JCPSLP Vol 17 Supplement 1 2015_lores

Table 1. Pro-ethical practice in clinical education Aim Justification

Strategies

To facilitate and respect autonomy in the student

Basis of rationale for health care

Discuss roles and responsibilities of:

The clinical educator is responsible for ensuring the student and clients are clear on their responsibilities. This explicit discussion is a vital step in being proactive with ethical reasoning by ensuring that role expectations are clear and

• Clinical educator

and clients

• Student

• Client

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 in the clinical placement context

The Code of Ethics and principles of truth, fidelity, beneficence and non-maleficence should be explicitly discussed with reference to clinical education and duties

• What does the code mean to you?

• Do you understand the values, principles and

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 and ensure a broad perspective to facilitate well considered decision-

Consequences

Discuss outcomes and the contribution the

It is essential that the outcomes of the clinical placement are placement makes to: discussed. This will facilitate students’ broad understanding • The local community (society)

of the process of clinical education / placements and the need to consider all parties in their decision-making

• A student • Our clients

making

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. Draw on the resources provided in the reference list to guide your discussions (including legislation, policies and procedures that guide service delivery

To ensure the student is making decisions with an

Other contextual factors (legal and social)

The clinical educator is responsible for ensuring the student and clients are clear on their responsibilities. The external factors depicted in the outer layer of the grid highlight the range of considerations that may differ between contexts.

understanding of the

external considerations of the placement context

such as risk management)

• Do you have any questions about your responsibilities within these?

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

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

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JCPSLP Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology

www.speechpathologyaustralia.org.au