Exam 1 Review Clinical Methods

Evidence-Based Practice

The integration of best research evidence with clinical expertise and patient values

IEP

Ages 3 to 23

IFSP (Individual Family Service Plan)

Birth to 2

PHI

Protected Health Information

- HIPPA

Services provided competently

- This is a continuous process. It does not end with the completion of a degree

Preparation

"Type of dishonesty that occurs when the truth is distorted or falsified"

Misrepresentation

"Sending a client to another professional whose area of expertise is better matched to the client's needs."

Referral

"The inclusion of clients in professional practice and avoiding clinical decisions based solely on a client's race, gender, ethnicity, religion, age, national origin, sexual orientation, or disability status."

Non-Discrimination

"A compromise in professional judgement in which a clinician loses their sense of objectivity because of personal or financial gains"

Conflict of interest

True or false?

Evidence based practice applies to all settings in our practice

True

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Components of ICF

1. Health Conditions

2. Contextual Factors

Health conditions

- Body functions and structures

- Activity and participation

Contextual factors

- Environmental

- Personal

Performance or Capacity?

How a person executes a task on their own/in real life

Performance Qualifier

Performance or Capacity?

How they execute a task with given support.

Capacity Qualifier

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Things that influence schedules

- Student clinician schedule

- Supervisor's schedule

- Student experience

- Type, frequency, duration

- Population served

- Clients' cultures

- Clinical site's priorities

- Financial resources

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University Clinic Schedules

- Operate during regular business hours typically

- Typically schedule clients 2-3x's weekly for 30-60 minutes

- Diagnostic sessions scheduled for 1-2 hours

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Hospital Scheduling

- May require 6 days per week

- Typically go in early (7ish) and get off around 3-4 to allow for family visitation

- Coordinate with nursing and other rehab services

- Allow time for conferences

- Punctuality

- Schedule time for indirect services

- Verify appoints with admin

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School Scheduling

- IEPS reflect service delivery

- Type of schedule: Intermittent, block, cyclical, blast

- Type of service delivery: - Pull-out, consultation, classroom-collaboration

- Individual or group

- How often services be received per client

- Allow time for consultation with teachers, testing, documentation, parent meetings

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CCC Requirements

- Graduate degree

- Demonstrate knowledge and skills (KASA form)

- Clinical practicum (400 total hours; 25 guided observation; 375 supervised)

- Pass the praxis exam (passing score of 162; 132 questions)

- Clinical fellowship (36 weeks of full time experience with 80% direct clinical contact)

- Code of ethics

- Maintain clinical certification

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Big Nine Areas

1. Hearing

2. Swallowing

3. Cognitive

4. Social aspects

5. Speech production

6. Fluency

7. Voice

8. Language (spoken and written)

9. Communication modalities

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Roles of a SLP

- Clinicians

- Researchers

- Diagnosticians

- Report writers

- Team members

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ASHA practice documents: Scope of Practice

- Delineate areas of professional practice

- Inform others re: roles & responsibilities of providers

- Support SLPs in provision of services

- Support SLPs in research

- Guide educational preparation & professional development

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ASHA Preferred Practice Patterns

- Clinical processes

- Clinical indicators

- Equipment specifications

- Expected outcomes

- Safety and health precautions

- Documentation

- Related references

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ASHA practice documents: Code of Ethics

• Composed of: preamble; terminology; 4 principles; numerous rules

◦ Preamble: summarizes ASHA's philosophy of service delivery; introduces the components of the code of ethics; lists individuals who are governed by code of ethics

◦ COE principle I: "individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a human manner."

◦ COE principle II: "individuals shall honor their responsibility to achieve and maintain the highest level of professional competence and performance."

◦ COE principle III: "individuals shall honor their responsibility to the public when advocating for the unmet communication and swallowing needs of the public and shall provide accurate information involving any aspect of the professions."

◦ COE principle IV: individuals shall uphold the dignity and autonomy of the professions, maintain collaborative and harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards."

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Key Steps in the EBP Process

1. Frame your clinical question

2. Find evidence

3. Assess the evidence

4. Make your clinical decision

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Why use EBP?

- So many intervention strategies have been developing and some do not have a theoretical base

PICO

- Population

- Intervention

- Comparison

- Outcome

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Three types of Communcation

1. Nonverbal

2. Verbal

3. Written

Nonverbal Communication

- Eye contact

- Listening to client

- Appearance

- Timeliness

- Organization of materials and information

Verbal Communication

- Interview skills

parent/family counseling

- Interprofessional meetings

- Professional contacts

- Telephone contacts

- Communicating with supervisors

Written Communication

- Diagnostic reports

- Daily session plans

- Treatment plans

- Progress reports

- Professional correspondence

Cultural competence

A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross cultural situations

KASA standards

- Knowledge and skills acquisition

- Insure: knowledge and skills needed as a grad student clinician; hours spent in the big 9; clinical, written, and oral skills for field

ASHA (what type of regulation are you granted)

- CCC's awarded

- Code of ethics, certification standards, continuing education

- Represents excellence & level of competence

ABESPA (what type of regulation are you granted)

- Arkansas board of examiners in speech language pathology and audiology

- State licensure; consumer protection