Progress on the
Clinical Doctorate
Discussion
November 2012
Conflict of Interest
None of the presenters for this
presentation have any financial
interests to disclose.
•
•
•
•
•
•
Alex Johnson
Lee Ann Golper
Gregory Lof
Malcolm McNeil
Barbara Jacobson
Susan Langmore
Nov. 2011-Nov. 2012
• Our group has met and planned a
consensus conference on the clinical
doctorate
• ASHA has completed a survey of
members regarding the professional
doctorate
• This session will report on outcomes from
both of these activities
Alex Johnson
Gregory Lof
Barbara Jacobson
Lee Ann Golper
Mick McNeil
Susan Langmore
EMail
Announcement
March 9, 2012
• 251 Program
Directors
• ASHA
• CAPCSD
• Others
June 21-23, 2012
Where the Participants Came From
79
72
2
5
Where the Participants Came From
9%
29%
30%
32%
Clinical Doctoral
Conference:
Consensus Summary
Lee Ann Golper
Barbara Jacobson
Vanderbilt University
Topic 1:The Nature & Type of the
Degree Program Clinical/Professional
Practice at the Advanced Level
Agreed
Clinical/Professional Practice at
the Advanced Level
A. Degree should be earned after
MS degree (non-entry level)
• ?Extension of current MS
degree OR earned after
period of clinical practice
B. 2 or 3 year post MS model
C.Inclusion of current CF model in
this degree (similar to AuD)
D.Current practitioners need a
transitional model
E.Credit should NOT be given for
prior work experience
Divergent Opinions
Discussion of planning
elimination of MS/MA
model and movement
directly into doctoral
entry
• Models from other
disciplines were used
to support this view
(e.g Psychology
PhD/PsyD)
Topic 2: Critical Foundations
for the Degree
Agreed
1. Core learning
outcomes should
consider:
a. advanced clinical skills
and knowledge
b. advanced professional
content (leadership,
supervision, etc.)
Divergent Opinions
1. Foundational content
should include preparation
for practitioners across
settings (schools/health
care)
2. Standards for foundational
content should be
established and agreed
upon by programs
3. Accreditation is
necessary/not necessary
Topic 3: Form/Content of the Program
30-40 credit hours within 3 years;
• 2 years of classes, 1 year of clinical experience
Coursework/Knowledge:
• Research methods/design, statistics,
epidemiology (emphasis on EBP)
• Professional development, supervision theory
• Genetics, embryology, pharmacology,
neuroscience, advance anatomy & physiology
(not inclusive)
Topic 3: Form/Content of the Program
• Specialty seminars in areas of concentration (e.g.
voice)
• Business practices, healthcare/education policy,
leadership, advocacy, ethics
Clinical experience/Skills:
• Specific to area of clinical focus with specific
competencies
• Hands-on instrumentation labs
• Mentor – faculty member (on campus), community
partner with affiliation to academic program
Cognate/minor:
• e.g. supervision, leadership, business practices
Topic 3: Form/Content of the Program
• Emphasis on communication, clinical and
research based presentations (e.g.,
rounds)
Summative project:
• Research alternative – clinically based, capstone
project
Topic 4: Degree Designator
3 Major degree labels
• SLPD
• DSLP
• CScD
To be determined by university or state
policies?
The Discussion Continues…..
• Advantages & disadvantages of accreditation
• Risk of cannibalizing existing resources
(MA/MS practicum needs)
• Need for large clinical employer partners (e.g.
VA)
• Opportunities for consortia and collaboration
• ? FUNDING
• Explore outcomes with former graduates and
clinical partners
• Learn from the experiences of other
professions including audiology
The Discussion Continues….
Dialogue with stakeholders:
•
•
•
•
•
•
•
•
ASHA
CAPSCD
Licensure boards
Accredited SLPs
Students
Accrediting bodies
Administrative entities
Persons with communicative disorders and
their families
Panel of Practitioners:
Addressed the Issue from
Their Perspectives
Panel Participants
Carmen Vega Barachowitz, MA – (Mass General Hospital)
Director, Dept of Speech Language and Swallowing Disorders and Reading
Disabilities
Assistant Professor, MGH Institute of Health Professions
Michael Biehl, CScD - (Greater LA VAHS, Los Angeles )
Staff Speech Language Pathologist Instructor, Cal State University, Northridge
Jennifer Peacock, MA -(Henry Ford Hospital)
Assistant Director, Div of Speech Language Sciences and Disorders, Dept
Neurology
Gail Kempster , PhD - (Rush University Med Ctr, Chicago)
Program Director: Speech-Language Pathology
Associate Professor, Comm Disorders and Sciences
Nancy Creaghead, PhD - (U Cincinnati)
Professor, Department Head (Chair)
Laisons with Schools – gave their perspective
Questions for the Panel and
Discussed in Each Group
1. Do we need a Clinical Doctorate in your setting? What
are the biggest needs from the clinical setting?
a. More clinical expertise?
b. Stronger administrative leadership?
c. Research skills?
2. Why would a doctoral level person be better at
meeting these needs than the MA SLP?
3. Are we falling behind other allied health professions
in your setting?
4. Is there a place for the clinical doc in your setting?
Would they be employed? What are the obstacles?
Do we need a Clinical Doctorate?
1. More Clinical Expertise
Unanimous YES – because: "the depth and breadth of our scope
of practice has expanded so much in the past 20 years……….
• “The student cannot learn the foundations of everything
he/she needs to know in a master’s program
• “MA is not adequate to acquire enough knowledge and
clinical skills in the acute care setting, even with CFY and 1 2 years experience
• More clinical expertise needed in medical settings
• Would advance specialization and broaden scope of practice
• Doctoral level SLP would bring clinical expertise to the
classroom
• This person will know how to apply critical thinking skills and
have greater expertise
Do we need a Clinical Doctorate?
2. Greater Leadership
•
•
•
•
•
We need a greater voice… more authority
More power in dealing with hospital administrator
Work for increased autonomy in the field (billing,
etc)
Would get increased respect from patients and
physicians
School based leaders would have more ability to
push for change with administrators in education
This is another track for SLPs who want to advance
in the professional ladder (administration)
Do we need a Clinical Doctorate?
3. Teaching
• “We need to improve competence of clinical
supervision of student interns, CFYs
• Mentor/teach clinicians/staff SLPs how to
supervise; liaison with university
Clinical Faculty Role
• Would be able to teach courses at local
university in place of MA level adjunct faculty
because of increased clinical expertise
Do we need a Clinical Doctorate?
4. Research Not the primary role!!
• Critique the literature well; teach this to
staff and students
• Participate in research at the institution or
be a participating clinical site for clinical
trials
• Run small research projects – single
subject designs, etc. for presentation at
meetings, publications
Would a doctoral level person be
better at meeting these needs than
an MA level person?
YES –-For all the reasons stated
Are we Falling Behind other Health
Professionals in Your Setting?
• Yes - in the VA, the AuDs are chosen for
Chief over MA SLPs
• Positions of leadership in the hospital are
going to professionals with clinical doctorates
(AuD, DPT, etc)
• (Other voices….) Not yet, but……it will come
“The ‘doctor’ card is helpful currency; it garners
automatic respect and trust from patients,
physicians, and administrators”
“We will have parity with other rehab professionals”
Would a Clinical Doctorate be
Hired in Your Setting?
• May not replace MA level supervisors now
but…in a few years????
• Yes, would be highly sought out in
academic medical settings
• There are opportunities for administrative
positions in schools
• Might be attractive credentials in private
practice
ASHA Academic Affairs Board Survey
(May, 2012)
SURVEYED ASHA members about the
Need, Possible pursuit, and “Accreditation”
of an Optional, Post-Masters Clinical Doctoral
Programs in Speech-Language Pathology
The survey emphasized that we were not
collecting data to be used in considering a
change in the entry level degree requirement
from a master’s to a clinical doctorate.
(Paul Abbas, Kenn Apel, Maria Armiento-DeMaria, Kathy Chapman, Neil Disarno, Julie Honaker, Janet
Koehnke, Malcolm McNeil, Janet Patterson, Loretta Nunez , Ex Officio; Margaret Rogers, CSO for Science
& Research)
ASHA Academic Affairs Board Survey
(May, 2012)
The survey was fielded to a random
sample of 4,083 ASHA-certified SLPs
in the United States
• Highest degree in CSD was a master's degree
• Primary employment was clinical service provider
• Return rate = 682 (17%)
“The demographics of survey respondents mirrored
that of the target population.”
(Sarah Slater, ASHA Director of Surveys & Information)
ASHA Academic Affairs Board Survey
Respondents Practice Settings
Schools
41.4%
Healthcare
38.4%
College/University
7.7%
Other
9.4%
Not Employed/Retired
3.1%
ASHA Academic Affairs Board Survey
The Degree Need and the Accreditation Need:
• Do you believe that there is a need for an
optional post-master’s clinical doctorate in
SLP?
• Would you pursue an optional post-master’s
clinical doctorate in SLP?
• Do you think an optional post-master’s clinical
doctoral program should have oversight by an
accrediting body (accreditation)?
NEED for the Degree
“Do you believe that there is a need for an optional postmaster’s clinical doctorate in SLP?”
Response
All
School
Univ.
Health
YES
47.5%
43.9%
48.1%
49.4%
NO
22.1%
23.7%
28.8%
20.3%
UNCERT.
30.4%
32.4%
23.1%
30.3%
• No difference across practice settings
• Overall, about twice as many find a need as do not
• One third of respondents uncertain
PERSUIT of the Degree
“Woud you pursue optional post-master’s clinical doctorate
in SLP?”
Response
All
School
Univ.
Health
YES
25.4%
22.0%
19.2%
31.4%
NO
40.5%
39.7%
73.1%
34.1%
UNCERT.
34.1%
38.3%
7.7%
34.5%
• Many more WOULD NOT pursue the degree than would
Need for Oversight
“Do you think an optional post-master’s clinical doctoral
program should have oversight by an accrediting body
(accreditation)?”
Response
All
School
Univ.
Health
YES
84.6%
81.5%
82.7%
87.3%
NO
2.1%
2.2%
1.9%
2.3%
UNCERT.
13.4%
16.4%
15.4%
10.5%
• STRONG opinion in favor of accreditation
Strength of Need for Oversight
“I would only consider an accredited optional post-master’s
clinical doctoral program.”
Response
All
School
Univ.
Health
Only
70.9%
70.7%
83.7%
70.2%
Either
10.3%
9.1%
6.1%
12.0%
UNCERT.
18.8%
20.3%
10.2%
17.8%
• STRONG opinion in favor of accreditation
Summary of ASHA Survey
• More than twice as many
respondents find a need for the
optional post-masters clinical
doctorate as do not
• There is no difference across practice
settings
• Strong opinion in favor of need for
accreditation
What’s Next?