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CALIPSO Clinical Performance Evaluation Criteria Updated 8/2017 Below are the minimum areas anticipated to be evaluated by supervisors and students for each type of registration/practicum activity. If an area of evaluation which is not currently marked with an arises during the course of the practicum activity, it should be evaluated, as well. Key: = Rees clinic; = offsite. ATP Coop practicum uses the column. Evaluation Comments: AGrp CLP 1. Conducts screening and prevention procedures (std IV-D, std V-B, 1a; CTC-SLP4) 2. Collects case history information and integrates information from clients/patients and/or relevant others (std V-B, 1b; CTC-SLP4) 3. Selects appropriate evaluation instruments/procedures (std V-B, 1c; CTC-SLP4) 4. Administers and scores diagnostic tests correctly (std V-B, 1c; CTC-SLP4) 5. Adapts evaluation procedures to meet client/patient needs (std V-B, 1d; CTC-SLP4) Note: Includes informal baseline measures and necessary task modifications 6. Demonstrates knowledge of etiologies and characteristics, anatomical/physiological, acoustic, psychological, developmental, linguistic and cultural factors for each cognitive, communication and swallowing disorders (std IV-C; CTC-SLP2) 7. Observes and identifies relevant client/patient behaviors 8. Interprets, integrates, and synthesizes test results, history, and other behavioral observations to develop diagnoses (std V-B, 1e; CTC-SLP4) 9. Makes appropriate recommendations for intervention (std V-B, 1e; CTC-SLP7) 10. Completes administrative and reporting functions necessary to support evaluation (std V-B, 1f; CTC-SLP7) 11. Refers clients/patients for appropriate services (std V-B, 1g; CTC-SLP7) Note: Following evaluation, student appropriately refers patients for speechlanguage pathology services and/or other professional services. An "appropriate" referral constitutes referring when necessary and not referring when not necessary. Please note: Student should receive a score, as verification of this particular skill, in each of the 9 disorder areas of which are being evaluated 12. Develops appropriate treatment plans with measurable and achievable goals DO NOT USE

Intervention 1. Develops setting appropriate intervention plans with measurable and achievable goals. (std V-B, 2a; CTC-SLP5) 2. Implements intervention plans (involves clients/patients and relevant others in the intervention process) (std V-B, 2b; CTC-SLP5) 3. Collaborates with clients/patients and relevant others in the planning process (std V-B, 2a; CTC-SLP5) DO NOT USE 4. Selects or develops and uses appropriate materials/instrumentation (std V-B, 2c; CTC-SLP5) 5. Sequences tasks to meet objectives (CTC-SLP5) 6. Provides appropriate introduction/explanation of tasks (CTC-SLP5) 7. Measures and evaluates clients'/patients' performance and progress (std V-B, 2d; CTC-SLP5) 8. Uses appropriate models, prompts or cues. Allows time for patient response. (CTC-SLP3) 9. Uses feedback/reinforcement which is consistent, discriminating and meaningful 10. Modifies intervention plans, strategies, materials, or instrumentation to meet individual client/patient needs (std V-B, 2e; CTC-SLP3) 11. Completes administrative and reporting functions necessary to support intervention (std V-B, 2f) 12. Identifies and refers patients/clients for services as appropriate (std V-B, 2g; CTC-SLP3) Note: This includes referring clients/patients for continuity of care and transitional services. During intervention, student identifies the need and makes appropriate recommendations for continued speech-language pathology management and/or other professional services. Please note: Student should receive a score, as verification of this particular skill, in each of the 9 disorder areas of which are being managed 13. Structures treatment sessions to maximize learning Comments: AGrp CLP

Preparedness, Interaction and Personal Qualities 1. Demonstrates knowledge of basic human cognition, communication and swallowing processes (std IV-B; CTC-SLP3) 2. Demonstrates the knowledge to integrate research principles into evidence-based clinical practice(std IV-F; CTC-SLP3) 3. Demonstrates knowledge of contemporary professional issues and advocacy (includes trends in professional practice, ASHA practice policies and guidelines, and reimbursement procedures) (std IV-G; CTC-SLP7) 4. Communicates effectively, recognizing the needs, values, preferred mode of communication, and cultural/linguistic background of the patient, family, caregiver, and relevant others (std V-B, 3a; CTC-SLP5) 5. Collaborates with clients/patient and relevant other in the planning process (std V-B, 2a; CTC-SLP5) 6. Provides counseling regarding cognitive, communication and swallowing disorders to clients/patients, family, caregivers, and relevant others (std V-B, 3c; CTC-SLP5) 7. Collaborates with other professionals in case management (std V-B, 3b; CTC-SLP7) 8. Displays effective oral communication with patient, family, or other professionals (std V-A; CTC-SLP5) Note: The definition of 'effective' includes appropriate clarity, rate, pitch, volume and grammar in oral communication 9. Displays effective written communication for all professional correspondence (std V-A; CTC-SLP5) 10. Adheres to the ASHA Code of Ethics and conducts him or herself in a professional, ethical manner (std IV-E, std V-B, 3d; CTC-SLP5) 11. Demonstrates openness and responsiveness to clinical supervision and suggestions 12. Demonstrates personal appearance that is professional and appropriate for the clinical setting 13. Displays initiative, organization and preparedness for all clinical sessions Comments: AGrp CLP DO NOT USE

Written Communication (std V-A; CTC-SLP5) AGrp CLP 1. Uses correct grammar, spelling, terminology, punctuation, tense consistency, voice consistency, etc. 2. Uses the correct format for required clinical documents 3. Writes relevant case history in concise, organized form 4. Accurately and concisely describes results of tests and informal procedures and covers all relevant information and areas, including client/patient strengths 5. Writes in lay-person terms, as appropriate, using examples to clarify 6. Provides an accurate summary of impressions and recommendations 7. Generates clinical documents in an acceptable time frame 8. Incorporates supervisory feedback into document revisions 9. Writes documents that are professional in presentation and tone Comments and Goals AGrp CLP Strengths/ Areas needing improvement: Selected goals for improvement: Progress towards selected goals: Final comments:

Performance Rating Scale Minimum of "3" rating required to meet minimum clinical competency requirement. 1 Not evident: Skill not evident most of the time. Student requires direct instruction to modify behavior and is unaware of need to change. Supervisor must model behavior and implement the skill required for client to receive optimal care. Supervisor provides numerous instructions and frequent modeling (skill is present <25% of the time). 2 Emerging: Skill is emerging, but is inconsistent or inadequate. Student shows awareness of need to change behavior with supervisor input. Supervisor frequently provides instructions and support for all aspects of case management and services (skill is present 26-50% of the time). 3 Present: Skill is present and needs further development, refinement or consistency. Student is aware of need to modify behavior, but does not do this independently. Supervisor provides on-going monitoring and feedback; focuses on increasing student s critical thinking on how/when to improve skill (skill is present 51-75% of the time). 4 Adequate: Skill is developed/implemented most of the time and needs continued refinement or consistency. Student is aware and can modify behavior in-session, and can self-evaluate. Problem-solving is independent. Supervisor acts as a collaborator to plan and suggest possible alternatives (skill is present 76-90% of the time). 5 Consistent: Skill is consistent and well developed. Student can modify own behavior as needed and is an independent problem-solver. Student can maintain skills with other clients, and in other settings, when appropriate. Supervisor serves as consultant in areas where student has less experience; Provides guidance on ideas initiated by student (skill is present >90% of the time).

Grading Scale SPPA -First Registration Start End Letter 4.00 5.00 A 3.66 3.99 A- 3.35 3.65 B+ 3.04 3.34 B 2.73 3.03 B- 2.42 2.72 C+ 2.11 2.41 C 1.80 2.10 D 1.00 1.79 F SPPA -Subsequent Registrations,, 6156 Start End Letter 4.27 5.00 A 3.96 4.26 A- 3.65 3.95 B+ 3.34 3.64 B 3.03 3.33 B- 2.72 3.02 C+ 2.41 2.71 C 2.10 2.40 D 1.00 2.09 F SPPA 6066 Start End Letter 4.57 5.00 A 4.26 4.56 A- 3.95 4.25 B+ 3.64 3.94 B 3.33 3.63 B- 3.02 3.32 C+ 2.71 3.01 C 2.40 2.70 D 1.00 2.39 F