Supervision of Clinical Fellows

Overview

The Speech-Language Pathology Clinical Fellowship (CF) experience is a mentored professional experience that begins after the graduate student completes their academic coursework and clinical practicum.

The goal of the CF experience is to allow the Clinical Fellow to transition between being a student enrolled in a communication sciences and disorders (CSD) program and being an independent provider of speech-language pathology clinical services.

As experienced peers in the profession, CF mentors play a critical role in the preparation of speech-language pathologists (SLPs). They

(1) provide professional support and personal guidance to the Clinical Fellow throughout the CF experience and

(2) assess the Clinical Fellow’s progress in demonstrating the skills and knowledge appropriate for independent practice.

On the page:

Supervision Requirements for the Clinical Fellowship
Clinical Fellow Mentor Qualifications
Clinical Fellow Mentor Responsibilities
Amount and Types of Mentorship
Multiple CF Locations and/or Multiple Mentors
Feedback Sessions
Ethics
Billing and Reimbursement
Resources

Supervision Requirements for the Clinical Fellowship

The following requirements are based on the 2020 Standards for the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) established by the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC).

Clinical Fellow Mentor Qualifications

All CF mentors must meet the following requirements to mentor a Clinical Fellow:

hold an active CCC-SLP throughout the entire CF experience.
have 9 months of full-time practice experience (or its part-time equivalent) working as a speech-language pathologist (SLP) after being awarded the CCC-SLP and
have completed at least 2 hours of professional development in supervision and/or clinical instruction since being awarded the CCC-SLP and before becoming a CF mentor.
The CF mentor and the Clinical Fellow cannot be related in any way.

Important: A Clinical Fellow cannot count hours earned during any time that the CF mentor does not meet the 2020 Speech-Language Pathology Standards’ supervision requirements. See Supervision Requirements for Clinical Educators and Clinical Fellowship (CF) Mentors for more information.

Clinical Fellow Mentor Responsibilities

The CF mentor must maintain active ASHA Certification throughout the segments in which they are mentoring the Clinical Fellow.

During each mentored segment (or partial segment), the CF mentor must

understand that all time a Clinical Fellow spends on activities listed in ASHA’s Scope of Practice in Speech-Language Pathology may be counted toward the 1,260 hours required to qualify for ASHA Certification.
know the differences between the use of telepractice / telesupervision for state licensure versus for ASHA Certification. See Standard VII for the most updated telepractice requirements.
complete the CF Mentorship Verification form sent through the Clinical Fellow’s online application within 90 days from the date that ASHA sent it.

Each CF mentor is strongly encouraged to read ASHA’s Issues in Ethics: Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology.

Amount and Types of Mentorship

Each mentor must complete a minimum of

6 hours of direct care observation and
6 hours of indirect supervision/other mentorship activities during each segment (or partial segment) in which they serve as a Clinical Fellow’s CF mentor.

Across 3 segments, this equates to 18 hours of direct care observation and 18 hours of indirect supervision/other mentorship activities to satisfy the full CF experience. Mentors may provide more mentorship if (a) their local or state policies require more hours and/or (b) they feel that their Clinical Fellow would benefit from more supervision.

A segment is one third of the CF experience, equal to approximately 12 weeks if the Clinical Fellow is working full time. Each segment is designed to provide structured opportunities to space out mentorship hours.

Direct care observation must be in real time—where the mentor is watching the Clinical Fellow provide evaluations, treatment, or counseling with the recipient of care and/or their care partners. See Standard VII for the amount of allowable remote supervision (telesupervision).
Indirect supervision/other mentorship activities typically include reviewing diagnostic reports, treatment records, and plans of treatment; monitoring the Clinical Fellow’s participation in case conferences or professional meetings; and/or evaluating the Clinical Fellow’s work by consulting with colleagues or clients and their care partners.

Important Note: The CF mentor and the Clinical Fellow must coordinate the observation schedule to ensure that all skills are observed and evaluated during each segment (or partial segment) of the CF experience.

Observations should be spread across the duration of the CF experience, with no more than 6 total observation hours completed in 1 day. You may use this template [PDF] for tracking supervisory activities.

Multiple CF Locations and/or Multiple Mentors

The CF experience can be completed with one or more employers, settings, and mentors and can be done through either full-time or part-time work. Each CF experience must include at least one CF mentor. Each CF mentor must complete the required supervisory activities for the weeks and hours to be counted toward the total CF experience unless the CF mentors collaborate to provide an enhanced CF experience. In these instances,

both mentors must share the same employer and
one CF mentor must be named as the primary mentor and must be the person to complete the CF report on the Clinical Fellow’s online certification application.

For more information, see A Guide to the ASHA Clinical Fellowship Experience.

Feedback Sessions

Feedback sessions are an integral part of the CF experience. The CF mentor must provide a formal performance feedback session with the Clinical Fellow at least once during each segment of the CF experience.

During feedback sessions, the CF mentor and the Clinical Fellow should discuss progress in the Clinical Fellow’s ability to independently practice as a clinician. Through discussion and goal setting, the CF mentor should use these sessions to assist the Clinical Fellow in developing the skills required by the end of the CF experience.

ASHA strongly encourages CF mentors to provide copies of written feedback to the Clinical Fellow during each segment. Both parties should also keep copies of these feedback session notes for their respective records.

The CF mentor should complete the 2020 Clinical Fellowship Skills Inventory (CFSI) form [PDF] at the end of each segment. This ensures that the CF mentor has completed all scoring in cases where the Clinical Fellow changes jobs or the CF mentor ends their mentorship role.

The Clinical Fellow must receive a score of 2 or better on all skills on the 2020 CFSI form [PDF] during the final segment of the CF experience.

The Clinical Fellow should enter the CF experience on their online application. Mentors then should verify the hours and enter the Clinical Fellow’s scores online. Mentors and Clinical Fellows should not submit paper copies to ASHA but, rather, should keep them for their own records.

Negative Recommendations

If—at any time during the CF—the CF mentor anticipates that the Clinical Fellow will fail to meet the clinical requirements outlined in the CFSI, then they must counsel the Clinical Fellow (both verbally and in writing) and maintain written records of all contacts and conferences conducted during the CF experience.

CF experiences with negative recommendations related to potential ethical violations will be reviewed by the CFCC and/or the ASHA Board of Ethics.

Within 30 days of making the negative recommendation related to ethical violations, the CF mentor must submit a letter of explanation to the CFCC with supporting documentation. The CF mentor must share this information with the Clinical Fellow. Following a negative recommendation, the Clinical Fellow may complete an entirely new CF, complete a portion of the CF, and/or contact the CFCC to request an appeal.

Ethics

Mentors share in the responsibility of preparing future speech-language pathology professionals for a lifetime of ethical conduct. CF mentors are expected to abide by the ASHA Code of Ethics (hereafter, “the Code”) and model the importance of the Code to their Clinical Fellows.

As such, CF mentors need to know (a) their obligations as described in the Code and (b) the certification standards. They should also know all supervisory obligations cited in the pertinent sections of their respective state licensure laws. Compliance with local, state, and federal laws as well as payer policies is required.

Although the Code does not apply to the Clinical Fellow until that person is an applicant for ASHA Certification, the fundamental principles and rules will be an essential part of their professional future.

For additional guidance, CF mentors can review ASHA’s Issues in Ethics: Responsibilities of Individuals Who Mentor Clinical Fellows in Speech-Language Pathology.

Billing and Reimbursement

Supervision requirements of Clinical Fellows can vary by state, payer, and setting. CF mentors must consider all applicable requirements to ensure that they are billing appropriately for services provided by Clinical Fellows.

In regard to billing and payment requirements, the final authority is the patient’s insurance plan (payer)—in compliance with state law. For more information on supervision requirements across payers, see Supervision of Clinical Fellows and Audiology Externs: Billing and Payment Compliance.