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102

JCPSLP

Volume 15, Number 2 2013

Journal of Clinical Practice in Speech-Language Pathology

society in bringing about growth in the health workforce,

while the actual process of their training is also beneficial

in some way to all clients that they come into contact with

on their clinical placements. In that sense it is important

to consider that although a session may not run optimally,

any effect may be short-term, balanced against the longer

term outcome for the client (as the student will learn from

the experience and invest additional time in their planning)

and society. Table 1 includes discussion points that can

be used by clinical educators to facilitate students’ broad

understanding of the process of clinical education and the

specific placement itself.

A broader ethical issue encompasses the significant

diversification of our profession and society as a whole.

Universities have a responsibility to embrace student

diversity, and Lincoln (2012) discusses the need for

clinical educators to adapt to universities recruiting

more Indigenous, culturally and linguistically diverse and

international students. As this shift is a relatively new one

in our profession, the opportunity for clinical educators to

draw upon previous experience is reduced. The current

needs of these students may not align with clinical

principle of fairness (Speech Pathology Australia, 2012) and

the need for all clients to have equitable access to services,

within the presence of waitlists and other constraints on

the service. Such decisions are delicately balanced as

presented in Figure 2, and the consequences of these

decisions cannot be ignored, for both the student and the

client who the student will (or won’t) see. It is advantageous

for the clinical educator to draw upon their previous

experiences in client management, student development

and clinical education, to ensure they allow all parties

the best possible outcome when selecting clients within

the difficult balance of clinical education. Asking oneself

questions such as: “Have I experienced a case like this

before? How did I manage this? What were the outcomes?

Should I respond in a similar way or modify my decision-

making?” will help guide the clinical educator in their current

planning.

It must not be forgotten, however, that often the

placement of students facilitates expanded service delivery.

The end product of students’ clinical education (being

graduation and entry into the workforce) has benefits for

Table 1. Pro-ethical practice in clinical education

Aim

Justification

Strategies

To facilitate and respect

Basis of rationale for health care

Discuss roles and responsibilities of:

autonomy in the student

The clinical educator is responsible for ensuring the student

• Clinical educator

and clients

and clients are clear on their responsibilities. This explicit

• Student

discussion is a vital step in being proactive with ethical

• Client

reasoning by ensuring that role expectations are clear and

Discuss clinical education process:

no assumptions are made.

• Relationships

• Supervision

• Feedback

• Learning opportunities

Develop clinical placement contract

Discuss responsibilities within the clinic:

• How does the clinic work?

• Who is responsible to whom?

• And why?

• What are the processes and responsibilities?

• Does everyone know this?

To facilitate students’

Duties aligning to key ethical principles

Discuss the Code of Ethics:

practical understanding of

The Code of Ethics and principles of truth, fidelity,

• What does the code mean to you?

the Code of Ethics in the

beneficence and non-maleficence should be explicitly

• Do you understand the values, principles and

clinical placement context

discussed with reference to clinical education and duties

duties?

within the current clinical placement.

• When might you need to apply the code in this

placement?

• How will the code frame our decision-making?

Look at the Code of Ethics together and discuss

examples from previous practice/placements

To motivate the student

Consequences

Discuss outcomes and the contribution the

and ensure a broad

It is essential that the outcomes of the clinical placement are placement makes to:

perspective to facilitate

discussed. This will facilitate students’ broad understanding • The local community (society)

well considered decision-

of the process of clinical education / placements and the

• A student

making

need to consider all parties in their decision-making

• Our clients

throughout the placement.

• Clinical educator

For each point above, discuss self-management,

readiness, preparation and motivation for the

clinical placement from both the clinical educator

and student point of view.

To ensure the student is

Other contextual factors (legal and social)

Draw on the resources provided in the reference

making decisions with an

The clinical educator is responsible for ensuring the student

list to guide your discussions (including legislation,

understanding of the

and clients are clear on their responsibilities. The external

policies and procedures that guide service delivery

external considerations of

factors depicted in the outer layer of the grid highlight the

such as risk management)

the placement context

range of considerations that may differ between contexts.

• Do you have any questions about your

responsibilities within these?