Working with a new clinical instructor can be daunting when you’re not sure what the expectations will be. Professional expectations in a clinical setting can vary based on your environment. For example, it may be acceptable in one setting for some office staff to wear Steelers jerseys on the Friday before a game (Go Steelers!). In another setting, it may be considered completely unprofessional. In any clinical situation, there are some things you can do to make yourself stand out that are sure to impress any clinical instructor.
1. Request specific feedback and evaluate yourself consistently.
Rather than waiting for your clinical instructor to give you feedback, ask them for feedback about specifics skills that you are trying to improve. Additionally, try to honestly evaluate your own performance. This shows that you are thinking critically and taking an active role in your clinical education. Examples could include, “I think the patient was confused by my test instructions – do you have any suggestions for ways I could be more concise?” and “I think I did a pretty good job when teaching that patient how to put the hearing aid in his ear – do you have any suggestions for me to improve this skill?” Even if you think you did a great job, there may always be room for improvement!
2. Try to understand the “why” behind what you’re doing.
Going through your day doing things the way they’ve always been done without questioning why is not a stimulating, fulfilling, or impressive way to practice. It is also not appropriate for a doctoral level clinician. For example: Why do you use supra-aural headphones and not inserts to test ultra high frequency thresholds? Why does interaural attenuation vary by frequency and how were the average values calculated? Why is it important to measure Real-Ear to Coupler Difference on all patients when doing hearing aid fittings? The answers are not, “Because that’s how it’s always been done” or “That’s just how I was trained.” Challenge yourself to dig deeper and understand why the evidence leads us to do what we do.
3. Get a little notebook to keep in your pocket and write things down.
As a clinical instructor, I do not want to show you how to do the same things 10 times. Things like how to level the Verifit, score and interpret QuickSIN testing, and complete tinnitus pitch and loudness matching are great things to write down in a notebook because they have clear steps to follow that do not change. Not everything you do will be as simple as following a set number of steps, but you should not need to be shown how to these simple things several times.
4. Bring a blank copy of the Placement Expectation Worksheet (Mormer et al, 2013) – or a similar form used by your institution – on your first day and review it with your instructor.
Elaine Mormer and colleagues from the University of Pittsburgh developed a great tool for students and clinical instructors to use to clearly outline expectations (not only for clinical practice, but even for logistical things like “What are the front desk staff’s names?”). It is a great way to initiate conversations like how to contact each other in case of emergency or last-minute changes to schedules, what you should expect to do when patients cancel or there is down-time, where the bathrooms in the clinic are, how you should introduce yourself to patients, etc. You know – the stuff that you only realize you should have talked about after it’s clear that you didn’t know what to do! The Placement Expectation Worksheet is Table 4 in the 2013 article An Evidence-Based Guide to Clinical Instruction in Audiology.
5. Take ownership of your patients and come prepared to contribute to their care.
You should not show up to clinic and expect that your instructor will allow you to just follow them around. Instead, you should look at the day’s schedule before the day of clinic, familiarize yourself with the patients, and think about how you can improve or streamline their visit. For example, if you see that a patient is coming for a hearing aid delivery, you can: print a copy of their audiogram, enter the patient into NOAH, familiarize yourself with how to connect the hearing aids to the software, etc. Obviously, these specific examples are skills that will apply to more advanced students who have some clinical experience. For students with less clinical experience, you can still prepare yourself for the day by familiarizing yourself with the types of appointments and the patients’ histories. For example, if you are seeing a patient for a hearing aid evaluation, you can print their audiogram and read any ENT notes that are available to see if there is any significant otologic history. Look up any terms that you are not familiar with. Think about the patient’s hearing aid style and technology options and come prepared to discuss your thoughts with your instructor prior to the appointment.
By doing these things, you will demonstrate to your clinical instructor that you are committed to taking full advantage of their expertise and your time with them. They will appreciate your dedication, preparedness, and thoughtfulness. Go forth and impress your instructors!
Lori Zitelli joined UPMC as an audiologist in 2012. She received her clinical doctorate in Audiology from the University of Pittsburgh. She is a part-time lab instructor at the University of Pittsburgh and teaches a Clinical Procedures Lab for first-year AuD students. Her special interests include amplification, tinnitus/decreased sound tolerance evaluation and treatment, clinical education, clinical research, and interventional audiology. She is an active fellow of the American Academy of Audiology.
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