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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?