Fix SLP: Advocacy & Accountability in Speech-Language Pathology

Dr. Jeanette Benigas, SLP, Preston Lewis, MS/SLP, and Dr. Tim Stockdale, SLPD, review ASHA’s Call for Peer Review of Proposed Changes to ASHA’s Speech-Language Pathology Certification Standards and explain what these revisions could mean for the field's future. They critically examine proposed changes such as removing undergraduate coursework, adding competencies at the graduate level, and adjusting clinical practicum guidelines. They raise concerns about reducing in-person experience, the risks of allowing fully remote mentorship and fully remote first-time jobs, and the potential consequences for new graduates entering the field.

Throughout the conversation, they emphasize the importance of maintaining rigorous training standards to ensure that SLPs are well-prepared for real-world practice. With real-world experience and strong opinions, they challenge assumptions and highlight what’s at stake for the next-generation clinicians.

Want to earn some PDHs or CEUs with a discount?
Want to lead or join your state team? Email your name and state to states@fixslp.com.
Become a sustaining partner to support our work.
Follow us on Instagram.
Find all our information at fixslp.com and sign up for our email list to be alerted to new episodes and content.
Email us at team@fixslp.com.
Leave a message on our Minivan Meltdown line!
★ Support this podcast ★

Creators and Guests

Host
Jeanette Benigas, PhD/SLP
Host of Fix SLP
Host
Preston Lewis, MS/SLP
Co-host of Fix SLP

What is Fix SLP: Advocacy & Accountability in Speech-Language Pathology?

Fix SLP is an SLP Podcast by Dr. Jeanette Benigas about advocacy, autonomy, and reform in Speech-Language Pathology. This show exposes credentialing gatekeeping and dismantles CCC requirements. Each episode equips SLPs with tools to reclaim their profession. Subscribe now and join the movement transforming speech-language pathology. Follow @fix.slp on Instagram and TikTok. Visit fixslp.com.

Jeanette Benigas 0:00
So these pre episode announcements are becoming a habit, but this one is a good thing. I've said more than once on the podcast that I'm looking for creative ways to pay my team so we can keep going. And after this recording, my colleague Tim Stockdale asked if he could purchase some advertisements. So I wanted to let you know that Tim is launching his medically focused SLP webinar and course platform. It is not a subscription service. He's selling super cheap medical focused SLP webinars. Some are live, and some you can even do at your own pace. We've got Chris Sapienza coming up with a respiratory muscle training course. There's a cranial nerve course this month in March, and it features my favorite PhD, dr, Jim Coyle. Jim was my mentor during my doctoral program, and his knowledge is probably unmatched. So anyway, head over to learn dot met, SLP, gap.com, if you use the code fix SLP, you get 10% off any course. And you guys, these courses are already cheap, so it brings it down just a little bit. And it's great because Tim has made this code reusable through the end of 2025 so if you take a course and you love it, you can go back, use the code again and take another one. And you know how I feel, but I gotta say it, these courses are Asha approved, so they will be reported to your registry if you want them, or you can just print the certificate. So again, learn dot met. SLP, gap.com learning shouldn't break the bank. Guys go check it out. Hey, fixers, I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy like the CCC, this podcast is your space to learn, engage and take action in the field of speech language pathology. We don't wait for change. We make it so let's fix SLP, you

Jeanette Benigas 2:38
Jeanette. Hey everybody. It's Jeanette. Welcome back. This is the first time we are recording, I think, since January, together. And, uh, I'm, I'm excited. I got my fellas here today. If you have a partner in life, you're really lucky, I think, if it's a good partner. So I have a, what we will call my personal husband, John. But then I also get to have two work husbands because I have 97 different things that I do. So we've got Preston, he's my fixer husband. So Preston's with us today. And then we have Tim Stockdale, who is my other work husband as part of my business with my mobile fees company, safe swallowing diagnostics I have and I'm growing an education arm. And Tim and I do fees as education together. So Tim Stockdale is with us. We'll let him tell you a little bit about himself. But Preston, where, where have we been? What have what's our excuse this time

Preston Lewis 3:39
We've we've been sick. I you got a case of, I think you had the flu. I know I did. And this current strain just really knocked me on my butt. And so it's, it's good to be back. You know, it's been a difficult few weeks, you know, not only for our own health, but there's a lot of anxiety out there right now, and we're continuing to, you know, hear from SLPs around the country that are expressing concerns in a lot of different ways. So, you know, we already felt crunched last year. We're still feeling crunched now, but it's, it's good to be back in conversation with you. I'm really excited today. I think this is the first we could be making fix SLP, history today. Is this the first two on one with more men in the on the pod than women?

Jeanette Benigas 4:24
Yes

Preston Lewis 4:25
all right!

Jeanette Benigas 4:26
You want me to me just excuse myself, and then it could just be two men.

Preston Lewis 4:29
Not at all, not at all. We wouldn't want to lose our mutual work wise. And I have a second work wife at the clinic that I work at so or at the hospital.

Jeanette Benigas 4:36
Does she listen? Should you shout her out so she's not jealous?

Preston Lewis 4:39
She does listen some. I won't say her name, but yeah, she's she's fantastic.

Jeanette Benigas 4:44
I'll share. It's fine. I also had flu way Preston went down first and then me. I think I also had reached some level of burnout, even though it's almost been, it's three and a half weeks, I think since i. It, the level of fatigue that I have been struggling with has been rough, and I do a lot of fixed SLP stuff at night, and I can't stay up late. Recently, I've really had to prioritize in my sleep to try to heal and also just heal a little bit from this burnout. I think a lot of us get burnout from our jobs, but I think me having really more than one job and doing fix, SLP, which is a full time plus job without any money really, just I, you know, we had gone hard all winter, and we put out a lot of content. We did a lot of stuff. This winter, we launched a lot of teams for the states, and I think it was the first time that I've truly been sick in four years. My body knew it, and I was done, and I'm having a really hard time climbing out. So I think, like Preston said, a lot of us are feeling this political stuff, plus just healing in general. You're gonna see us slow it down a little bit over the next few months. We're not going away. We're still working behind the scenes. We have state teams to launch, but we do have to make our health and mental health a priority. So you know, we're struggling with the same kinds of things you guys might be struggling with right now. So let's bring on. Tim. Tim, tell us a little bit about yourself.

Tim Stockdale 6:20
Hey, thanks, Jeanette. My background is pretty diverse, so I've worked clinically for a number of years, pretty much perpetually. Since I entered my CF after graduation, I have worked at a couple, actually three different universities, two of them full time and one as an adjunct. I've worked in outpatient, neuro acute care, university outpatient clinics. I got clinical doctorate from Northwestern University in 2022 and I just recently, maybe a little over a year ago, started a continuing education business that has the podcast follow the gap, but may or may not be rebranded soon to the Met SLP gap, and really focusing on courses for that that try to bridge the gap for medical speech pathologists who get out of school and don't feel as prepared as they should be, just because that's kind of systemically how we're set up.

Preston Lewis 7:11
How did you meet?

Jeanette Benigas 7:13
How did we meet? That's an excellent love story. Actually, we met on an elevator. Actually, no, so, yeah, face to face for the first time. We were on an elevator together, but we were both asked to be on the Stranger Things CEU

Tim Stockdale 7:30
Upsidedown world of dysphagia, education

Jeanette Benigas 7:34
through the step portal that Ianessa Humbert and Rinki, I'm gonna sorry. Rinki. Varindani Desai, did I say your last name?

Tim Stockdale 7:42
Vernon, Varindani Desai I think

Jeanette Benigas 7:45
yeah, there you go. We were asked by Ian ESSA and rinky to do that together. We did not know each other. Then didn't really have a conversation. But then that same year after that experience, ended up on an elevator together on our way up to a SIG 13 breakfast, and I looked at him, and he looked kind of familiar. So I said, Are you Tim Stockdale? And so we had a quick little Hello on and we don't do well. It was very early in the morning.

Tim Stockdale 8:15
yeah. I was tired

Jeanette Benigas 8:16
We weren't really functioning. And then after that, I think he reached out when he started swallow the gap and asked me to be on his podcast. So I had the pleasure of being his first recording. And then we've just connected a lot since then, and now we do education together for fees.

Preston Lewis 8:33
Tim, I'm a big fan of fees, and when I worked in the skilled nursing facility environment, I had brief access to fees from one of the best speech language pathologists I've ever known in Arkansas. It is such a amazing tool, and I can't thank you, and I thank Jeanette before enough for bringing that to patients and pushing that forward, because it is invaluable.

Tim Stockdale 8:57
Thank you. It's good stuff, but I think you're giving us too much credit. We're just trying to help a little bit, yeah, but for what it's worth, all right, but thank you.

Jeanette Benigas 9:09
We're here today. Preston and I asked him on for an added layer of thought, but we have gotten dozens of messages over the last maybe week or two, I'm not quite sure. Well, here I can look I have it open in front of me. So four days ago, although I feel like it's been longer than four days, because I've gotten so many messages, Asha sent out an email call for peer review of proposed changes to Asha, speech language pathology, certification standards. Many of you have reached out asking what our thoughts are. Many of you have reached out, sometimes asking with kind of a tone of what are they doing now? And so I just want to clear this up. Asha is not doing anything nefarious here. This is standard practice for Asha. They do this approximately every four. Years, maybe less than that, but it is how they change the standards for the CCC. And so I will say we have talked about this, not it, not in the last year, but certainly we talked about about it before that, because our first crowdfunding effort was to purchase the last report for $40 that was published. And so it's called, like, the practice standards guideline, or something like that. I don't know. It's not on my account, so I don't have access to it anymore, but they do this every couple years to determine these CCC standards. And so they'll send this out to everybody and and I know you know, dropping your C's, dropping your membership, if you did that for last year, you probably still got it. But I know people who haven't been ASHA members or CCC holders for quite some time that still got it. So I don't know if there's a method behind that madness or if there was a mistake, but they send it out pretty broadly, and this is how they decide on the changes that they're making to the seas, which then trickle down to the CAA. So I've always wondered, what comes first, the chicken or the egg, and now I think this answers my question, because these changes haven't yet been made, but if they make them, the CAA will put it out there so programs can prepare, and they will say, like these, CAA standards will change for the class of starting whatever year. So programs will then adjust accordingly. And so everyone who graduates from that time forward, who will be applying for these c's once these standards go into effect, those changes roll out. So we're still a couple of years from that. It's not like we're putting in our survey today and the changes happen at the end of the year. It's a slower process than that. What I think it speaks volumes to though, is something that we've been saying from the beginning is that the CCC is not evidence based. You can see the questions that we're going to talk about that maybe you've answered already, or you're planning to answer. This is how they decide on the requirements that for this product that we're purchasing. So we're not really getting into the ethics of all of that you've been asking us for your thoughts, so we're here to give you thoughts from a PhD, an slpd and an MS holder, all in the field, all who actively see patients and Preston, do you take students? Probably not, because of the nature of your job. No, I don't it would be terribly difficult. Preston's never really talked about his job, but he has a cool clinical job. He works with a very special population. So anyway, Preston doesn't take students, but certainly Tim and I have a lot of experience with students, and I've taken CFS, so we'll just jump into it. So the first question is, allow research methods coursework to fulfill the statistics requirement, and their rationale is, this proposed provision will allow greater flexibility for applicants to meet the standard for knowledge of basic statistics, and recognizes that this course is a common offering at the undergraduate level. And then they give you four choices, agree, disagree, unsure or no option, and then you can provide additional details about your response in a box. What do you guys think about this one? Preston, we'll start with you.

Preston Lewis 13:30
I I'm going to be the man on the street here. I'm going to be the average working class SLP. And frankly, I read a lot of this, and I don't know what the hell they're talking about.

Jeanette Benigas 13:42
Awesome. Okay, see, this is why we this is what. This makes complete sense to Tim and I. So this is why we have you on so as part of the requirements to purchase the CCC, and then also to graduate with a master's in speech pathology, you have to have a statistics class. Another class that is required is research methods. And so typically, statistics is taken at the undergrad level, when you're going through an undergrad and then at the master's level, you're taking a research methods course. Those are required for both the CCC and the CAA currently. So what they are saying is we will allow the elimination of statistics because research methods can cover that.

Preston Lewis 14:31
I'm not trying to seem adversarial about it, and I appreciate the explanation. It's great for our audience. But this survey, and this was a common refrain that I have on many of these questions, is that for some of us who may have graduated 1015, 2025, years ago and aren't in the academia circles, this is a very typical pro academia pointy headed, elitist kind of survey. To me some of it, I can certainly. I guess, but like a lot of things from Asha, it's a lot of inside academic gobbledygook. Sorry.

Jeanette Benigas 15:06
So we're gonna then put myself in the pointy headed elite category. And really this is why we needed you here, because here's what I said. I said disagree, and this is what I wrote, because I have this knowledge and background to kind of apply from a different path that I've taken. And I said research methods can be taught by a TA so a teaching assistant, a master's holder or even a bachelor's holder, depending on the setting, with little to no statistical experience, meaning those three people teaching those research methods courses may not have statistics background. So for example, prime example, an r1 institution. So we're talking Ohio State, Michigan, those big State University, colleges, often the faculty there are there to research. They're not there to teach, and they all have TAs. So even if they were assigned to a class, their TA is teaching that course, the TA is often a PhD student, but they might not have gone through their stats series yet. So you might get someone who has no statistical background at all teaching research methods, which means those students are not going to get any knowledge and stats at all, or if they do not good knowledge. So then I wrote, statistics are essential for reading and interpreting research, for the integration into clinical practice. You have to know, really, if you, if you're it's one thing to read research, but you have to know what statistically significant means. I don't think SLPs need to take a three series Stats course, like I had to that stuff I have never applied, but knowing the foundation is important, and there's not going to be any consistency to ensure that someone in a research methods class is getting that, whereas, if you're taking something from a stats department, you know you're going to get stats. Where you at with that, Tim?

Tim Stockdale 17:11
All right, first of all, I'm just here to give my opinion on all of these things. I can see different perspectives with this. My short answer is yes, the reason being, nine diagnostic categories. How many classes I mean? So credit hours vary tremendously and in graduate level programs, so five or six semesters? Yes, of course, it looks good if we have an undergrad stats class and then a research methods class and all of this stuff. But how much of this stuff? One is really going to translate over and two, like, there's a big difference between taking a class and actually understanding how to apply these things. Like, I don't know. So I took econ 225, which is was at my original University use, or my undergrad University's business statistics. I mean, I took away a little bit, like, one factorial, two factorial, three factorial, like, that type of thing. And then I took another class in my graduate program. I still don't know how much of that I took away from it. And then I took more in my slpd program, which I took the most away from that. And I think part of it is because I had the overall context for what's going on, and an undergrad who doesn't really know what they're going to be going into, like, I just question how much carryover that's going to have toward what we're doing later on, additionally. Well, you know what? As I'm thinking through this, I kind of recognized something in my in my thinking that's not exactly what I thought. So if we're if we're trying to cram just as many classes about different things into our graduate program to make it look better, like oh, we're trading in statistics, we're trading in phonology, we're trained in aphasia, we're trained in dysphagia, we're trained in voice and all these different things like that, comes to be a little pretentious to me as it's currently set up, because I think it might have face validity. Like, look, we're learning all of these things, but how many of us actually walk away, like, really knowing how to do those things, every one of those things, but so I guess I'm thinking of this backwards, if you're talking about undergrad foundations, then, yeah, that doesn't take away from what we're doing in our graduate studies. I just, I still question how much carryover it's going to have in when you know you're a freshman or a sophomore and you're taking a statistics class and you don't understand how that might apply to research. This isn't that huge of an issue to me, I guess, yeah, and so I don't, I don't care that much.

Jeanette Benigas 19:34
To, to reinforce that, yes, this is they're talking about removing this as an undergraduate requirement, and you have to take stuff like this anyway. So it's not like we're asking undergraduate students to load up on another class. This fulfills a requirement for their Gen Ed. If they don't take stats, they're going to have to take something else. This just. Funnels them to something they're going to count towards the requirement anyway. So we're not talking about loading it onto a masters level load.

Tim Stockdale 20:09
Yeah, and that's kind of where my train of thought was going originally.

Jeanette Benigas 20:12
We're going to keep rolling because we have Preston at a certain time. But again, I also want to reinforce how Tim said he's only here to give his opinions. That applies for all three of us. We are all coming from different places different thoughts. That's why we have three different people on today to bring you different thoughts from different backgrounds. And you answer these however you want to. We are not here to tell you how to answer just some things to think about. Okay, so the next one this, and by the way, questions one through four are demographic so that was actually question five on the survey. So this is question six allow communication sciences and disorders related coursework to satisfy the prerequisite requirements. So the answer here, or the rationale here, is this proposed revision will allow flexibility to acquire the necessary knowledge through the use of undergraduate CSD coursework and massive online, open enrollment courses that appear on a college transcript to satisfy the prerequisite requirements. This proposed revision will also decrease the financial burden and shorten the time required for applicants to meet the coursework requirement in instances where one course can be used to fulfill two prerequisite content areas, Preston, are your eyes glazed over on that one?

Preston Lewis 21:43
No, I think I'm a little bit more dialed in on this. And my first instinct is I'm not a big fan. The reason I say that, and I do like flexibility, but the reason I say that is knowing the some folks that I do, that are in academia beyond SLP, have expressed, and these are people that have just retired from academia or career educators. There's a lot of concern about massive online, open enrollment courses and the quality that people are getting. And I am concerned that from a college standpoint, while those things have certainly had their place, especially during the pandemic that we're sometimes getting away from some of the skills that direct instruction is offered. So this is something that I kind of like to sort of push back against, in terms of where I've seen some academia going.

Jeanette Benigas 22:33
What do you think, Tim?

Tim Stockdale 22:35
I'm missing something the last part of this, okay, decrease the financial burden and shorten the time required for applicants to meet the coursework requirements in instances where one course can be used to fulfill two prerequisite content areas. I feel kind of dull with this question, because I don't know that I'm fully wrapping my head around what they're asking. The implication of the last part makes more sense, but I think there's something I'm missing.

Jeanette Benigas 23:00
I interpreted this as in order to get a CSD degree, you have to have a physical science, a biological science, a college algebra, like those things. And sometimes some of those classes can fulfill two of the requirements. But I think, as it stands out and Tim, have you ever done undergraduate advising? No, okay, I have. There's a no double dip rule, if that's what it's about. I think this is gonna allow double dipping and some of these massive online open enrollment classes, those are cheaper. So if you have a family or a student who doesn't have the kind of money where you can kind of save, you know how some people go to college at at a community college for some prereqs before they move on. It's that concept where you can get these prereqs elsewhere for cheaper money than the university that you're at. And if you choose wisely, you can use them to double dip, which is going to save you money in the long run, which is good for people who don't have the resources. But I like what Preston said, where you're Are you losing quality there? And I think probably the answer is yes, but also I'll challenge Preston and say, does a quality chemistry really matter when it comes to speech pathology? So we're not talking about CSD courses. It says CSD related coursework. So we're talking about science, math, English, those kinds of things.

Preston Lewis 24:35
Well, okay, so that's where I'm just going to say I think these explanations, these rationales are very poorly written for the average person, because I am sitting here right now talking to two people who have extensive in and outs with academia, and even the two of you are not exactly clear on this, which is like, oh my god, think about somebody like me. Because one. I read this, the use of undergraduate CSD coursework. I'm thinking, well, communication, science, disorders, these are like courses within our field. I'm not thinking about chemistry. I'm not thinking about biology. So, yeah, I'm sorry, whoever wrote this? Wow, do you ever go out to a bar and have a conversation with people and kind of communicate on a regular basis?

Jeanette Benigas 25:22
So it does give the standards and the questions too. So you can go look yourself. So this is standard four A.

Preston Lewis 25:28
Okay, hang on, hang on, hang on. I can go look myself. Am I doing that when I'm being 87% productive? Am I doing that while I've got patients that are coughing and choking?

Jeanette Benigas 25:36
No

Preston Lewis 25:37
Okay, I'm just curious when I'm gonna look up these damn things that ASHA wants me to look up.

Jeanette Benigas 25:41
To fill out their survey for free. That then, by the way, you have to purchase the results of? Yeah.

Preston Lewis 25:46
Yeah. Am I gonna get? We're gonna get like five CEUs for this. How's this work?

Jeanette Benigas 25:49
Zero. Zero..

Preston Lewis 25:51
Smell my napkin. Okay.

Jeanette Benigas 25:53
This is, this is biological sciences, chemistry, social and behavioral sciences and statistics. So for example, like statistics could count as, like, the math and the stats requirement, right? Like that could be a double dip, whereas, right now, I don't think you're allowed to double dip.

Tim Stockdale 26:13
I don't know this question is is quite ambiguous to me, and part of that's probably on me, but part of it's like, could be explained a little better, I think,

Jeanette Benigas 26:22
yeah, yeah. But anyway, I said, Yes, allow it, because I did interpret it as allowing to double dip, and I didn't even, I didn't even write an explanation, because it just made sense to me after advising 70 plus undergrads a year at one of my institutions that made sense.

Tim Stockdale 26:43
If it's in terms of double dipping, if that's the question that we're answering, then I'm going to step back and say, Okay, what's the purpose of these courses in the first place? And because we have to understand that, I don't think, without fully understanding the rationale, that we can make a great informed decision on how to answer this question, and, you know, to provide foundational knowledge that will apply to CSD, to diversify our skill set, to give us, you know, more of a broader background. Sure, I don't have a problem with it if it's done well. And perhaps there should be some mechanism of quality control out there anyway, because where is the validity like, where's the evidence to show that we're having better outcomes by taking a biological science and a physical science two courses separately, versus taking, you know, one course that somehow would fulfill both of those requirements. I don't know. I think that there needs to be some sort of validity established to the method before we say, like, this is a good method. And let's, you know, now, let's ask all these other questions. It just Yeah,

Jeanette Benigas 27:43
Okay. So people can decide for themselves. Let's jump to number seven. Add telepractice to the list of contemporary professional issues. Rationale, this proposed addition will better ensure awareness of the professional issues surrounding telepractice as a reflection of the current clinical landscape, I said, Yes, sure, let's, let's allow it. Why not? It'll be in the professional issues course. Go for it. We're not adding coursework.

Preston Lewis 28:11
Yeah, sounds sensible to me.

Jeanette Benigas 28:13
Yeah

Tim Stockdale 28:13
Yeah, I agree.

Jeanette Benigas 28:15
Okay, let's go to number eight. Number Eight collection of information related to social determinants or drivers of health during evaluation and intervention, this knowledge and or skill will improve client centered care through comprehensive assessment of the client's protective and risk factors and how they influence functional outcomes. Who's got some thoughts?

Tim Stockdale 28:45
I think we should be doing that. Say there's a magic blue pill that cures cancer and it costs a billion dollars. And how many billionaires are there in the country, right? But that's the best thing to treat something so as a clinician, not knowing somebody's access to resources and all of these different things, I'm going to be like, You need to take this blue pill. Obviously, if you do that, it's going to cure this. But if I don't understand their access to resources, then what's it worth? Like, why does that matter? So yes, I think we shouls.

Jeanette Benigas 29:13
Right. I can only come from where I'm at with Med, SLP, but sending someone home with a home exercise program where it's going to take someone else to help them do it, and they live alone. That's a social determinant of health. I'm asking you to do something that I I know you're going to need to do five days a week to actually improve, but if you're only seeing me one day a week and you don't have someone to help you the other four days, this is a waste of everyone's time, I need to figure out something else to give you that's going to help you improve. And I think as we move along as speech pathologists and become more skilled in what we're doing, we start to recognize and realize these things. But I can't tell you that this was something I was thinking about out of the gate as a CF or in my first few years of practice. And. Or, you know, even when I worked in the schools my first year or two and getting mad because the kids aren't doing their homework well. Now, as a mother with kids and 87 jobs and a husband and groceries and laundry, I understand how hard it is to get homework done and so like, that's another social determinant. If you've got a single mom with a house full of kids or a single dad or grandma or whatever, you understand why you can't send that kind of homework. But as a new clinician, your mind just isn't there. You don't have the experience or training. And so what this is saying is they're going to learn this in school as part of their clinical experience, and it will be one of those things that have to be checked off on the box that has been assessed. A lot of people use Calypso, so this would be something in Calypso as the supervising or mentoring clinician saying these are the skill sets that this student has. This would be added to the list, saying that the student is able to collect and recognize these things during evaluation time. And I think it's really valuable. So I said yes, and I didn't write anything else. Preston?

Preston Lewis 31:05
Yes, I real quick. I agree with what Tim said, and I did reflect back to one of the really good professors I had when I was in college master's level that said, we're clinicians, we're not technicians, so you have to look at individualized care and consider everybody's circumstances. So yeah, I agree.

Jeanette Benigas 31:23
Number nine, demonstration of technology literacy, rationale, this knowledge and or skill will improve efficiency and confidence with the use of technology for client care, documentation, professional communication. Anyone have thoughts?

Tim Stockdale 31:41
Why are they even asking this question?

Jeanette Benigas 31:43
I know I said I disagree with this, and I said students largely have this knowledge. This is unnecessary, and I didn't write this. But think about how many things as we're talking about competencies, like I just mentioned Calypso and adding that. Can you imagine adding this to Calypso, like it's one more box that needs checked, one more thing programs have to take care of. To me, I actually had the word micromanagement in my response, and then I deleted it and just put it this is unnecessary. Yeah, that was, I was like, What is this?

Tim Stockdale 32:18
You know, this is a graduate level degree we're talking about. So hopefully, if someone did not have any technical literacy, they wouldn't have gotten this far overall. So maybe it's a fairly easy assessment. I mean, they we, I think we have to have this living in the world we live in today. Yeah. So it's a good thing to make sure that we have but I what is being done here? Like, what is it? What is being asked for programs to do here to prove this. And maybe that's where I've got the disagreement.

Jeanette Benigas 32:46
It would say on Calypso demonstration of technology literacy. And then you'd pick the one through four or the what I forget. I've only been out for a year, but I've already blocked it out however you rate them. That's what it would say. And then you're going to check a five. I see, yeah, okay, we don't need that. Everybody vote no, just,

Preston Lewis 33:07
I, you know, Can I say something? I just, no, I, my first response when I read this is I looked next to me because I thought I was going to see Doc Brown, and I was going to be sitting in the DeLorean and actually had gone back to 1984 and Ronald Reagan was president. Nancy and I, and we're just starting up this thing called computers. And I mean, to me, it's a pedantic question, it's obvious. And yeah, I thought I really had gone back in time, and I was like, Gee, I get to do it all over again. I can try to make Asha realize we have state licenses. It was going to be cool, but anyway, it's not the case.

Jeanette Benigas 33:46
Yeah, I just think the people who need that, whose knowledge is lacking in that area, they're already so far out of school, they're not getting this anyway, but every year that we put another cohort through those those students are going to be more and more and more technologically savvy. We don't need to check it off on Calypso.

Preston Lewis 34:05
I'm going to jump in real quick because I do have to go in a moment, and I'm going to insert this question in there, and just kind of want to have a brief conversation before I step out, which is, if you're somebody like me who's in the clinical sector and you're not a big fan of ash already is even participating in this survey, is like, non participation kind of something. You're like, you know what? I'm really I don't agree with any of this, so I don't want to participate. Now. I'm not trying to dissuade anybody that says, you know, I do want to shake the direction this is going. That's very well meaning. But I do think that for some of us out there, we're wondering maybe just ignoring this is the best way to proceed. So I thought I'd throw that out there.

Jeanette Benigas 34:47
As much as you all know that I don't always love Asha. I think this is one that is really important for people to participate in, because this is talking about the CCC. But the CCC. Drives the decisions of the CAA, and whether or not someone has the CCC doesn't matter. Everybody in every state everywhere has to graduate from an accredited program, and that's what the CAA is. It's the accrediting body, and so we're making accreditation decisions here through this survey, and I think it's important for us to all have a voice in this, because our future SLPs are going to graduate from a program whether they get the CCC or not.

Preston Lewis 35:33
And Jeanette, I appreciate you giving that because that ultimately was the conclusion I came to. But because I had that question, I thought, let's go through this exercise, and, you know, have that discussion, and I appreciate it. But for those of that are out there, even if you're oppositional, I agree with Jeanette. I think there's value here. And if some of these questions, you don't know them, then just put no opinion. You know, so

Jeanette Benigas 35:53
True. True. All right, Joe, get out of here. Tim, and I will bring our non clinic only opinions. We're not going to have as good of a input here without Preston. We're also almost done. There's only four more questions. So the next question, this is question 10, functional outcomes, application and measurement during evaluation and treatment. And I'll just jump in with my answer. Right off the bat, I said, agree and agree so much to the point that I did write something and I said, this is very important in today's billing and reimbursement environment.

Tim Stockdale 36:31
Well, and why are we giving therapy, I mean, for functional outcomes, so you should be able to measure that.

Jeanette Benigas 36:39
Right. But I mean, I'm not knocking pediatric therapists, if you're thinking about articulation, the functional outcome, there is better communication, right? That's obvious. You can't communicate as well. You're not as intelligible. And so those aren't things really, that speech pathologists have to think about, I guess, because built in, right? Like the functional outcome is we're going to communicate more intelligibly, where it gets a little harder. And I think this is where I see people struggle, is with adults in cognition, you know? Oh, yeah, I think a lot of people in our field have poor cognition training, especially when it comes to dementia, or poor training when it comes to functional outcomes following a stroke. And I think increased training in this specific thing in grad school is really needed, because I do think it is a result of poor preparation, that people can't do this.

Tim Stockdale 37:44
Well, but even in your example of talking about articulation for kids, so my son has had a lateral lisp in the past, I've looked at the data that the therapist has reported from there and in a session without like, all these extra pressures. Yeah, he can, he can do it okay. But then when he comes home and he's, you know, talking like, sorry, and I'm not trying to mock anyone with a lateral list, but all, but when he's talking, not generalizing that, then that's not so much as of a functional outcome for him. And so, I mean, I can see it applying everywhere, just maybe a little more direct and less abstract in certain cases.

Jeanette Benigas 38:22
Yeah, it absolutely does apply to every single thing we do. I do think it's harder, though, with that dementia, with that a cognition for adults is that, you know, putting a worksheet in front of someone and telling them to list all the animals, or reading a paragraph to someone and asking them questions following the paragraph. And there's still a ton of therapy like this that happens out there

Tim Stockdale 38:51
Impairment based therapy, and there's no guarantee that it's going to translate to a specific function in your life.

Jeanette Benigas 38:57
Correct. And so the question is, what is the functional application of that? How is that generalizing? And again, you're not always getting these things in school. And so this is saying, add this to the types of things that are being taught in clinic and in externship rotations. And so, yeah, I strongly support it, because it is a hard thing, the older, especially that your client gets, and you're in a nursing home or even an acute care. How are you going to be functional? This is going to teach people to do that a little better. Won't be perfect, but it's a good start. Good. I like it. Love it. Okay, let's do 11. Oh, there might be opinions. I'll let you give. Give your opinion first. I have strong opinions on this one, and I think this is something in going back to what Preston said, If you don't have experience in academia, you don't even know that these things are a thing. 11 initiate a limit of 12 students who. A may participate together in a clinical simulation debrief group, and B may each count the time toward the clinical practicum experience. Rationale, this proposed revision will ensure that graduate programs can tailor the guided debrief for individuals during the group learning experience, what did you say? Tim,

Tim Stockdale 40:24
Why 12 and not six or 15 or 20? I don't know. I mean ratios, having small ratios, so people can participate. I think it's pretty important, especially within the debrief. That's a very more of a cerebral process where you're thinking, well, why'd you do this? What could you have done differently, that sort of thing, too. So, yeah, I think it's good not to have a ton of students for like, one or two instructors, and might just kind of like 12. Like, where did 12 come from? I don't know.

Jeanette Benigas 40:55
I know where 12 came from. Pretty sure it is the suggested number from simia case. I don't know where they got it from, but I'm pretty sure that is the suggested number. So let me give you my answer. I said, agree. I wrote clinical simulations often compensate for a lack of actual clients and are often added to faculty load without regard to the number of students. Limiting this will benefit the students and reduce abuse of faculty. So if faculty are working in a non union job, there are no rules, regulations and protections regarding how many credit hours they have and how many supervision experiences they can do before being paid more money. This happened to me, which is why I feel so strongly about it. Simulations were added onto my load at my last job without additional pay, and it was included as part of my clinic supervision credit hours, even though I had the same number of students as everyone else. And so now I have a cohort of 20 plus students that I had to meet with. And it's not always meeting if you're doing a clinical simulation. Well, there are, there is some written work that the student should have to do. So if this is a clinical simulation where they're doing an evaluation, they should be doing the evaluation report. This isn't watch and then talk about it. If you're doing it well and you're using it in place of actual clients, you need to do it like the actual client is sitting in front of you. And now do all that work 20 students in that cohort. Now I have 20 evaluation reports to look at.

Tim Stockdale 43:01
It's a lot of work. But, I mean, what would keep them from just saying, like, Okay, now you do two simulations, you still have to do 20 students, but now you're going to do two and there's going to be 10 students on each one. So I got this from more of, like, the quality perspective, from us, from a student, which I agree

Jeanette Benigas 43:16
that was going to be. My next point is, then also, there is a recommended amount. So if you're doing like a 30 minute simulation, the time that you meet isn't very much. So during COVID, I think my students were doing four simulations, like one hour simulations, and I was meeting with them for an hour. So they must have been doing four hours of simulation, and that is a 15 minute meeting per simulation. So we're only talking 15 minutes of instructor time with the students on that simulation, and you put 20 people in that meeting. How much is actually one on one. How much is being learned? How, you know, clinic is meant for a one on one or a one on two, intensive experience with the person that's supervising you. Not this broad. We're going to meet for 15 minutes and go over everything. It's it's not well done. And I didn't write it, but you heard me say, with Preston, our students are already under prepared, even allowing them to do these clinical simulations. Okay, I get it. You can especially get some of those populations, like head and neck cancer and some of those things that are harder to find out in the field, to give everybody experience. So it does play a role, and it is valuable, but programs are leaning into this more and more, and our students are becoming less and less prepared, and it's a problem. And so then, when we're allowing this huge group of students to be in the same meeting, now it's an even greater problem, and I'm not seeing every. Right? Every program does this. I am not saying that, but the programs are out there, and I know because I worked in one, I also worked in one that did it right, by the way, and saw how it should be done, which is why, then when I went to that next job and saw how it was being done, I blew the whistle, because it was a problem. So, yeah, I think this would force institutions to comply with the recommendations from these simulated programs. Let's hope that it came from some kind of research. We don't know, but I know from experience, meeting with those larger groups can become very problematic for many reasons. Yeah, sure. All right, 12 consider the following clinical care and care management activities to count toward the 400 hours of supervised graduate clinical practicum experience, the CFCC will still require 250 hours of on site, in person care allow up to 50 hours of clinical documentation, report writing, IEP meetings, Team conferences, etc. Agree, disagree, unsure.

Tim Stockdale 46:11
Those are different. Those are different things. Clinical documentation and report writing is different than a team conference. I don't, I don't think, I mean, I would agree, perhaps with some of these, but, like, I don't necessarily agree that report writing should go toward it, but team conferences, potentially IEP meetings, potentially, you know, you're, you're, you're meeting with others who are involved in somebody's care, I guess it, it depends.

Jeanette Benigas 46:39
And so this question is agree disagree, like yes or no, and that's what they're going to go off of. So what you're saying could be put in the box, but you should then disagree. You disagree with

Tim Stockdale 46:51
Probably, yeah, I think so.

Jeanette Benigas 46:54
And then, and then you can explain that in your box. So I disagree. It comes back to this. This is what I wrote. Students are ready. Do not receive enough hands on time with actual clients. Allowing up to 50 hours will likely be used because who wouldn't count that, right? Who wouldn't count if you're going to have 50 hours of documentation time and all of these things by the end of your graduate program? So allowing up to 50 hours will likely be used in full reducing student preparedness. We already have students who aren't able to give clinical care face to face if we're reducing their face to face time by 50 hours of the 400 How is helping them? And that leads us into this next question, allow, but not require, up to 25 hours of guided observation. So when I went through, we have people from all over listening, and probably even when you went through, Tim, it wasn't guided observation. It was just 10 hours of any observation. Now it's guided, which means it's almost like a clinical simulation experience. There has to be a debrief that goes with it. So it has improved a little bit, but it right now it's required. So they're just saying you can do it, but you don't have to. What do you think?

Tim Stockdale 48:26
I think it's nice before you get in there, to have some direction from being able to observe somebody else and being guided in it. Like you said, My observation wasn't necessarily guided as it is now, and so it wasn't as useful, but I know I think it's help. I think it's helpful.

Jeanette Benigas 48:44
I do too, and this is what I said. This is a valuable undergraduate experience that helps prepare students for clinical practice. Undergraduate Programs have already removed clinical experiences. This is the next best thing, and I think it is valuable because there's not a whole lot you can do with a bachelor's degree in speech and hearing science or speech language pathology. And if you don't really get a feel for that until you're in grad school, that's kind of a disservice too. So this gives people a taste of what they might be doing and a chance to say, You know what, this isn't for me and change their major even before they graduate with a bachelor's that isn't going to do a whole lot for them without the partnering master's degree. So it's just another Hey, like, Are you sure you want to do this? And watching people give therapy is a good way to learn.

Tim Stockdale 49:38
Yeah. No, I agree

Jeanette Benigas 49:39
I said I disagree it needs to stay.

Tim Stockdale 49:42
I know. I think there's a lot of benefit and watching people.

Jeanette Benigas 49:46
So this leads me into my next one remove the allowance for up to 50 hours of undergraduate clinical practicum experience to count toward the 400 hours of supervised clinical experience.

Tim Stockdale 49:59
Disgree, that's my gut is, to disagree. I think we should be trying to do more things in, in undergraduate so that we can focus more in graduate studies.

Jeanette Benigas 50:09
Mm-hmm. So here's what I said. Let me give you the background. I went to a university that at the time, I'll shout them out, University of Toledo, in Ohio, at the time, had three undergraduate experiences where I gained a minimum of 25 hours, two in clinics, and one externship style, where I went to up school. And it was amazing. I think they're now down to two. I think they only do two, especially because the number of hours that you were allowed to count has been reduced. So this is what I said. As someone who had this experience, I found it very beneficial, and it assisted me with more advanced learning in the clinic. During graduate school, I graduated with more hours than was needed for the CCC, which only helped me and the people I serve. Removing the allowance may further reduce the number of institutions implementing undergraduate clinics because grad schools that you have clinic requirements. In grad school, for example, one of the institutions that I was teaching at in the last few years, we required our students to get 125 face to face hours at each externship, regardless of how many hours they had. I'll tell you, I see this time and time again, both when I was doing student advising when I was doing externship placements at another institution, when people are in their second and last year of grad school and they are in their last clinical rotation, these students think when they hit 400 they are done, and that's not the case. What we often had to tell them was, this is not about ours. This is about acquiring a skill. This is about becoming better at what you're doing. So in a few months, when you have your own job, you are prepared. This isn't about ours. It's about being able to do the job and do the job well. So anyway, I graduated with way more than 400 because I had that extra experience. 25 of those hours, I couldn't even count, and it only did me a favor, and it therefore, in turn, did the people I was serving a favor. We need to keep it. If there are institutions that can manage this and they're giving that experience, those students need to be allowed to count that time. They're gonna they're gonna graduate with more hours, and it's going to make them better. And we have a preparedness problem in this field. We all say it, I didn't feel ready. I didn't feel ready. It didn't feel ready.

Tim Stockdale 52:51
Yeah, and a lot of times you're getting this from a different institution than you are from your graduate hours. So I think it's neat to get therapy from a different perspective.

Jeanette Benigas 52:58
Absolutely. So much value there. Question 15, continue allowing up to 25 hours that the student clinician can earn while enrolled in a Speech Language Pathology Assistant Program. I said, Sure.

Tim Stockdale 53:13
I don't know enough. I mean, I don't know what an SLPA program looks like, but if Sure, if it's there's good quality control, yeah, why not?

Jeanette Benigas 53:21
I think it's the same kind of thing. And I said similar to allowing undergraduate hours. These hours are a valuable experience. Let them count it, please. All right, next question, this is question 16, when counting clinical practicum hours for purposes of Asha certification up to two graduate students can participate in the same session, and both participants can count the full experience and time of the session, provided that they are both actively engaged in the session throughout its duration. This has to do with standard 5c and I'll give a little explanation here, because I could see where the everyday clinician isn't aware. Well, now let me give you their rationale. First. It says this proposed revision will allow graduate programs and graduate students increased flexibility and or access to clinical practicum opportunities while maintaining the integrity of the learning experience. So as it stands right now, if there is one client and two therapists, let's say it's a kid doing articulation 30 minute session. You've got two clinicians in there. They each can only count 15 minutes towards their 400 hours.

Tim Stockdale 54:42
I don't like that. I think that. I think we should allow them both to get their full time. I mean, obviously, if all 400 hours are being done in CO therapy, that's something different. But you can get a lot out of doing therapy with somebody else, through going through the planning process together. You don't just learn from your instructors like you learn from peers, too. Do and you get to talk about things. I think that this has a lot of strengths, and that sometimes you can get more more out of it, even much more than you do in a one on one session, where your supervisor may not be as accessible as you know you'd like them to be.

Jeanette Benigas 55:15
I do too. So I wrote students do an immense amount of work to prepare for a session, allowing them to take full credit is essential for learning and growth. Just same thing that you said, I just hope that as finding supervisors becomes more difficult, institutions don't abuse this by like you said, always doing partnered sessions

Tim Stockdale 55:38
Set a limit, I don't know, up to however many hours.

Jeanette Benigas 55:41
Folks, if you're listening and you haven't filled it out yet, maybe put in there up to 50 hours of shared hours may count, or up to 25 hours of shared hours may count.

Tim Stockdale 55:51
I don't know. I mean 100 hours, I would be careful with limiting it too low, but maybe just even open endedly, with putting some sort of a limitation in there. So not all 375, 400 whatever you can come from this.

Jeanette Benigas 56:03
I like that. Cap it somewhere. Okay, 17, here we go. Oh, I have strong opinions about this. One real strong

Tim Stockdale 56:12
Jeanette has strong opinions. What?

Jeanette Benigas 56:15
Mmm... Who knew? Okay, allow individuals applying for certification to complete 100% of their clinical fellowship experience via telepractice without prior CFC C approval. This proposed revision will further acknowledge tele practice as a practice setting.

Tim Stockdale 56:40
I mean, maybe there's something that I'm missing, but I don't like this.

Jeanette Benigas 56:46
So allowing individuals to apply for the CCC to complete their clinical fellowship experience via telepractice, what that means is they are giving therapy 100% of the time online as their job. And I said, I disagree, and here's my rationale, students are already under prepared when leaving the graduate program. Face to face experience is a different skill set than teletherapy experience. So what this is saying is sure graduate from grad school and go into a teletherapy job 100% online immediately. I don't think it's okay. I know that it is a valid practice setting, but the purpose of the CF, according to Asha and the CS, is to finish getting all of those hours, and we know that the majority of jobs, at least right now, are still face to face. So if you're giving a brand new graduate this option as 100% because right now, you're allowed, but there's a cap on how much time you can do, you still have to have face to face. And I think we are taking away a valuable experience from them by allowing this to happen. I think we are making weaker clinicians by brand new students coming out of school and giving therapy on a computer all day.

Tim Stockdale 58:16
I'm having a hard time articulating this without acknowledging what a valuable modality teletherapy can be. But to to establish the relationship like, I think there would have to be some sort of of evidence to show that doing teletherapy all the time, without experience, with working with somebody in person, putting your, you know, your your hands on them, if needed, and more of a, perhaps in some ways, more of a direct way that that's going to translate as well. So I would be hesitant without perhaps more evidence, yeah, yeah. I just, I do want to be very careful not to imply that that teletherapy is not a, you know, is not a strong modality, for certain, for many circumstances,

Jeanette Benigas 58:58
I agree with that. But again, like I said in my rationale, it's a different skill set, and I think you need all of it. I think you need all of it, but allowing it to be the only skill set that you sharpen after graduation, I think, is a disservice to the future you, because you have no idea where you're headed down the road. And if all of your learning and mentorship has come from telepractice only, you're going to struggle when you get into the clinic or get into that acute care hospital room, right? Yeah, for sure. Okay, allow the clinical fellow and CF mentor to complete 100% of their direct observations of CF experiences via tele supervision. And the rationale is, the proposed revision will allow flexibility for individuals to provide clinical mentorship. No, no way. Here's what I said. I said disagree is that there are nuances missed when not present. I said this for everything our graduate students already. Feel unsupported. Removing the mentor from the CF experience from the room further reduces the support they desperately need. If anything, it should be all face to face. And I didn't write this, but I will add as someone in the adult med SLP world who has worked with contract therapy companies for 16 of my 18 years of experience, I can tell you what the contract therapy companies in nursing homes will take full advantage of this, because I have been hired by multiple contract therapy companies who have been unable to find a local CF supervisor who have hired me. One of them, I lived two hours away from her, and they would pay me to drive to see this CF to to give the mentorship. And this was before online supervision was even a thing. They would pay me to drive there because they had to, and they would pay me my PRN rate if this is allowed, that they're never going to allow someone to drive again. They wouldn't pay for in person supervision when they know they could get someone because there's always people who say yes to things that aren't right. They'll find an SLP who will say yes to 100% teletherapy supervision to save their butts money. There will be companies that abuse this, again, not everybody, but we have to look out, and we have to protect against the ones that are going to abuse this, and people aren't ready. The mentorship is already awful. We have a supervision crisis in this field. This is going to make the crisis worse. I said, what? I said, passionate. You want to add to that? Or you're like, yes, with your passion, girl, get it?

Tim Stockdale 1:01:59
I'm not saying that some of this, you know, some of the supervision shouldn't be able to be through telepractice, but I don't think it should all be.

Jeanette Benigas 1:02:09
Yeah, and at this time, some of it is allowed. I don't know how much, because I've not supervised a CF since it was a thing, yeah, fine. Some is fine, but not all can't No, no. Thank you. All right. Last question, 19, each mentor must complete the clinical fellowship skill inventory, the CFSI tool at the culmination, end of each segment. Rationale, this proposed revision will better ensure that the clinical fellow receives specific, consistent feedback at regular intervals throughout the CF experience, it will also better ensure that the hours earned will be portable between different employment opportunities and when completed with different CF mentors. So for anyone who is not aware, currently the CFCC, who sells the CCC product, requires that during a CF experience, the CF get three mentorship interactions, three segments. So it's nine months, you have to meet with your supervisor once each segment at minimum. And what this is saying is, during that meeting, this inventory would be provided you got thoughts before I say mine. Let's hear your thoughts. Jeanette, okay. I said, agree. Hard agree, yes. And you heard me just say, a minute ago, we have a supervision crisis. This is what I wrote. While this doesn't come close to resolving the supervision crisis, at least it gives everyone a consistent tool. So I am sure that there are really, really, really strong CF mentors out there who are already doing stuff like this, but then you have the ones that are awful, who give zero feedback, who do nothing well, who send our fellows into PTSD situations. At least this is going to give them some guidance on how to help build a better clinician. Yes, all day. Why aren't we already doing this?

Tim Stockdale 1:04:19
I'm with you there. I'm sorry. I mean, you've, you've kind of articulated it pretty well already. I don't know that there's much I need to add to it, but, feedback

Jeanette Benigas 1:04:25
Alright, I like being the voice of reason.

Tim Stockdale 1:04:30
It's some, some you're not used to, right, Jeanette?

Jeanette Benigas 1:04:32
Correct. All right, guys, we've already, like, way went over. We were like, "Oh, this will be a 30 minute podcast." Wrong. So, Tim, thank you for being on. Little teaser. Tim and I have something huge coming up that I am not allowed to say yet. We are not permitted. He's looking at me like he's confused.

Tim Stockdale 1:04:53
Oh, no. I mean, could be a couple things, could be a couple things.

Jeanette Benigas 1:04:57
Well, Tim always has something coming but together. As a pair, as a work wife and a work husband. We have a work cousin who is working with us. Yeah, we have something big coming in, hopefully, like, any minute, we'll be talking about it. It'll be out there. So we've been hard at work for a couple months with our our work cousin and yeah, be watching for that, but Tim, I'll see you tomorrow or the next day, or for sure, in three days, we have a meeting, so yeah, we'll see you soon. Gotta get to work. See you soon. Guys, we'll see you next week. Thanks for fixing it!

Tim Stockdale 1:05:34
All right. See ya!

Transcribed by https://otter.ai