaction advice to carers of a person with dementia. There may be a structured approach with a standardised voice case history followed by a one to one treatment block. In an acute environment there may be communication and/or swallowing assessments but rapid change and turn over. Each experience has much to offer.

Finding out new information

Dealing with new and unusual situations is an important part of being a therapist. If you are presented with an unusual medical condition or a disorder where you have not yet completed the relevant lecture, ask your therapist to guide you towards relevant reading. Your practical experience and reading will make your lecture more meaningful and vice versa.

Practising core skills

Whatever the environment and irrespective of the fact you have not covered a specific topic in lectures yet, there are core skills which are always applicable. You need to practise and develop core skills to work towards independence, for example:

Taking a case history and collecting information from different sources regarding medical and social background

Interacting with other professionals is also important, who is involved in delivering your client’s care package?

Developing interaction skills with clients, modifying your own communication while retaining patient dignity. What can you learn about your client’s condition from informal conversation?

Completing formal and informal observations and assessments-Are there specific published assessments used, what are their limitations? -Can you devise informal assessments to get the exact information you require?

Making a differential diagnosis from the information gathered Conveying assessment results to the client, to their relatives or to other health

professionals Using the information gathered to inform your management and treatment plan. Goal

setting should be completed wherever possible with the client or carers to ensure the plan is client centred-Can the plan be realistically achieved?-What are your success criteria?-How will skills learned in therapy be generalised in the client’s environment?-How can tasks be made relevant to the client’s social needs/interests?

Writing case notes and reports

Recognising transferable skills

More specific clinical activities are also highly transferable, for example:

Augmentative and Alternative Communication Implementing AAC strategies may be as relevant to an ALD caseload as to clients with progressive neurological conditions. Consider free apps for iPhone and android as well as purpose built communication aids.

Impairment focused exercisesRespiratory exercises can be used with clients with voice disorders as well as those with dysarthria following a stroke.

Conversation PartnersProviding advice to conversation partners could be a treatment aim for an adult with learning disabilities, a client with dementia or aphasia. Visit www.connect.org.uk

Developing strategiesFor example, working with clients to develop strategies to cope with communication in everyday situations. Negotiating strategies is also a skill required when working with clients with Dysphagia.

Acute Wards

For those who have never been in hospital before as a patient or visitor it can be quite a shock to walk onto an acute ward. The environment often has a strong smell and can be very noisy with people dashing about, patients calling out and phones ringing. It can make it difficult to concentrate and to summon the confidence to speak to other members of staff. There is a strong drive to discharge patients quickly, with a package of home rehabilitation if necessary. This means that most of the people who are inpatients will be very sick and this can be shocking if you are not prepared. People are dealing emotionally with diagnoses of stroke or head and neck cancer for example. This means dealing with patients and relatives requires sensitivity and compassion. Talk to your therapist if you are upset by something you see or something that happens. Also tell your therapist if you feel unwell and need to remove yourself from a situation. Once you become used to this new environment, offering people support and spending time with them talking can be extremely rewarding.

Make sure you have a basic understanding of dysarthria, aphasia and dyspraxia as your therapist may ask you about differential diagnoses. Reading the pamphlets available on the Stroke Association website is helpful – www.stroke.org.uk . Practise describing these disorders to someone who knows nothing about speech and language therapy. Currently many therapists are taking a more social approach to assessing clients with aphasia using supported conversation to find the best communication strategies to help them cope with their hospital stay, rather than

carrying out formal assessment which can highlight new and frightening difficulties. There will undoubtedly be opportunities to observe swallowing assessments. Perhaps you will be able to get involved with lunchtime assessments with patients who are already eating and drinking or completing oro-motor exercises to benefit speech and swallowing. Make sure you revise your anatomy and physiology e.g. cranial nerves.

Outpatient Settings

Therapists who work in an outpatient setting usually see between two and three clients in a session (am or pm). They may specialise in a particular field or see a more generalist caseload of patients with acquired neurological disorders as well as voice and fluency patients. Useful websites include www.parkinsons.org.uk www.mndassociation.org www.stammeringcentre.org It is useful to find out about the type of clients before you attend so that you can be better prepared. Paperwork and telephone liaison may form a bulk of the daily work. There is also a lot of preparation as sessions tend to be approximately 40 – 60 minutes and patients may also require work or advice sheets to take home. Working with a patient’s relative or friend is also very important and there is a lot of interest currently in training conversation partners and carrying out conversation analysis. There is more time in outpatient settings and the client is usually more ready to cope with longer more formal assessments.

If you are observing an initial voice case history the appointment could take up to one hour. There may be a formal document, which the department uses. It is always useful to revise anatomy of the larynx beforehand and practise explaining normal voice production. If the therapist has an ENT caseload they may also be seeing patients with head and neck cancer looking at articulation, eating/swallowing or even voice restoration if the patient has had a laryngectomy. www.laryngectomy.org.uk is the website for people living with a laryngectomy.

If clients do not attend, or there are transport problems, take the opportunity to find out about administration procedures or take a look at assessments or resources.

Forward planning is a good idea as this is an ideal opportunity to collect video material for use later on in your course if not required immediately.

Adults with Learning Difficulties

This client group will present with a wide variety of needs and severity levels. They may have multiple physical, cognitive and communication needs. You may see these clients in a variety of settings depending on how the speech and language therapy service is delivered, working directly or indirectly with the family/carer. You may need to adapt published assessments and will need to ask your therapist for direction and ideas. There will be other professionals involved and understanding their role is important. There may be an opportunity to learn more about alternative and augmentative communication systems such as communication passports. Visit www.nbt.nhs.uk and search for communication aids.

Rehabilitation Hospital or Day Hospital

As with ALD placements if you are visiting a Rehabilitation Hospital or Day Hospital you may be working with a highly specialist caseload. For example, young adults with complex physical and cognitive deficits following a road traffic accident. Their behaviour may be challenging or they may be disinhibited. Perhaps the day hospital specialises in clients with dementia and you may observe people wandering or lacking in initiation. In these situations you will need to ask your therapist on

your first day to tell you about her/his caseload and the types of specialist assessments used. It will hopefully be a very relaxed environment and there will be excellent opportunities to find out about multidisciplinary working and joint goal setting. Therapy may take place during other activities with a multi-disciplinary team member or in a small group, you may need to ask your therapist for an observation checklist to help guide your observations and learning.

Domiciliary Service

Your therapist will have a system to ensure someone is aware of the address of the home visit for safety. When entering a client’s home, be aware of individual customs or traditions, it may be considered the norm to remove your shoes at the front door. Visiting a client’s home gives excellent insight into their personal circumstances, conversation partners and interests. They will often feel more relaxed than attending an outpatient appointment.

Often domiciliary service is offered to clients with progressive neurological conditions. This will be to review their swallowing and communication. Ask your therapist what the aims of the visit are because it is not always clear in the informal style of interview completed on a home visit. The topics covered are usually initiated by the client or their carer rather than following a structured format. Counselling skills are important. Do not be afraid of this. Often it is enough to actively listen. Do not worry if you do not know about something, but offer to find out or to ask if they wish to speak to someone else, a specialist nurse for example. Be led by their needs, people react very differently to their condition. Some people will not want to know about details, whereas others will ask lots of questions. Often managing symptoms is about providing information so that the person can make an informed choice about their care.

Group Therapy

Group therapy has been demonstrated to be an effective mode of intervention. It also can help as services become more stretched as more people can be seen. For a student, although this provides a different type of placement there are many advantages. For example, exposure to a wider variety of clients, an opportunity to work as a team and to observe people interacting with their peers as well as client-therapist interaction. Groups enable people to share ideas and support each other in coping with long-term communication impairment. There is a very specific placement offered which involves attending an evening group for adults who stammer. The purpose of these sessions is to provide the opportunity to observe and interact with clients who stammer and to observe some treatment regimes. The sessions are run collaboratively by two speech and language therapists employed by Wokingham NHS PCT. There will be opportunities for you to participate in the group activities at the discretion of the therapists.

Working with adults is both challenging and fascinating as every client is an individual personality presenting with an impairment of varying severity, and coping with personal barriers to participation in everyday life.

Types of PlacementThe following sections cover more specific guidelines for each type of placement you are likely to encounter, whether these are external placements or within the University Clinic.

You will have queries and problems during your placements. Ask your therapist for time for some discussion but make sure you prepare for these sessions by writing down your queries. Time is always short in a speech and language therapy clinic. Clinical queries about cases or treatment seen can always be raised with your clinical tutor. However, if you have any urgent queries or anxieties do contact your clinical tutor as soon as possible. Don’t let anxieties become ‘a big problem’. Act sooner rather than later.

No one expects you to be fully experienced or to know everything. Ask for help when you need it. Everyone has to learn and placement educators and tutors also gain experience and learn from students. Learning from each other is something you will continue to do throughout your career. Share your knowledge. Discussing techniques with other students can be very helpful

Preparation Clinic Placements

Your clinical observation as a student is the initial stage in preparation for becoming an effective placement educator. Therefore the observation/participation experience in your preparation clinics is your first chance to match theory to practice with a real caseload. You will be provided with a preparation handbook to accompany the preparation clinic placements.

You will attend two preparation clinic placements, with 10 sessions in each. These are usually a paediatric clinic in the autumn, and an adult clinic in the spring. These clinics takes place in our onsite clinic

The University SLT Clinic is funded by the University and sessions leased to the NHS who run regular NHS clinics within the University. The same information, professional behaviour such as attendance, punctuality and confidentiality apply to this clinic at all times.

The preparation sessions are generally 3 hours long. They will be a mixture of live observations and learning through DVD recordings of clinical sessions.

Sessions will normally begin with some background information about the client you are observing, and the session aims including relevant theoretical background where appropriate. You will be required to: do data analysis, scoring and summarising test results; transcription of spontaneous speech; look at clinic procedures and protocols; consider key issues in clinical practice; consider management issues and service delivery, all of which will prepare you for future clinical work. You will be expected to participate fully in these sessions both as an individual and as a group member.

Within both paediatric and adult participation sessions you may have an opportunity to participate individually in a clinical session. Please ensure that you show sensitivity to all present. The placement educator will give you feedback on how you interacted in clinic.

Aims for preparation clinics:

To develop professionalism skills To develop structured objective observation skills in assessment, therapy and overall clinical

management across a range of clients To develop skills in case note and report writing To apply a developing knowledge base to the clients observed

To participate in discussions around clients and clinical topics including discussion using the virtual learning environment

To ask and respond to questions in a professional clinical setting To devise assessment/therapy materials with guidance To develop an understanding of the role of each of the SLTs within this setting To develop reflective practice to support professional and personal development

Weekly Placement

Weekly placements will offer you the opportunity to continue to develop the observation and interaction skills developed through the preparation clinics. The placement may be adult or paediatric. Please refer to the previous notes on different service settings and client groups.

There are different models of weekly placements made available to us by the SLT services, which include a day a week for 10 weeks, 2 days a week for 5 weeks or a mini block within the summer term. Your summer term weekly placement may extend into your summer block; your summer block may extend into your Autumn term weekly placement. Services determine the placement model that work best for each individual placement

Clinical aims for this placement are to:

Continue to extend observation and interaction experience with a wide range of clients. Develop further your ability to make objective observations of a client and report back to

your supervising placement educator. Collect and analyse clinical data, including on line transcription. To have participation in assessment and treatment sessions (with specific guidance). Continue to develop your professional interaction skills. Attend any meetings/case conferences as appropriate. To be involved in routine clinical/administration activities To reflect on your own professional and personal development.

Elderly Care Setting

You will spend 5 days in an elderly care setting. During this placement you will need to consider the following aims:

By the end of the placement you should be able to:

Outline the factors (i.e. general health, mobility, medication, hearing, cognition and vision) which affect communication, both spoken and written, in the group you have observed.

Examine how these factors restrict interaction or are detrimental to social interaction/communication.

Describe the structure and processes at the setting that are in place to support individuals with eating & drinking and /or communication difficulties.

Propose how a SLT might work in this setting and with whom to support a person with eating/drinking and/or communication difficulties.

By the end of the placement you will have:

Engaged staff members of varying responsibility in conversation, regarding patient care and their individual roles.

Understood the role and hierarchy of the care staff in the setting and noted where roles overlap.

Actively participated in group/individual activities and taken new ideas of activities into the setting that will optimise participation/communication.

You will have seminars to support this placement.

Block Placements

You will attend 2 block placements during your Clinical Practice modules. The first one (usually 4 weeks duration) is in the Summer vacation between year 1 and 2 and the second one (2 weeks long) will be either in the Easter Vacation or in May, depending on placement availability. The aims of these block placements are to provide you with wider experience in a number of different settings and allow you to consolidate your knowledge and skills. The placements are arranged by the University. You will be asked to provide details of as many places as possible in the country where you will be able to access accommodation for the block placements. We cannot guarantee that your placements will be in your preferred town.

Summer Vacation block placement- Year 1

This is a 4 - 6 week placement. Each student will have a different placement experience in terms of client groups. The weeks may be concurrent or in separate weeks. The placement may be a continuation of your summer term placement or may lead into one of your autumn year 2 placements.

Clinical aims for this placement are:

1. Observation and participation of interviews, assessment and treatment of clients.2. Observation and interaction with a wide variety of clients.3. Participation in assessment and treatment sessions (with support).4. The opportunity to collect and analyse clinical data. This includes transcription and analysis

of spontaneous speech data. 5. Discussions with placement educator regarding the verbal and non-verbal behaviour

exhibited by clients, comparing the behaviour with that expected from age matched peers.6. To gain some understanding of service delivery and management issues and how the

speech and language therapy practice fits into the local education and health services.7. To attend staff /multidisciplinary meetings, or discussion groups when possible.8. To begin to understand the administration of a speech and language therapy clinic, via

looking at notes, reports and liaison procedures.

The block gives you an opportunity to observe an experienced therapist (or therapists) as well as benefiting from the placement educator's guidance and advice about her/his own treatment/ interaction/management decisions.

We suggest these guidelines for the placement:-

Develop an awareness of the running of the speech therapy department and its relationship to the hospital/rehabilitation/clinical setting.

Observe therapists working with adults with acquired communication or swallowing problems. Take opportunities to develop your objective observation and interaction skills with this client group. (Including taking opportunities for transcription).

If possible, discuss diagnosis, intervention plans, treatment techniques and methods of evaluation. Also discuss your observations and conclusions from this with the therapist.

Discuss and evaluate intervention with the therapist.

Allow yourself time to explore assessment and intervention materials. Allow yourself time to read medical and speech and language therapy notes. Learn about and be aware of administrative routines of the clinic, e.g. referral procedures,

transport arrangements, requesting further professional opinions, discharge procedures, report writing, ordering equipment, etc.

Ask/discuss with the therapist relevant aspects of the local speech and language therapy services, opportunities for specialist clinics, methods of service delivery, aspects of quality assurance, relevant departmental policies, etc.

Take opportunities to interact with clients and carry out any specific therapy tasks (under specific guidance).

First Year MSc Clinical Learning OutcomesBy the end of the first year you will have experienced preparation clinics within the university and your first external placement. These clinical experiences are supported by tutorials and seminars at the university.

It is expected that you will be able to:

1. Demonstrate the development of a professional manner including an awareness of and compliance with the protocols for the clinical environment, including understanding and adherence to the relevant HCPC standards of ethics, conduct and performance

2. Show ability to identify relevant assessment protocols for specific client groups (with some support) demonstrating objective observation skills.

3. Abstract relevant data from observations/assessment or other relevant sources showing development of skills in clinical problem solving and clinical reasoning.

4. Participate and conduct specific identified clinical tasks effectively 5. Show developing critical self-reflection of own performance in the clinical setting (this will

develop over the year)6. Present effective verbal and written reports7. Relate theory to practice with support in the clinical environment8. Evidence development of independent practitioner skills such as responding appropriately

to criticism and taking initiative

Second Year MSc Clinical Learning OutcomesIn the second year you will continue to develop your clinical skills and integrate your theoretical knowledge with clinical experience via observation and practice in a variety of clinical settings, with a varied client base. At the end of this year, you will have completed the clinical placements and associated activities designed to help you achieve the learning outcomes for the clinical programme, detailed at the beginning of this booklet.

In all these second year placements you will be expected to take on increasing responsibility for clients, following the outline below:

Move from a mainly interaction role to an active role in the clinic, becoming involved in all aspects of the clinical process as appropriate to the client group and model of service delivery

Start taking responsibility for treatment and management of one/two clients. Your placement educator will discuss plans with you and make suggestions, particularly in the early stages. Progression to new responsibilities will be at your placement educator's

discretion - we find students develop at different rates clinically, and it is important that you are ready for each stage as you encounter it

Assess, plan and deliver appropriate treatment within the placements’ model of service delivery

Interact as a member of the professional team

By the end of the second year of their clinical study, you should have achieved the following clinical learning outcomes. The learning outcomes below are the outcomes expected by you at the end of the programme and they encompass all the clinical placements as well as all the other relevant clinical lectures/tutorials.

You will be able to assess, diagnose and manage communication and eating, drinking and swallowing disorders in children and adults using appropriate clinical skills and theoretical knowledge. You will demonstrate competency levels in all these areas, sufficient for graduate level entry to the speech and language therapy profession.

Conduct yourself in a professional manner in the establishment of relationships, communication skill s and awareness of professional issues, including understanding and adherence to the relevant HPC standards of ethics, conduct and performance and standards of proficiency

Critically identify and administer relevant assessments procedures demonstrating knowledge of the social and educational implication of communication/swallowing disorder

Analyse and assemble a clients’ speech and language (or dysphagia) profile from relevant gathered data

Take an holistic approach to the planning and delivery of management of a client based on the assembled profile and relevant theoretical basis evidencing clear clinical reasoning and decision making skills.

Carry out intervention in a professional and flexible manner Self-evaluate and show critical evaluation of own sessions Communicate effectively in verbal and written forms Relate theory to practice in all aspects of their clinical work Demonstrate development as an independent practitioner

Please remember that these skills will be developed throughout the second year. The profile and speed of development will depend on the individual student and their clinical learning opportunities.

Clinical SkillsDuring the placements, you should aim to be developing skills in the following areas, initially through observing the placement educator, and then through trying these out for yourself:

1) Case history taking and interviewing.

2) Selection and administration of appropriate assessment procedures.

3) Recording information/data from a number of sources.

4) Analysis and interpretation of information.

5) Diagnosis.

6) Formulation of measurable treatment aims (short and long-term).

7) Use of treatment techniques and materials.

8) Client management. Consider service delivery options and management plans.

9) Contributing to any multi-professional team in a manner appropriate for your level of experience.

10) Evaluation of own performance

Support in these areas will take place at the university, not only in lectures, but in clinical seminars and tutorials. During this year you will need to develop appropriate interactive skills with clients, parents and other professionals at a fairly rapid rate. Do not despair if this seems slow in coming - it all takes practice and you will get there!

Your clinical management will be monitored by the placement educator who will discuss treatment plans, make suggestions and regularly (but not necessarily every week) observe your sessions. You will also be seeing some clients for one session only. They may be on review, a second opinion the therapist is seeing, in-patients etc.

Due to the structure of your lecture courses, it may be the case that you are participating in treatment of a client before you have completed the relevant lecture course. Be aware of your limitations but take advantage of learning, through practice, in the field. Your practical experience should make your lectures more meaningful and vice versa. In many hospital settings your placement educator may be working largely with dysphagia clients where the opportunity for you to take responsibility is more limited (depending on where in your programme this placement occurs). You should however, ensure you become aware of local policies and assessment procedures, how to build up a case history, liaison with other professionals and the role of the speech and language therapist with this client group.

We suggest that you take responsibility for the management and treatment of one or two clients. This will be monitored by the placement educator who will discuss treatment plans with you, make suggestions and regularly (although not every week), observe your sessions.

Clinical ExperiencesYou can try to extend your clinical experience by some of the following activities:-

1. Practical administration - Practise carrying out initial interviews/assessments and reviews (and making decisions about these). You will do this having ascertained and collated relevant medical/educational/social history/previous assessment information as appropriate to the client and client group, as well as full information regarding the language/speech/swallowing impairment the therapist is treating.

2. Use this information to inform your management and treatment of two (maximum 3) clients in the clinic.

3. Take any opportunity to become involved in management activities which go beyond the clinic itself – for example home, residential home, day centre and school visits (where this is practical).

4. Be aware of and apply professional issues e.g. clinical governance, to your practice. Consider how you can imbed the principles of clinical governance in your clinical work.

5. Practise writing reports to other professionals involved with a case, under the guidance of your placement educator.

6. Carry out some of the administrative duties associated with the clinic e.g. sending out appointments. Get to know how your placement educator organises records and the booking of clinics. Develop practical administration skills such as booking transport, manipulating wheelchairs.

7. Observe your placement educator working, where possible, particularly with unusual or difficult cases.

8. Finding out about the Trust/Educational establishment and how the speech and language therapy service functions within or with the organisation.

9. Developing further your interaction skills with clients, including issues of non verbal communication such as manner of dress, seating arrangements and so on

10. Observe and be involved in multidisciplinary working where appropriate

Clinical ActivitiesA check list of some clinical activities you should seek to experience

Case histories

-Taking a case history from client and relatives

-Selecting appropriate reports from other notes for the case history. Respect confidentiality.

Assessment procedures and protocols

-Published assessments: practice in using these and also developing critical skills; what do the results tell you? What else do you need to know? Which assessments/assessment protocols are relevant to your client group/client?

-Probing specific skills: own tasks and tasks replicating studies in the literature.

-Instrumental analyses.

-Informal screening procedures.

Planning management

-Relating to assessment, client's medical and social background, the availability of treatment hours, and the profile of the overall caseload of the clinic (prioritisation).

-Relating treatment to published studies on treatment.

-Selecting materials appropriate to client and disorder.

Treatment

-Selecting order and method of presentation.

-Selecting size/length of task.

-Continuous appraisal leading to modification of session as necessary

-Setting objective long and short term aims.

Evaluation of treatment

-Providing base line and means of objective evaluation

-Keeping appropriate records both for your use and the clinic.

Discussing all above stages with therapist and tutor (as appropriate). Report and Letter writing Observing therapist: discussing cases and management with therapist. Seeing review clients: developing ability to make decisions about future treatment. Initial interviews: developing ability to decide on appropriate treatment and additional

agencies that should be contacted. Develop professional relationships with other disciplines in the placement setting, where

appropriate discussing and/or observing treatment of your client. Clinic administration

-Appointment system, referrals and discharge.

-Report writing

-Transport

-Statistical data recording

General management

-Awareness of the local NHS structure

-General points about staffing, equipment, n-service training

-Clinical governance, risk management

-In addition you will need to use your time in clinic to supplement/collect data for your written work. (Case studies and advanced case study)

Placement EvaluationYour placement educator will complete a report form at the end of your placements. They are asked to discuss this with you. This will help you identify some aims for your next placement, or learning objectives to support you in achieving your NWP competencies. We ask you to discuss your assessment with the therapists during the placements so you can take advantage of the feedback and improve your performance. You will be able to discuss this report with your clinical tutor. If more than one placement educator is involved with you, either separate reports or an amalgamated one are acceptable.

Evaluation of your progress in clinic in the 2nd year will be supported by some visits by university staff.

You will be on a steep learning curve in your placements and evaluation will inevitably involve positive feedback and also identification of areas for development via constructive feedback. Please try to bear in mind that this is done solely with the view of helping you to develop clinically, and is an integral part of your training. Discuss this in a constructive way with your placement educator and it is also important to discuss this with your clinical tutor, to enable you to make the most of this information.

Placements vary. Your experiences may not seem to match your friend’s but be reassured, we strive to ensure that all students get adequate clinical experience and most get very good experience. To a large extent, the success of a placement depends on you.

Linguistic Assessment Clinic (LAC)LAC is a specialised teaching clinic using DVDs of clients already in receipt of speech and language therapy. The clients have been referred for a detailed assessment of their language, speech and communication skills. The assessments involve a variety of testing protocols involving standardised tests, experimental procedures, and language sampling.

You will attend LAC in small groups in either the autumn or spring term alongside the Second Year MSc students, and the MSc Language Sciences’ students. Each group will undertake the following:

Assessment Clinical Reasoning: small group work to analyse referral info, identify areas requiring assessment and plan relevant assessments which could be used. Session facilitated by clinical tutor.

Assessment Observation and Analysis (part 1): watch recording of client’s initial appt. Specific observation tasks given to students, to work in small groups to analyse data and explore initial hypotheses on client’s disorder.

Assessment Observation and Analysis (part 2): watch recording of client’s follow-up appt, again with specific observation tasks for student groups and follow-up analysis. Small group work and discussion of observations and data, as per previous week. At end of this session a nominated member of each small group should upload any assessment scores / outcomes to BB, for others to use where relevant for interpretation of their own data and observations.

Analysis and Interpretation Group Work: Student groups work independently to complete their analyses and research the evidence base to support their interpretations. Each group to prepare short oral presentation of their work

Compiling the Client’s Profile: seminar for presentation of all data from each group, as well as whole group discussion of client’s overall profile

A final report on the client will be made available to you afterwards.

Case ReportOne case report will be submitted during year 2, on an adult or a paediatric client. This report must reflect your knowledge across all areas of your studies as appropriate. You are expected to discuss the client against a theoretical background, referencing your sources. You are expected to draw on theoretical and clinical knowledge and demonstrate accuracy in data gathering and analyses.

Please refer to your Academic Handbook for task criteria

Clinical reasoning seminarsIn Year 2, you will have 2 small group seminars a term in the autumn and spring terms. In both of these you will be given information about a client to consider and arrive at clinical decisions. How you achieved this and the processes used will be discussed during these seminars.

You will be provided with briefing notes from the clinical tutors at the start of Autumn Term year 2

The client that you write up for your case study and the client you present for your final video exam should be different clients. Therefore you need to keep this in mind when beginning your placements, as you may wish to use data from a client seen right at the beginning of the placement in case someone suitable cannot be found at a later date. If in doubt about any of this please contact your clinical tutor in the first instance.

Use your clinical tutorials to discuss any problems you have with planning your case report. Please refer to examples of past student work which is available.

Clinical Practicum ExaminationThis is taken in the Summer term of your 2nd and final year. Please note: The gaining of a degree does not automatically ensure registration by the Health and Care Professions Council (HCPC). The HCPC will require you to fulfil their criteria for registration.

Failure of the Clinical Practice 2 ModulePlease refer to your academic handbook for further information.

If you are required to resit your clinical exam(s) the following procedure will be followed:

You will have a tutorial with your clinical examiner to devise appropriate learning outcomes

The clinical coordinator will arrange additional clinical sessions and tutorials prior to the resit. The location and timing of these sessions will be dependent on placement availability. The number and nature of the clinical sessions will be dependent on the learning outcomes identified

In exceptional circumstances, where there is evidence of risk to speech/ language therapy clients, the university reserves the right to refuse a re-sit.

Video Presentation of a client seen in one of your placements. You will have opportunities to make the required video-recording towards the end of the Autumn, Spring term or during the Summer term. Students are normally expected to produce a video for the final examination that shows a client not previously discussed in a group tutorial or presented in a case study. If neither of these options is possible, the student needs to discuss the problem with the programme director and special arrangements will be made.

Unseen DVD exam: your unseen exam is of a client being informally assessed. You will receive background information about the client 24 hours prior to your exam. On the day of the exam you will watch the DVD and then you will have just less than two hours to analyse and interpret what you have read and seen, in order to propose a tentative differential diagnose and to discuss a management plan. Critical reflection of the task observed will also be assessed

Full written and verbal briefings regarding these two components are given in the autumn term of the 2nd year. Your final mark for the clinical examination is the average of marks gained for the two components.

Appendices Personal Profile

Personal aims

First day placement checklist

Telephone contact form

Flowchart -actions to be taken when concerned about a student’s progress

Statement of Confidentiality

Session plan –assessment

Session Plan – intervention

Placement Evaluation form

Guidelines for Clinical Diary

Five Moments for Hand Hygiene at the point of care

Remote Supervision Placements

Student Guidance Notes for Clinical Tutor Visits

Dysphagia clinical experience and clinical learning opportunities on placement

Summary of Clinical Placements

Personal Profile(To be updated for each clinical placement and sent to placement educator before the start of the

placement; to go through with the educator on the first day of the placement)

Name of student:

Name of Clinical Tutor:

Clinical tutor contact details (email and telephone)

Student’s mobile number:

Student’s emergency contact number:

1. Practicalities (e.g. reasonable adjustments)

2. Clinical Strengths

3. Clinical Areas that need development and suggested activities to support these areas

4. Feedback that I have previously received regarding my strengths

5. Feedback that I have previously received regarding areas to work on

6. Previous feedback that I have received that I did not agree with

7. Previous placements and clinical experience

8. Academic areas I enjoy

9. Academic areas I find difficult to integrate into my clinical development

10. Learning style preferences

11. Indications of first language, if other than English

12. Other information

Signature: Date:

BSc/MSc Speech and Language Therapy

PERSONAL PLACEMENT AIMS

Name:

Term and Year

Type of Placement:

PERSONAL AIMS FOR PLACEMENT( these aims need to be measurable so that you can evidence that you have achieved them)

SKILLS/KNOWLEDGE I WILL DEVELOP

How I will evidence this development in skills/knowledge

1.

2.

3.

4.

Notes: ideas for next personal aims

BSc/MSc Speech and Language Therapy

PERSONAL PLACEMENT AIMS Example

Name:

Term and Year Autumn 2017

Type of Placement: Paediatric Preparation Clinic

PERSONAL AIMS FOR PLACEMENT( these aims need to be measurable so that you can evidence that you have achieved them)

SKILLS/KNOWLEDGE I WILL DEVELOP How I will evidence this development in skills/knowledge

To write up notes in SOAP format

To ask a question each clinic session

To be able to describe the role of the paediatric OT on this placement

Written observations

Structure of how to write SOAP notes

Professional Writing style

Knowledge of appropriate content

Use of professional terminology

Speed of writing

Purpose of case notes

Confidence to ask questions

The ability to ask questions using appropriate professional terminology

Independent thinking

Active listening

Knowledge from the answer received

Knowledge of the OT role

Knowledge of how the OT can work collaboratively with SLT

Ability to ask relevant questions

I will compare and contrast my SOAP notes from the beginning, middle and end of the placement.

I will write a reflective narrative on the skills and knowledge I did develop in SOAP note writing from the start to the end of the placement

My current confidence rating to ask questions is 3/10. I will re-rate my confidence at the end of the placement.

I will reflect on why my confidence rating has changed

I will make a written record of the questions I ask and the knowledge gained.

I have recorded my bassline knowledge at the start of the placement and will add to it during the placement.

I will critique the first observation schedule I use for strength and areas to develop; will then use again and re-evaluate

To devise and use an observation schedule for use in the classroom Knowledge of what I need to observe

Ability to make accurate observations

Accuracy of interpretations

Flexibility in using an observation tool

Notes: ideas for next personal aims

First day placement checklist

Student’s Name BSc/MSc 1 2 3 Date Placement Educator’s Name Employing Organisation

PE = Placement Educator Yes/No/NA

PE has received by email from the student the : PE handbook

Report form

PE has read and discussed with you your personal aims

PE has read and discussed with you your personal profile (including learning styles).

PE has talked with you about the Clinical setting

You have received the Student Induction Pack

You have discussed and agreed how and when feedback will be provided

You have agreed a date/time for mid-placement review

You have agreed a date/time for end of placement report discussion

PE has discussed with you key policies and how to access to them: Infection control Safeguarding Equality and Diversity

Adverse Incident/Near Miss reporting

Dress Code Other(Please name)

PE has Informed you of Emergency procedures including location of: alarm call points/fire marshal. fire extinguishers emergency exits and

assembly point first aid box and first aider

PE has discussed with you relevant risk prevention in relation to the:

Clinical environment

Lone working

Equipment

Placement related emotional stress

You have had a tour of the premises and introductions to key staff

You have discussed administrative arrangements e.g. computer access, photocopier codes, phone use

You have swapped contact telephone numbers

You have provided an emergency contact number

Your PE has your clinical tutor contact details

You have discussed any coursework relevant to the placement and consent forms

Record of Telephone Contact with Supervising Clinician

Name of student: Name of Placement Clinician:Email of Placement Clinician:Telephone Contact number of Placement Clinician:Number of Sessions at time of contact:Placement Type:Placement dates: from _ _ / _ _ /_ _ to _ _ / _ _ /_ _ Please circle:MSc or BSc Year: 1 2 3 4

Comments (completed by the Clinical Tutor following contact)

Professionalism e.g. Appearance &

professional presence Timekeeping,

awareness of confidentiality

Asking for advice when

appropriate Degree of responsibility

taken Interaction with clients,

SLT, other professionals

Theory to Practice e.g. Asking relevant

questions Adequate theoretical

knowledge Relating theory to

practice

Management e.g. Planning and carrying

out assessment and treatment

Interpreting and discussing findings

Report/case note writing

Self-reflection and implementing feedback

Other

Any further action required by the clinical tutor

Date Signature (Clinical Tutor):

This form will be placed in the student’s academic file

Actions to be taken when concerned about a student’s progressPLACEMENT EDUCATOR HAS CONCERNS OVER STUDENT PERFORMANCE

PE contacts Clinical Tutor

PE discusses issues with student**

Clinical Tutor has discussion with PE and student

All parties to keep a written record of all discussions

No further action at present -agreed by all

Action plan agreed

** The PE contacts the most relevant person within their SLT service to discuss these issues and any support from servicer required. (Student confidentiality must be kept)

Statement of Confidentiality

HCPC Guidance on Conduct and Ethics for Students: Respect Confidentiality. You should: keep information about service users and carers confidential, and only use it for the purpose it was

given

follow local policies or guidelines on confidentiality produced by your education provider and

practice placement provider

remove anything that could be used to identify a service user or carer from information which you

use in your assessments or other academic work related to your programme

The confidentiality statement and guidelines below refer to ALL WRITTEN WORK, ORAL PRESENTATIONS

and ASSESSMENTS in ALL modules; to any mode of communication in any location, including email,

Blackboard and social media

Clinic/medical notes Under no circumstances remove confidential notes and information from the clinic

When summarising case histories, making your own notes, writing case studies, writing and

delivering presentations, always anonymise your notes/work according to the guidelines below

Never talk about clients by name anywhere in public

You must ensure that you have the full permission of your supervising clinician prior to making any

photocopies; any photocopies must have all identifying information removed in accordance with

the guidelines below.

Ensure any identifying information is FULLY DELETED ( do not use correction fluid; draw a line

through or scribble out and ensure it cannot be seen in any light)

Any oral or written work submitted where one or more of guidelines below is breached will incur a minimum

10 mark penalty. It is YOUR responsibility to check this by using the guidelines below. You will be required to

attend a meeting with the clinical coordinator to determine an action plan to avoid any future breaches

Prior to submitting/presenting work it is your responsibility to check that you have: only used one initial

only given the age of client (e.g. 79 years; 3 years 6 months), not their date of birth

deleted the names of all professionals and relatives, friends etc.

only used titles (e.g. ENT Consultant; parent) for professionals and relatives

deleted the names of any locations, services, professionals, any identifying name

deleted all addresses, and web addresses

deleted all letter heads and logos

deleted any other information which could be used in isolation or in conjunction to identify the client

I have read this statement and will adhere to these confidentiality guidelines

Student Signature ..............................................

PRINT Full Name .............................................. Date

Please email a signed copy of this statement to l.a.heaton@reading.ac.uk

Session plan –assessment

Assessment Session Plan - Evidence of clinical reasoning

Client’s Initial Age Date Assessment EnvironmentRationale for assessing this client

(why am I assessing this client?; relevant background information about the client; impact; previous therapy; what does the client want to get from the session?)

What do I need to assess and why?

(e.g. verbal comprehension; play; mental capacity )

What factors do I need to consider for this client when choosing my assessment method? (e.g. attention; vision; language demands)

How am I going to assess this client? Why have I chosen this method?

(e.g. observation;, informal assessment, standardised assessment)

Assessment Session objectives: derived from the reasoning in the sections above. The number of objectives is individual to the client and the situation; objectives must be SMART.

1.2.3.

Outcome of assessment and interpretation Management Decision with rationale

Post Session Reflections

Client’s Initial Age Date Assessment Environment

What clinical skills/knowledge did I use effectively?

Consider the impact of this on the outcome of the session objectives; what the client gained form the session

What clinical skills/knowledge do I need to develop and why?

Consider the impact of this on the session/future sessions; what the client gained from the session

University of Reading Speech and Language Therapy

Session Plan – intervention

Intervention Session Plan - Evidence of Clinical ReasoningClient’s Initial Age Date Position of session within the client’s management: Relevant Information about the client

Objectives (May also be known as aims, targets or goals on placement)

Specific Measurable Achievable Relevant Time bound

Why have these objectives been chosen?(holistic knowledge of the client; baseline evidence; what client wants to gain from intervention; impact for client/others; relevant theory)

Outcome

Long Term objectives 1.

Short term objectives

Session objectives

2.

Activities and materials needed for session objectives How will I simplify the objectives if the client is under-achieving how will I know when to modify them? How will I modify activities to incorporate this?

How will I develop the objectives if the client finds them too easy and how will I know when to modify them? How will I modify activities to incorporate this?

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Post Session Evaluation Client’s Initial Age Date Session numberNow I have evaluated the session objectives, what are my next session objectives for this client (which will progress them towards the SHORT term objective/s?)Why have I chosen these as my next session objectives?What clinical skills/knowledge did I effectively use? Consider the impact of this on the session

What clinical skills/knowledge do I need to develop and why? Consider the impact of this on the session/future sessions.

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Placement Evaluation form

Introduction to Placement Evaluation for all learners in HETV and HEW

The University seeks feedback from students on clinical placements to enable us to ensure quality and development of these placements. We do this via informal means (discussion with yourselves), but also by formal feedback. How we do this is led by Health Education England who are responsible for monitoring quality of placements. As this is a national initiative we utilise the questions developed by the national ‘learner voice’ working group, in which we have involvement.

Health Education Thames Valley (HETV) and Health Education Wessex (HEW) are responsible for working with your placement and education providers to ensure that the healthcare education you receive is of the highest quality. The NHS Constitution and HETV/HEW ‘Learning Placement Charter’ expect all healthcare professionals to take responsibility for providing honest and constructive feedback on their practice experience, and for this to be heard and responded to. Your placement evaluation is one of the key tools used to recognise areas of excellent education in practice, but to also identify those requiring improvement.

Stakeholders (learners, placement providers and universities) from HETV and HEW have shared good practice, and developed a multi-professional placement evaluation framework with agreed principles, and identified priority themes and core questions for all HETV and HEW learners/trainees to answer about their practice experiences. These were piloted across a range of professions, organisations and learners during 2014 and changes made in response to feedback received from stakeholders.

The final recommended questions for inclusion in all HETV and HEW placement evaluations are listed below; the tool includes four nationally agreed questions (in red) to enable reporting to Health Education England (HEE). The questions you are being asked provide relevant feedback to your Educator, the organisation providing you with your practice experience, University of Reading and to HETV, HEW and HEE (Health Education England) who commission and support healthcare training. We have added some questions to further enhance this feedback about the placements we organise for you here at the University of Reading

A process to assure all stakeholders, including yourselves, that your feedback has been heard and responded to in a consistent and timely manner is being implemented in partnership alongside this initiative. To support this process, your feedback should always be given professionally as your comments may be shared verbatim; whilst it will be kept confidential and be anonymised when shared with stakeholders, you are accountable for your feedback and can expect any specific concerns raised to be followed up individually and professionally with you by your university in partnership with the placement provider. This will ensure continual improvement in the learner/trainee experience in practice and supports HETV and HEW organisations’ ambition to be your future employer of choice.

Please take the time to answer these questions within 2 weeks of the end of each placement, as directed by your university/education provider – your feedback is important to your placement, University of Reading , HETV/HEW and HEE, and will further enhance learning in practice as part of a wider education quality assurance process.

Please complete this survey about your most recent or current practice experience within two weeks of placement completion.

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BACKGROUND INFORMATION:i. Which University / College are you currently studying at? or N/A

ii. What Healthcare Programme / Training are you currently studying?

University of Reading Speech and Language Therapy

iii. Are you BSc or MSc Speech and Language Therapy

iv. Which year of the programme are you in?

v. What are the dates of your most recent placement?

vi. Name of Trust / Organisation?

vii. Client Group (adult; paediatric; ALD)

viii. Service setting, e.g. language unit; in-patient acute; triage; drop-in; domiciliary etc.

Theme 1: Learner Induction Skills and Preparation ‘…to ensure that service users are cared for by staff (including learners/trainees) who are properly inducted and prepared for practice…’Qu. No.

Question/Statement Rating ScaleScale 1 to 5(1 = strongly disagree 5 = strongly

agree)1 The quality of the University preparation pre-placement was excellent.2 There was excellent pre-placement information from my placement area (e.g. first

contact, mentor /educator / supervisor name, placement profile, pre-placement reading).

3 My own preparation for this placement was thorough.4 My local induction/orientation to this placement was excellent.Theme 2: Quality of Placement Education and Excellent Role Models in Practice Education - Learner Experience of supervision on clinical placements

5 My Educator understood what was required for my learning outcomes.6 I received constructive feedback (verbal & written) during this placement about my

learning needs and achievements which has enabled my professional development.7 I felt supported in this placement to make improvements in the care I deliver.8 Overall, the quality of the supervision I have received on this placement was

excellent.Theme 3: Quality of Learning Experience & Learning Opportunities - ‘Quality of Clinical Training’;

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linking theory to practice, ‘…workforce is educated to be responsive to changing service models and responsive to innovation and new technologies with knowledge about best practice, research and innovation…’9 Overall, I was provided with a range of learning opportunities which were

appropriate to my stage of training and allowed me to meet my learning outcomes.Theme 4: Quality of Team Leadership: Support for Learners; Team Culture & Values - ‘Staff (including learners/trainees) opinion on the standard of care provided’

10 The leadership of this team demonstrated a positive culture for learning and development, which supported me, and other learners, to ask questions and challenge each other.

Theme 5: Inter-Professional Working & Learning – ‘Safe & competent teams who communicate and put the patient at the centre of their care’

11 I witnessed excellent communication between team members, other professionals, teams and agencies, to ensure high quality patient care, which has had a positive impact on my learning. 12 I had appropriate opportunities to experience inter-professional and inter-agency working (to learn about the unique contribution to patient care made by all staff, and from a range of professionals).

Theme 6: Quality of Patient Experience & NHS Constitution (High Quality, Safe Practice Experiences) – ‘Putting patients first and at the centre of everything we do, ‘Staff (including students) opinion on the standard of care provided’.13 There is clear information about where to go for support, both in the placement

provider organisation and the University.14 This placement enabled me to give patients/service users the best care and put them

at the centre of everything I did.15 I would feel able to raise concerns about patient care and/or learner experience. Yes/No16 Please explain your answer (to question 15) (Free text)17 Would you be satisfied with the standards of care in this environment for a friend

or member of your family?Yes/No

18 Please explain your answer (to question 18) (Free text)19 Would you recommend this placement as a valuable learning experience? Yes/No20 Please explain your answer (to question 19) (Free text)General – To prepare you for your future professional role, and for the benefit of patient care and future learners in this service, please comment in more detail in the free text boxes below on the following:21 What were the strengths/most valuable aspects of this placement?

Please give examples of good practice.

22 In summary, if there was one area that you could suggest to improve the learner experience on this placement what would it be?

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Guidelines for Clinical Diary(To be completed for each child/adult ensuring that throughout the confidentiality of client and clinician is

maintained as per your confidentiality statement)

Clinic Type:

Patient/Client Initial Age:

Diagnosis:

Observations of clinician or Tasks carried out by student with client

For each client begin with a new diary. Consider which of the following aspects/headings below you observed/commented on or have carried out.You may wish to just keep adding to one diary for a particular client as they work through the different aspects of the assessment and management process within speech and language therapy.

Reflection:At the end of the session consider one aspect of the session to reflect on and write this out on the diary. You will not be able to do this in detail for all clients as the programme progresses.

Things you may wish to include: (this list is not exhaustive) Observation of client:

Observation of client/therapist interaction:

Assessment: see assessment process seminar to consider which aspects of assessment to include

Therapy aims:o Long term:

o Short term:

Outcome measures: how will we know if the aims are met?

Liaison with parents/carers:

Liaison with other professionals:

Therapy procedures/techniques: what was used? [You may wish to reflect on a) what worked well and why or what did not work and why or b) what skills did the therapist (or you) need to do these tasks]

Other sources contacted for information:

Referral on to:

Case notes written:

Any special equipment or references used:

Any specialist clinics attended:

Other:67

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Clinical Diary (To be completed for each child/adult maintaining confidentiality)

Year of study:

Clinic Type: (adult/paediatric/ALD/specialist)

Patient/Client: Age:

Diagnosis:

Insert relevant headings here

Reflection

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Five Moments for Hand Hygiene at the point of care

Name of Placement Eductaor SignatureDate

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Remote Supervision to a Placement Student If you are considering a remote style of supervision as part of your clinical placement model, please read through the checklist below. A clinical tutor will be happy to advise you on any aspect of the placement (contact details below). These guidelines are in addition to the first day placement checklist.

Early on in the placement:o I have directly observed the student working with a similar client group to determine

their current level of competency, in order to provide an appropriate level of support for this model of placement.

Risk assessments:o I have previously visited the setting my student will work in and am happy that it is a safe

setting in which to work, and to travel to, from the placement base. o I have taken into consideration any specific needs / disabilities my student has disclosed

to me.o I have communicated with the clients and relevant staff at this setting that the student

will be visiting alone, and explained the student’s level of responsibility. o I have clearly communicated to the student whom they should report to on

arrival/departure or if they are unable to attend the appointment.o I have made the student aware of how to report ‘Serious and Untoward Incidents’,

including Child Protection and Safeguarding of Adults, as appropriate to the placement setting.

o The student is aware of the Fire Evacuation Procedure for each setting they visit.Supervision of the student:

o I have discussed with the student the purpose of the session(s) they are to undertake. o I have seen the student’s session plan(s) and have advised as appropriate.o I have agreed with the student how and when we will discuss feedback on their

independent session(s).

University of Reading Speech and Language Therapy Degree Programmes MSc Student Clinical Handbook 17-19

Student Guidance Notes for Clinical Tutor VisitsOne of the clinical Tutor team will arrange to visit you in one of your final year clinics. This will be either your adult or paediatric placement and will be chosen at random. The clinical tutor will initially contact your placement educator to agree a suitable date. The clinical tutor will then confirm the date with you.The intention of these visits is to see you working within the clinic environment as appropriate to the caseload. We do not expect your placement educator to arrange a special appointment or create a situation you would not normally be working with. A clinical tutor or academic member of staff will observe you working with one client, although this may be on a one-to one basis or within a group. You will be asked to provide a short summary for the visit. This should contain the following information:

1. A brief history of the disorder including relevant personal, developmental and medical history; assessments (you may find it useful to present assessments in a table format); diagnosis; past speech and language therapy if appropriate.

2. Rationale for current therapy, including long- and short-term aims.3. Plan for session to be observed using the appropriate form.4. Copies of any materials to be used that may be helpful to the visiting member of

staff.The purpose of the summary is to permit the member of staff to rapidly gain an overview of the client's communication/swallowing disorder and the management approach you are using. It should therefore normally be no longer than 4 sides of A4 (including the session plan).

If your placement procedure means that you do not know who you will see from one week to the next, prepare a generic review/initial assessment session plan and discuss with the tutor how you will brief them on the day when you know who you are seeing.

Your session with your client will be observed by both your placement educator and the visiting clinical tutor.

Following the session with your client there will be a period of time to discuss the client. This will usually follow the same format as the feedback discussions you normally carry out with your placement educator. This discussion will be for about twenty minutes and will allow you to reflect on the session and plan and discuss considerations for your client in a wider context.

Guidance notes for clinic visits 1. Check arrangements with your tutor and placement educator, making sure everyone

knows the following: Place (precise directions within your setting are helpful) time of arrival length of visit how many clients are to be seen (normally one) Emergency contact details in case of last minute changes.

2. Request access to the speech and language therapy notes and, if possible and appropriate, medical notes, so these are available as well as your own notes for the session. It is helpful if the clinical tutor can have your summary in advance (a few days

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ahead of the visit is generally sufficient) but it is recognised that this is not always possible.

3. Make sure you have checked the information you are using. For example, you should have some knowledge of assessments reported, the scope of the assessment scores gained and the conclusions drawn from assessments.

4. Include some general background information in your summary as well as details of assessments, aims of the intervention and your therapy plan for the session.

5. Make sure you consider carefully the nature of the disorder you are treating. A label such as 'expressive dysphasia' or 'word-finding difficulty' is insufficient.

6. You are not expected to know everything about the disorder; you are a student and therefore learning. The visits are primarily tutorial.

7. The clinical tutorial discussion aims to explore in more depth your ideas about the client you are seeing and how this fits into the service delivery in your particular placement setting.

8. If you are carrying out a treatment session this should follow from a clear assessment summary and be motivated not only by theoretical considerations, but also by the communicative needs of the client.

9. Take into consideration your client and their part in the visit. This means showing consideration of him/her as a person within his/her social context. Explain the nature of the visit, if this is appropriate, and check that they are happy to be involved. Introduce the clinical tutor to your client at the beginning of the session where this is appropriate.

10. If you have concerns about your placement don't wait for a clinical visit before voicing your anxieties about the placement or your clients. Discuss these with your placement educator if this is appropriate and/ or contact your clinical tutor if you need to discuss things further.

11. Ensure confidentiality. We expect that you have followed the confidentiality guidelines within the personal notes you use in the session/send to the clinical tutor.

12. Clinical visits are expensive in terms of time, but they are an important part of the teaching programme. You should therefore consider them as a learning experience rather than an examination.

13. The visiting clinical tutor will follow up the session by e-mailing written feedback to you based on the tutorial discussion. See overleaf.

14. Nobody expects you to be fully confident and competent. You do, however have a professional duty to put your clients' requirements and needs before your own anxieties. The visiting member of staff will be looking for signs of professional growth as well as an increasing knowledge base.

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Clinical Placement Tutorial Visit

Student:

Placement: Placement Educator:

Preparation for SessionHandout:

Rationale for current therapy including long and short term aims:

Session Plan:

Session:Consider issues such as: communication with the client; establishing a therapeutic environment; appropriateness of tasks to both the client and the session aims; introduction of tasks; feedback given to client; flexibility demonstrated within the session.

DiscussionComment on ability to consider client within their communicative context; self-reflective skills; objective evaluation of session aims and ability to engage with tutor in a professional manner.

Clinical Tutor: Date of Visit:

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Dysphagia clinical experience and clinical learning opportunities on placementSuggestions for clinical experience and clinical learning opportunities on placement with specific reference to dysphagia.

CLINICAL TASK Observation of clinical practice Engaged in Clinical practiceunder direct supervision of

PE(note level of support)

Engaged in Clinical practice under indirect supervision

of PE (note level of support)

Identification and use of relevant information from a range of sources (e.g. medical notes, nursing staff, parents, carers, school staff)

Case history taking from client (as appropriate to client group)

Oro-motor assessment

Clinical Swallowing Examination (with oral trials)

Observational assessment of client eating/drinking (formal and informal procedures)

Objective assessment techniques (FEES & VF)

Adjunct assessment techniques (Cervical auscultation & pulse oximetry)

Dysphagia Screening Test (local protocol for non SLT staff)

Preparation of thickened drinks and modified food consistencies

Feeding other people and being fed in a range of positions

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CLINICAL TASK Observation of clinical practice Engaged in Clinical practiceunder direct supervision of

PE(note level of support)

Engaged in Clinical practice under indirect supervision

of PE (note level of support)

Formulating dysphagia diagnosis/hypothesis of impairment

Verbal feedback to SLT

Verbal feedback to client and/or relatives

Verbal feedback to MDT members

Formulating clinical notes (SLT or medical)

Formulating guidelines for staff or carers

Formulating management plan (compensatory)

Formulating management plan (rehabilitative)

Identification of /participation in referrals to other disciplines

Discussion of alternative feeding methods (with client, SLT or others)

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CLINICAL TASK Observation of clinical practice Engaged in Clinical practiceunder direct supervision of

PE(note level of support)

Engaged in Clinical practice under indirect supervision

of PE (note level of support)

Discussion of ethical issues (with client, SLT or others)

Discussion of risk management (with client, SLT or others)

Identification and use of utensils and/or aids

Carrying out compensatory swallowing intervention

Carrying out rehabilitative swallowing intervention

Carrying out oral hygiene programmes

Involvement in mealtime feeding programmes

Tracheostomy management (e.g. weaning, speaking valves)

Participating in in-house training, INSET days and workshops

Researching conditions, dysphagia presentations and/or management

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THE UNIVERSITY OF READINGSchool of Psychology and Clinical Language Sciences

MSc and BSc Speech and Language Therapy

THE UNIVERSITY OF READING

MSc Speech and Language Therapy

Summary of Clinical Placements Record of Clinical Placements

Name: Year of entry:Year 1 Location (s) e.g. community

clinicType of placement(s)/Client Groups seen Skills and Knowledge developed No. of sessions( a session is

half a day)Autumn

Spring

Summer

Year 2Autumn

Easter Vacation

Spring

Spring

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University of Reading Speech and Language Therapy

THE UNIVERSITY OF READINGDepartment of Clinical Language Sciences

Video Consent Form

MSc Speech and Language Therapy

Please tick all the relevant boxes to indicate how you wish the video to be used:

(At no point will the video be put on the internet or be accessible by the internet)

To contribute to the client’s own assessment and therapy programme.

To contribute to this student speech and language therapist’s professional training and assessment.

To contribute to the professional training of other student speech and language therapists at the University of Reading in lectures or seminars. Only speech and language therapy students will see the video.

To contribute to the education of other professionals about communication / feeding difficulties. Only professionals attending education from the Clinical Language Sciences Department will be shown the video.

Declaration of Consent

I give permission for my / my child’s speech and language therapy sessions to be video recorded for the purpose(s) identified above. I understand that:

My / my child’s name will not be disclosed. If the recording is made off the university’s campus, it will be transported safely back to the

University of Reading in a sealed envelope and immediately given to a member of staff for safe storage.

The recording will be kept stored in a locked cupboard in a locked room within the Clinical Language Sciences Department at the University.

At no point will the video be made available to the general public. I can request that the video be destroyed at any time.

Signed …………………………………………………………………

Name …………………………………………………………………

Relationship to client (if relevant) .…………………………………………………

Date ………………………………………………………………

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Notes

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