• Nikki McRory

Supervisor Guidelines for Effective Observation of Clinical Fellows

A large portion of our supervision is spent observing the CF leading treatment sessions. The ultimate goal of these systematic observations is to support and guide the clinician to effectively transition from student to independent clinician. To do this effectively, you need to have an action plan.

Plan to take notes. Taking notes during the observation will aid recall of specific examples as well as broader impressions. Consider capturing elements related to the CF's goals, activities, prompts used, client success, data collection and caregiver training where applicable. I learned this when I sat down to complete my first quarter evaluation of my clinical fellow using ASHA’s Clinical Skills Inventory Form. At the time I was struggling with determining which rating to select. It was only after I had time to reflect on my notes and process the whole picture that I was able to confidently select what I believed was the correct rating.

Include a pre-session discussion. Providing the opportunity to discuss the client’s goals, treatment strategies, and progress can provide valuable insights regarding the CFs perceptions, reasoning and treatment efficacy. I learned how important this was a new clinical fellowship told me she was nervous to work with me and to have me observe her. After our pre-discussion she was much more relaxed and had a great session; it only took that one session to build trust and rapport.

Begin with the CF's self-evaluation. At the conclusion of the session observation, prior to providing any feedback, provide the opportunity to for the CF to reflect on their session including what went well and where there might be opportunities improvement. This will help the CF to develop their independence as well as their critical thinking skills. It will also allow provide you with great information regarding where the CF is with respect to their learning journey and where you might need to offer more support.

Provide Effective Feedback: Do not overwhelm the CF with excessive information, but instead distill the many potential pieces of feedback into a core set of strengths and opportunities - ideally no more than 2-3 of each. Be prepared to provide specific examples to illustrate each strength and opportunity. Although some CF's may wish to receive more detailed feedback on the session, CF's early in their fellowship often find it challenging to process and respond effectively to a series of minute-by-minute reflections on what happened or could have happened differently throughout the therapy session. I learned this the hard way when I was first learning how to effectively supervise as I wanted to give them so much information. But really, all it did was cause over-whelm, so trust me when I say less is more!

Follow-up: Make yourself available to discuss questions or revisit points raised during the observation. Consider observing the CF with the same client in a few weeks or having the CF record a future session so that you can discuss progress made on behalf of the clinician.

Having supervised clinical fellows over the course of the past 15+ years, I have learned that having a consistent action plan will reduce stress levels of both parties and will ensure that observations are meaningful with executable outcomes necessary for the clinical fellow to develop their core skills.