Clinical Education

Please email Jennifer St. Clair at [email protected] for the following Clinical Instructor materials:

• Placement Expectations
• Clinic Grading
• Clinical Performance Scale
• Approving clock hours
• Completing the midterm
• Completing the final

Academic Year 2025-2026

Junior Year

Senior Year

• CMSD 467 - Sp. Lang Path & Aud Practicum (1-4 units) – The students have the option of enrolling for up to 4 units of this practicum in the senior year. 
• CMSD 267 - SLPA Fieldwork (Elective) (2 units) – The students have the option of enrolling for this practicum during any quarter of the senior year if needed.
• AHCJ 305 - Infectious Diseases & the Health Provider (1 unit) – The students have the option of enrolling for this course autumn quarter of the junior year or spring quarter senior year.
• Religion courses (2 units) – Must complete an average of 4 quarter units of religion for each year of residence at Loma Linda University. Students enroll in these courses as needed and when it is convenient to their academic loads.

2025-2026 ACADEMIC YEAR

Students in the First Year

Students in the Second Year

Please email Jennifer St. Clair at [email protected] for the following Clinical Instructor materials:

Free Supervision CEUs

There are many challenges to interpersonal communication. Gender differences, cultural differences, and role identity are just a few. The most common challenge is that, often, we just do not understand each other. Research has shown that in a typical dyad, the two communication partners can correctly interpret and explain only 25% - 50% of the other’s behavior. Interpretation plays a role in virtually every human act. Interpretations are influenced by: degree of involvement with the partner; relational satisfaction; past experiences; assumptions about human behavior; assumptions about the other’s background or world view; perceptions about the other person (to name just a few). Evidence shows that judgments say more about our own attitudes than about the other person. Our attitudes impact our communication, sometimes preventing us from understanding the other person’s communicative intent.  In order to be an effective communication partner, each partner must: learn to see our own behaviors and understand how we come across to others; observe with a discerning mind the behavioral styles of others; and adjust as necessary!

In every relationship, adjustments need to be made.  If, however, the clinical instructor and/or student clinician feel that there are problems that threaten student learning or jeopardize quality of service, the following steps should be taken:

1. Determine that expectations of the student are appropriate for the level of experience and education.
2. Discuss concerns directly with student. Provide specific examples and details.
3. Work together to develop a specific plan to address the concerns.  ID deadlines.
4. Contact the Director of Clinical Education (DCE) at LLU to share the plan. Advice and suggestions may be provided.
5. Collect specific data on identified goals.  Have ongoing discussions regarding progress.
6. At deadlines, identify goals that need to be changed/adjusted.
7. Throughout this process, continued honest conversations should happen.
8. Determine that expectations of the student are appropriate for the level of experience and education.

Clinical Improvement Plan (CIP): At various times during the student's progression through clinical rotations there may be specific clinical or professional skills that the student may need to devote special focus to.  Placement on a CIP should not be perceived as a negative as there are many possible causes for the need for this kind of special focus.  Possible causes may be, but are not limited to, lack of previous knowledge, lack of understanding, or lack of exposure.  For this reason, CIPs can be requested and implemented by students or CEs at any time during the clinical experience.  CIPs must be implemented at times indicated in the above flowchart as a part of the clinical assessment process.  This CIP form should be used for all documentation, and the following flowchart should be followed to ensure all aspects are being addressed.  Please contact Jennifer for a copy of the form.

Teaching:

The ultimate goal of the clinical process is for students to actively apply knowledge that is learned in the classroom to the therapeutic setting. As students progress through the levels of the training program, they are expected to move from teacher-focused learning to self-directed learning.  At each level, and in every venue, whether it is the classroom or the clinic, the objective is for students to learn independence.

The classical educational model for progression towards independence is Bloom's Taxonomy (Bloom, 1984). In this model, levels (types) of learning are presented hierarchically, each one being dependent on successful accomplishment of the previous level.

The ability to move back and forth through these levels is critical if one is to be independent in making good clinical decisions. It is the responsibility of the CI to help students move towards mastery each of these levels.

Working within this framework, the CI evaluates the student clinician's level of performance and provides whatever assistance is needed to ensure student learning and quality patient/client care.  The CI identifies the level of functioning of the student clinician, and develops a plan that will move the student clinician to a higher level.

The procedure used by the CI is not unlike that used by clinicians in regards to the client. The process involves: systematic observation of the student clinician; identification of clinical skills that need development; and, provision of appropriate instruction, opportunity to practice, and immediate and accurate feedback.

Assessment:

The ultimate responsibility of the CI is to help student clinicians identify existing strengths that will support the goal of becoming competent and employable professionals and to address those areas that will hinder their achievement of this goal. As part of this process, it is necessary for CIs to assess student clinicians’ skills in many areas, and to base their evaluation on actual performance. It is not necessary to ensure that all skills are mastered in a single quarter; however, student clinicians in their final two quarters of the graduate program should be expected to be approaching mastery on most skills.

Supervision is not just observation. The term, “clinical instruction,” is used purposely throughout this manual in order to reinforce the following principle:  clinical education is a developmental process that intrinsically depends on the participation of the clinical instructor in that process.

Clinical education involves both formative and summative assessment. Formative assessment requires that the student clinician receive organized, continuous formal and informal feedback, opportunities for remediation, and documented progress towards accomplishment of skills. Summative assessment, on the other hand, is a summary of achievement, provided at the end of a specified unit of time.

DIRECT SUPERVISION

The Council for Clinical Certification/ ASHA requires that student clinicians be supervised by an individual who holds the Certificate of Clinical Competence in the appropriate area of practice. The amount of supervision must be appropriate to the student clinician’s level of knowledge, experience, and competence. Supervision must be sufficient to ensure the welfare of the client/patient; however, direct supervision must be in real time and must be a minimum of 25% of the student clinician’s total contact with the client/patient, and must take place periodically throughout the practicum.

DOCUMENTATION

The clinical placement of students is guided by the “rules and regulations” (standards) imposed by several accreditation and certification organizations. ASHA’s Council on Academic Accreditation (CAA) and Council For Clinical Certification (CFCC) set standards for university programs (curriculum) and for the Certificate of Clinical Competence, respectively. The Committee for Teacher Credentialing (CTC) sets the standards for the California public school credential, and the Board of Examiners in Speech-Language Pathology and Audiology (SLPAB) sets the standards for licensure in the State of California. Loma Linda University strives to ensure that our students graduate having met the various standards for all these “governing” bodies. However, since each organization has its own standards (which sometimes do not overlap with each other), documentation may seem cumbersome. Clock hours reporting forms, skills tracking forms, observation reports, supervisory data, etc. are all important pieces of information, designed to demonstrate that the student clinician has met the criteria for the master’s degree, ASHA certification, the teaching credential, and the California license.

The student clinician is responsible for keeping track of the number of clock hours and all other data; however, clinical instructors are requested to carefully read each document in this handbook so that the clinical paperwork is complete and accurate. At the end of the quarter, the clinical instructor will be asked to verify the student’s submitted hours on Calipso.

SCHEDULING

Typically, students are placed in their clinical practicum for ten weeks, consistent with the academic quarter.  The ten week block may be modified, only with permission from the clinical coordinator, when circumstances require it.  Such modifications are considered on a case-by-case basis and the clinical coordinator should be contacted if any changes are being considered.

During the educational fieldwork II and medical fieldwork II experiences, students are required to be on site a minimum of 10 weeks (equivalent to one quarter), fulltime. The goal is to achieve 120-150 face-to-face clock hours in assessment and treatment, as well as have a variety of experiences, achieving competencies noted on the skills tracking form.

The schedule of hours per day and days per week vary according to each placement.  The student clinician and the clinical instructor should jointly arrange a schedule that is reasonable for both. If it does not appear that the student will be able to meet all of the goals for the quarter, the student clinician should inform the clinical coordinator immediately.

Vacations and planned time off should be arranged in advance. There are no unexcused absences. If the student is absent for more than two days, this constitutes excessive absences and the clinical instructor should notify the university clinical coordinator.  The student must make up unplanned missed time if the clinical instructor's schedule can accommodate.

A schedule, in the form of a weekly checklist is included in this handbook.  While the student clinician is responsible for submitting the completed form to the clinical coordinator at the end of the quarter, the schedule can be modified as appropriate for each setting. 

Free CEs in Supervision can be accessed through the link below.  Please contact Jennifer for a code to obtain free access.

Key Principles in CSD Clinical Education

Learner Objectives

By completion of the six modules in this course, the learner will be able to:

• Module 1 - Precepting in Clinical Education
  • Describe the roles and responsibilities of the preceptor and clinical learner.
  • Identify at least three characteristics of an effective preceptor.
• Module 2 - Strategies for Clinical Teaching
  • Describe common models of clinical supervision.
  • Utilize the ‘One Minute Preceptor’ approach to feedback.
• Module 3 - Relationships in the Clinical Education Process
  • Describe communication strategies that enhance preceptor-clinical learner relationships.
  • Explain strategies to productively manage conflict.
• Module 4 - Cultural Dynamics in Clinical Education
  • List aspects of their culture and identity that are relevant to clinical education/precepting.
  • Describe strategies related to culturally responsive teaching that they can incorporate into precepting for clinical learners.
• Module 5 - Assessment and Feedback
  • Define and explain feedback, debriefing, and assessment/evaluation in clinical education.
  • Discuss examples of how to engage in feedback, debriefing, and assessment in as a preceptor.
  • Describe the role of clinical learner feedback for the preceptor and several ways to engage in that discussion.
• Module 6 - Ethics in Clinical Education
  • Identify key ASHA Code of Ethics issues that relate to clinical education.
  • Describe a situation common to working with clinical learners that may present an ethical challenge.
  • Recognize opportunities that may require the preceptor to initiate a challenging discussion.