Information for supervisors of clinical interns

  1. All clinical supervisors must be holders of a current Certificate of Clinical Practice

  2. Supervisors must not accept any remuneration from the clinical applicant.  This does not preclude provision of travelling expenses or of supervisory allowances by the employing authority where appropriate.

  3. Supervision of an audiologist must entail the personal and direct involvement of the supervisor in any and all ways that will permit him/her to attest to the adequacy of the Intern's performances during the internship. 

  4. Since the purpose of the Clinical Internship program is to evaluate the clinical effectiveness of the intern, the supervisor must provide opportunities for the applicant to share his/her ongoing evaluation, and to discuss with him/her any areas of deficiency, and ways in which these areas may be improved.

  5. At the conclusion of the 12-month equivalent full-time internship, the supervisor will be required to submit to the Membership Committee, along with documentation as detailed in the Internship Program

    1. A signed report, certifying that to the best of his/her knowledge and belief, the intern has met both the spirit and the letter of Audiology Australia's Clinical Internship program, and has in the opinion of the supervisor, reached a level of professional practice such that s/he may be expected to perform clinical services in audiology competently, without supervision by persons with more education and/or experience. 

Types of Supervision Recognised for the CCP

Supervision of an audiologist must entail the personal and direct involvement of the supervisor in any and all ways that will permit him/her to attest to the adequacy of the intern's performances in the clinical training experience. ASA prefers that supervision is carried out in-house, especially for an intern in the early months of their internship. However, in circumstances where this is not possible details of the proposed supervision should be submitted to the ASA for approval. The following guidelines are provided for the advice of interns and their proposed supervisors, and employers.

In-house Clinical Supervision

In-house clinical supervision applies to those interns working in the same establishment and therefore in daily contact with their supervisor. In-house supervision also covers circumstances where the intern works off-site for short periods of time to see cases such as home visits or to work in another centre for a period of time no greater than 20% of the work week and where the case load is judged by the supervisor to be appropriate for the intern without the immediate support of a more experienced audiologist.

The Supervision Agreement

A formal (i.e., written) supervision agreement helps to facilitate the negotiation of the structure and content of the 12-month clinical development period for the intern and is a requirement for Audiology Australia members undertaking their Clinical Internship. The supervision agreement gives a framework against which both parties can judge progress. It should be done as soon as the intern asks you to take on supervision of them for their Clinical Internship. Both parties should sign the agreement and both should have copies of the agreement. The agreement should be reviewed periodically throughout the 12 months, and at a minimum every 3 months.

Questions to be addressed when negotiating the supervision agreement include:

  1. How much observation does the intern do of other staff? What types of clients are observed? Note: Observation and discussion of what was learned should continue throughout the 12 months, with the intern gradually moving into more complex areas of practice.
  2. How much observation will you do of the intern with the client? When will this occur? How will this occur? ('at elbow' supervision, through observation mirror, video tape of client (remember to have the client sign permission for this to occur)). How will you select clients to directly observe? Who will decide the need for observation? Remember that the intern is skilled to work with non-complex clients in a wide range of areas. However, direct observation enables you to identify areas where further mentoring would benefit the professional development of the intern.
  3. How will you interrupt a session if you feel there is need to redirect the intern's work with a client?
  4. How will feedback be given? When? Will the intern be expected to self-evaluate? In what ways will the intern self-evaluate?
  5. How will you provide a summative assessment to the intern? Remember, Audiology Australia requires the supervisor to sign a document to indicate that the intern is capable of competent, independent work.
  6. When and how will the intern move on to the management of more complex clients?

Fostering clinical independence 

One of the goals of the Clinical Internship year is to develop highly competent, independent clinical skills in the intern. Unfortunately, the word "independence" can convey to the intern the impression that they should not ask questions, should not consult their supervisor and they should manage things on their own. As a supervisor your role is to encourage "independence" through consultation that develops true independent competence in the intern. You can do this by:

  1. Encouraging questions that are enquiring and challenging. Discourage questions that seek "the answer".
  2. Don't provide answers to questions. Instead, ask them how they might find that out? Or ask them to self-evaluate before you discuss it.
  3. Reward the intern for consulting appropriately. Make comments that indicate you appreciate them consulting with you about their clients.
  4. Model appropriate consultation with colleagues and other professionals.

Assessing the Abilities and Skills of the Clinical Intern

A supervisor is responsible for mentoring and assessing a range of generic and professional skills in the intern.  The areas covered include:

Professional and Ethical Practice

A supervisor should ensure that the intern

  1. Practises in accordance with the profession's code of ethics and engages effectively in ethical decision-making.
  2. Ensures confidentiality of information.
  3. Has knowledge of and acts to ensure that rights of individual clients or client groups are not compromised.
  4. Accepts accountability and responsibility for their actions in client management.
  5. Recognises the limits of their own knowledge base and scope of competence and consults with an experienced audiologist when client care requires expertise beyond their scope of competence.
  6. Refers clients appropriately when the client's needs fall outside the scope of audiological practice.

Critical Thinking and Analysis

A supervisor should ensure that the intern

  1. Acts to enhance their professional development and self-evaluates effectively.
  2. Uses the Professional Practice Standards to assess their own performance.

Clinical Skills

A supervisor should ensure that the intern

  1. Uses a structured approach in the process of assessment.
  2. Carries out tests appropriately.
  3. Analyses and interprets test results accurately.
  4. Formulates a plan of care in collaboration with the client.
  5. Identifies expected outcomes including a time frame for achievement in collaboration with the client and monitors these outcomes effectively.
  6. Organises workload to facilitate planned care for individuals and groups.
  7. Collaborates with other members of the health care team.

Communication

A supervisor should ensure that the intern

  1. Communicates effectively with individuals and groups.
  2. Ensures documentation is accurate and maintains confidentiality.

Problems with progress and outcomes in the Clinical Intern's skills

If the supervisor has concerns about the intern's skill development the supervisor should document these early and work with the intern to develop a program to address these concerns. If the intern agrees, the supervisor should consult with Audiology Australia about options for him/her and the intern. It is also recommended that the supervisor consult with the head of clinical education at the university that has graduated the intern. In general, the supervisor who is not satisfied that the intern has reached a satisfactory level within the 12 months can recommend 

  1. Extension of the period of supervision and
  2. Nominate specific areas to be addressed prior to CCP being granted

The Membership Committee of Audiology Australia will make a determination about the requirements for the intern to be granted a CCP based on submissions from the supervisor and intern.