Taking Clinical Education Outside University of Tennessee student clinicians put down their flashcards and provide treatment in the great outdoors. Academic Edge
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Academic Edge  |   December 01, 2016
Taking Clinical Education Outside
Author Notes
  • Tricia Hedinger, MS, CCC-SLP, is an assistant clinical professor in the Department of Audiology and Speech Pathology at the University of Tennessee Health Science Center. She is an affiliate of ASHA Special Interest Group 4, Fluency and Fluency Disorders. thedinge@uthsc.edu
    Tricia Hedinger, MS, CCC-SLP, is an assistant clinical professor in the Department of Audiology and Speech Pathology at the University of Tennessee Health Science Center. She is an affiliate of ASHA Special Interest Group 4, Fluency and Fluency Disorders. thedinge@uthsc.edu×
Article Information
Professional Issues & Training / Academic Edge
Academic Edge   |   December 01, 2016
Taking Clinical Education Outside
The ASHA Leader, December 2016, Vol. 21, 38-39. doi:10.1044/leader.AE.21122016.38
The ASHA Leader, December 2016, Vol. 21, 38-39. doi:10.1044/leader.AE.21122016.38
“It’s cold!” she said.
Heads snapped around at the sound. The ocean waves lapped as we heard her again. “Water cold!” she shouted. It was loud. And clear.
For the first three days of summer camp, Tahlia used her picture symbols and sign language, and shook her head “yes” and “no” excitedly to communicate her wants and needs. As a 21-year-old camp counselor in the midst of applying to graduate school for speech-language pathology, I assumed this skinny little 8-year-old with a big smile and an awkward gait could not talk.
After all, we had played board games, read books, eaten meals together and done a bunch of arts and crafts for the past three days. She hadn’t said a word. Until she stuck her feet in the ocean and hollered, “It’s cold!”
“Yes … yes … you’re right, Tahlia! It’s really cold!” I said, beaming with a feeling of accomplishment (for both her and myself).
It has been almost 20 years, but that memory sticks with me like it was yesterday. It guided me in clinical practice and followed me to my role as an educator in a university clinic. Environment makes a difference.
Barring certain circumstances, a speech-language pathologist can conduct treatment just about anywhere, because communication happens everywhere. I’ve held sessions in a tree fort, on a swing set, at the pool, while playing basketball, in Chick-fil-A and on the beach.
But as recently as a decade ago, researchers Carl Dunst and Mary Beth Bruder wrote in Psychological Reports that clinical faculty in physical therapy, occupational therapy, speech-language pathology and other programs provided “minimal training in using everyday community activities as sources of natural learning opportunities.”
When bound by classroom and clinic walls, how do we effectively and efficiently provide instruction using real-life contexts in a way that will be memorable and motivating? We can tell students about our own experiences, have them read articles, or maybe even show them videos of treatment conducted in natural environments.
But, if it’s possible, why not take them for a walk outside of the box?

When bound by classroom and clinic walls, how do we effectively and efficiently provide instruction using real-life contexts in a way that will be memorable and motivating?

Students learn, clients progress
I offer students multiple opportunities to take speech-language treatment outside of the clinic. The most popular option is a highly sought-after clinical experience at a week-long summer camp. The University of Tennessee Hearing and Speech Center in Knoxville is less than an hour from The Great Smoky Mountains National Park. In collaboration with an environmental education facility in the Smokies, we created an overnight camp for children with communication disorders.
The student clinicians experience the benefits of bringing treatment outdoors. “In the therapy room I cannot even get her to look at me,” says Megan Brogan, a first-year graduate student, of her client. “We might make eye contact about four times in an hour-long session,” she says, referring to a 9-year-old social butterfly who was flitting alongside the stream catching salamanders with friends.
“I had reached a point in the therapy room where I really didn’t think she would be able to progress any further,” Brogan says. “I was so wrong!”
Bowling, anyone?
Clinical supervisors need not live in the mountains, sleep in tents or fetch salamanders to give students an out-of-the-box experience. Clients and grad students have ventured out in a number of ways:
  • Taking young clients to playgrounds within walking distance.

  • Going on a tour of a sports arena/museum/campus facility.

  • Ordering lunch at a local fast-food place.

  • Hosting a game night or Parents’ Night Out for clients.

  • Partnering with a therapeutic horseback riding center.

  • Taking clients to a campus basketball court or bowling alley.

  • Visiting an academic department that interests the client.

  • Inviting pet therapy to the clinic.

  • Interviewing a local celebrity with a client.

  • Interviewing a person with a similar communication disorder.

Whether options include going barefoot on a beach or quizzing a campus tour guide, counsel your student clinicians to put down their flashcards and exit the four walls.

Students can incorporate their clients’ articulation, language, fluency, reading and writing goals into these contexts with a little planning. Of course, medical needs, privacy laws, campus regulations and parent permission must be considered before determining outside events. And although some of these activities will not count toward the graduate students’ clinical hours, they may add educational enrichment and appreciation for the profession.
When surveyed, all participating student clinicians “highly recommended” the less-conventional clinical education opportunities. “These little humans that we spend so much time evaluating, analyzing and ultimately treating are still kids!” says graduate student Paige Fisher after a Parents’ Night Out fundraiser, where children with communication disorders mingled with typical peers in a social, nontherapeutic environment. “They have feelings, personalities, questions and interests that should not go unnoticed.”
In training students to exceed expectations and become super SLPs, clinical educators need to help them stretch their minds and say, “Hmmm … I never thought of it that way.” When we urge them to be innovative in their treatment, we encourage their creativity and challenge them to develop new programs and ideas. Whether options include going barefoot on a beach or quizzing a campus tour guide, counsel your student clinicians to put down their flashcards and exit the four walls. Then, sit back and watch their joy for the profession unfold.
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December 2016
Volume 21, Issue 12