In compliance with federal law, including the provisions of Title VI and Title VII of the Civil Rights Act of
1964, Title IX of the Education Amendment of 1972, Sections 503 and 504 of the Rehabilitation Act of 1973,
the Americans with Disabilities Act (ADA) of 1990,the ADA Amendments Act of 2008, Executive Order 11246,
the Vietnam Era Veterans Readjustment Assistance Act of 1974 as amended by the Jobs for Veterans Act, the
Uniformed Services Employment and Reemployment Rights Act, as amended, and the Genetic Information
Nondiscrimination Act of 2008, Vanderbilt University does not discriminate against individuals on the basis of
their race, sex, sexual orientation, gender identity, religion, color, national or ethnic origin, age, disability, military
service, covered veterans status, or genetic information in its administration of educational policies, programs,
or activities; admissions policies; scholarship and loan programs; athletic or other university-administered
programs; or employment. In addition, the university does not discriminate against individuals on the basis of
their gender expression. Requests for information, inquiries or complaints should be directed to these offices:
Equal Opportunity and Access Office, eoa@vanderbilt.edu, telephone (615) 343-9336; Title IX Office, Title IX
Coordinator, titleix@vanderbilt.edu, telephone (615) 343-9004, 110 21st Avenue South, Suite 975, Nashville TN
37203; Student Access Office, studentaccess@vanderbilt.edu telephone(615) 343-9727.
VUMC Non-Discrimination and Accessibility Notice is included in Appendix A of this handbook.

The Master of Science (M.S.) education program in speech-language pathology (residential) and the Doctor of
Audiology (Au.D.) education program in audiology (residential) at Vanderbilt University are accredited by the
Council on Academic Accreditation in Audiology and Speech-Language Pathology of the American Speech
Language-Hearing Association, 2200 Research Boulevard, #310, Rockville, MD 20850, 800-498-2071 or 301-296
5700.

Vanderbilt University is, above all, a center for scholarly research, informed and creative teaching, and service to
the community and the society at large. The University avows as its essential task the unique fusing of the quest for
knowledge through scholarship with the dissemination of knowledge through teaching. Creative experimentation,
the development of high standards, and an enhanced atmosphere of intellectual freedom are both evident and
valued on this campus. In addition, the University has an inherent regional role. It recognizes that as a private
institution it is almost unique in its offerings of advanced programs in the region. Moreover, the diversity of
programs promotes an interchange manifested in a wide and rich curriculum both remarkable for its size and
complexity. Vanderbilt values an environment conducive to the cultivation of liberal learning, logical thought,
and disciplined inquiry into the education of our youth and the training of creative professionals. Vanderbilt
understands itself as self- contained and self-regulating, subject finally only to generally acknowledged standards of
excellence and a sense of responsibility to the national community. High in priority among Vanderbilt’s many goals
is to have a diversified student population.

Vanderbilt University Medical Center is one of the nation’s longest serving and most prestigious academic
medical centers. Through its historic bond with Vanderbilt University, VUMC cultivates distinguished research
and educational programs to advance a clinical enterprise that provides compassionate and personalized care
and support for millions of patients and family members each year. World-leading academic departments and
5 comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical
advances across the entire spectrum of health and disease. VUMC’s leadership in the delivery of academically
based health care is recognized by the nations most trusted advisory bodies and reporting organizations including
the National Academies, the Magnet Recognition Program, U.S. News & World Report, the Leapfrog Group,
Truven Health Analytics and others. Our Schools of Medicine and Nursing and residency training programs are
consistently among the most selective, and are valued for their diversity, innovation and capacity to transform the
educational experience, while the breadth of our scientific discovery is propelled by a research enterprise that is
consistently ranked among the nation’s top 10.

Through the exceptional capabilities and caring spirit of its people, Vanderbilt will lead in improving the healthcare
of individuals and communities regionally, nationally, and internationally. We will combine our transformative
learning programs and compelling discoveries to provide distinctive personalized care.
www.vumc.org/Elevatesite/46643

We will sustain a collaborative community fully committed to diversity and inclusion and to supporting one
another, our patients, and their families.
• We will deliver the highest quality and safest health care in a seamless manner that always places our patients
and their families first.
• We will personalize the care of every patient, fully leveraging our knowledge, values, and strength in science
and technology.
• We will invest continuously in the capabilities of our people, helping each of us realize our goals and
potential.
• We will advance the knowledge of human health through a commitment to research, a passion for learning,
and an unyielding pursuit of better ways to deliver care.
• We will improve the effectiveness and efficiency of everything we do to achieve greater value for those we
serve.
• We will provide prompt and continuous access for our patients and colleagues throughout VUMC and the
Vanderbilt Health Affiliated Network. https://www.vumc.org/strategy/vumc-strategy

We provide excellence in healthcare, research, and education. We treat others as we wish to be treated. We
continuously evaluate and improve on performance.
• I make those I serve my highest priority.
• I respect privacy and confidentiality.
• I communicate effectively.
• I conduct myself professionally.
• I have a sense of ownership.
• I am committed to my colleagues. https://www.vumc.org/Elevatesite/53369

Vanderbilt University Medical Center is committed to excellence. We will:
• include you as the most important member of your healthcare team
• respect your right to privacy
• work with you to coordinate your care
• personalize your care with a focus on your values and needs
• communicate clearly and regularly
• serve you and your family with kindness and respect
www.vumc.org/Elevatesite/53369

The DHSS is dedicated to serving persons with communicative and related disorders through treatment,
education, and research; enhancing our knowledge of communicative and related disorders; shaping the future
of communication disorders and related disciplines through national and international leadership; promoting
public awareness and prevention of communicative and related disorders; ensuring continuous improvement
of operations through personal and professional development; and generating measurable benefits for our
community, employees, students, clients and their families, and other customers.

Staff and faculty in clinical roles have the primary responsibility for clinical patients. While providing patient
care, clinical staff and faculty also serve as clinical supervisors for graduate students. Their top priority is always
to provide services to patients in an effective and efficient manner. A secondary responsibility of supervisors is
the clinical education of students. The interaction of the primary and secondary responsibilities presents a unique
challenge to supervisors who must address both client and student interests.
Because all clinicians who hold the Certificate of Clinical Competence (CCC) and meet ASHA requirements for
supervisors participate in clinical supervision, the department is committed to offering supervisor education on a
regular basis. Each supervisor who is new to the center or who has not supervised in the past is required to have
an individual meeting with the Director of Clinical Education, their team leader, or the coordinator of the clinic in
which they work to receive instruction in the supervisory process in general as well as in procedures specific to the
site. In addition, an annual supervisor’s workshop is conducted each year to provide supervisors with additional
knowledge and skills to support supervisory activity. All supervisors are expected to attend, and ASHA continuing
education units are awarded without cost to those who supervise students in the program, both at on-campus and
off-campus sites.
Clinical supervisors are present and/or accessible 100% of the time a student is involved in patient care. The
supervision model in all clinical placements is 1:1 (one student to one supervisor). All students are supervised
100% of the time when beginning all clinic placements. Supervisors observe and have detailed discussions with
students to determine level of support needed and level of independence for all aspects of service. When requested
by supervisors, students complete self-evaluations in CALIPSO and share them with their supervisors. Supervisors
use their observations and feedback from the student to determine level of independence and supervision.

Supervisors are responsible for guiding students to:
• develop appropriate goals and strategies for evaluation and treatment using evidence-based practice
• develop skills in utilizing a variety of clinical techniques
• develop skills in utilizing a variety of clinical equipment/materials
• develop clinical writing skills
• develop self-evaluation skills
• develop skills in patient and family counseling
• develop skills in ethical practice
• develop professional practice competencies (accountability, integrity, effective communication skills, clinical
reasoning, evidence-based practice, concern for individuals served, cultural competency, professional duty,
collaborative practice)
To achieve the above goals, supervisors:
1. supervise students during clinical assignments (Level of supervision meets or exceeds ASHA requirements.)
2. provide written/verbal feedback about observations
3. suggest alternative procedures for implementing clinical goals
4. edit diagnostic and other reports/plans
5. demonstrate effective evaluation/treatment techniques as appropriate
6. participate in patient and family counseling sessions
7. foster independent clinical performance
8. consult with students regarding clinical procedures
During all stages of clinical practice, students benefit from feedback regarding performance. Ongoing regular
feedback is critical to the development of effective clinical skills.
Beginning Fall 2017, the DHSS began a phased implementation of CALIPSO. “CALIPSO is a web-based
application that manages key aspects of academic and clinical education designed specifically and exclusively for
speech-language pathology and audiology training programs.” (https://www.calipsoclient.com/) All new students
enrolled in the speech-language pathology and audiology educational programs beginning Fall 2017 have their
educational and academic requirements tracked in CALIPSO. For these students, mid-term evaluations and endof- semester evaluations are completed in CALIPSO. (Appendix B, Appendix C)
At minimum, supervisors will have the following formal interactions with student clinicians for the purpose of
evaluating student performance:
1. Goal setting for expected student performance will be completed at an initial conference using the area specific
form developed for the clinical placements site.
2. Midterm evaluations of clinical performance will be provided and discussed with the progress toward goals
highlighted.
3. Final evaluation of clinical performance will be provided and discussed with the progress toward goals
highlighted.
CALIPSO also allows students to complete self-evaluations. Supervisors are encouraged to have each student
complete self-evaluations during their clinical assignments. The following times are encouraged for selfevaluations:

• beginning of externship
• prior to midterm
• prior to each final evaluation

Once completed, students will share their self-evaluations with their supervisors.
The following performance rating scale is used in CALIPSO:

1 – Unacceptable performance: Specific direction from supervisor does not alter unsatisfactory performance
(skill/behavior is present <25% of the time).
2 – Needs Improvement in Performance/Maximum Support: The clinical skill/behavior is beginning to emerge.
Efforts to modify can result in varying degrees of success. Maximum amount of direction from supervisor
needed to perform effectively (skill/behavior is present 26- 50% of the time).
3 – Moderately Acceptable Performance/Moderate Support: Inconsistently demonstrates clinical behavior/skill.
Exhibits awareness of the need to monitor, adjust, and make changes. Modifications are generally effective.
Moderate amount of direction from supervisor needed to perform effectively (skill/behavior is present 51-75%
of the time).
4 – Acceptable Performance/Minimal Support: Displays minor technical problems that do not hinder the
therapeutic process. Minimum amount of direction from supervisor needed to perform effectively (skill/
behavior is present 76-90% of the time).
5 – Acceptable Performance/Independent: Adequately and effectively implements the clinical skill/behavior.
Demonstrates independent and creative problem solving (skill/behavior is present >90% of the time).
Clinical supervisors are responsible for completing evaluations and rating students on evaluation items as
accurately as possible using the performance rating scale.

The final semester grade is determined by the Director of Clinical Education. In CALIPSO, evaluation scores are
weighted by the number of clock hours approved by the clinical supervisor. The Director of Clinical Education
reviews weightings and scores to assign a final semester grade. The following are possible grades:

• P – Pass
• F – Fail
• IP – In progress (temporary grade)

VUMC supervisors are required to follow all VUMC guidance and requirements related to COVID-19 protocols
outlines on the VUMC employee website.
https://www.vumc.org/coronavirus/information-vumc-employees-and-patients
This webpage is regularly updated and supervisors should refer to them first for information about testing,
monitoring symptoms, etc.

Register for Clinical Courses

All students are expected to register for the appropriate clinical course each semester. Course information for each
semester is as follows:

Provide Documentation of Health Screenings

Students are required to submit immunization records and tuberculosis (TB) information prior to coming to
Vanderbilt University. Student who have not met immunization and health screening requirements will not be
permitted to register for classes. Detailed information on requirements and submission instructions are found
on the Student Health Center website: https://www.vumc.org/student-health/immunization-requirements-new-students.

Healthcare professional students in the School of Medicine (applies to speech-language pathology and audiology
students) are required to have an annual influenza vaccination if they are in a clinical setting between, October 1
and March 31. Consult the Student Health Center for information on the deadline and exemption request process.

Students are responsible for monitoring their immunization/health screening compliance and responding to the
need to update information/compliance in a timely manner.

Complete Required Training

CPR
Students must have on file a current CPR card. If the card expires during enrollment in the training program
at Vanderbilt, it is up to the student to obtain renewal training and provide documentation that it has been
completed. Acceptable courses are instructor-led, Basic Life Support (BLS) for Healthcare Providers CPR training
classes that cover both adults and children (Red Cross, American Heart Association, or Military Training
Network). Further information on courses and acceptable certification is found on the Vanderbilt Resuscitation
Program website: https://www.vumc.org/Resuscitation/

Initial Compliance Training
Incoming students are assigned “initial compliance” training in The VUMC Learning Exchange that consists of
training modules on HIPAA, Cyber Security, Sexual Misconduct, Code of Conduct, and Fraud, Waste, & Abuse.
In addition, students are assigned training on Bloodborne Pathogens and Infectious Diseases. This training must
be completed prior to beginning clinical practicum. This training is accessed on The Learning Exchange: https://learningexchange.vumc.org

eStar Training (EMR)
eStar is the electronic medical record used at VUMC in hospital units and outpatient clinics. Students are required
to complete eStar Live and eStar online training modules before access will be granted to the system. Online
modules are assigned, and live training is scheduled prior to the start of clinic assignments.

CALIPSO Training
CALIPSO is a web-based application that manages key aspects of academic and clinical education designed
specifically and exclusively for speech-language pathology and audiology training programs. Students receive
training during orientation which includes the following: registering in the system, accessing the system,
navigating the system, submitting clock hours, completing self-evaluations, site evaluations and supervisor
evaluations.

Clinic Assignments

Clinic assignments are made prior to the start of each semester in coordination with clinic leaders. Potential
clinical placements are based on supervisor and student availability each semester.

Entering students will be assigned to clinical experiences based on admission information and the expectations
for clinical skill development during the first semester of enrollment. MS-SLP students complete a form prior to
starting their clinical experiences that describes their prior observation experiences and preliminary preferred
patient populations and settings. This form is shared with the Pediatric Clinical Coordinator who assigns students
to their initial placement.

Continuing students will be asked to indicate requests for assignments prior to the end of each semester. The
Director of Clinical Education sends an e-mail approximately 3 weeks prior to the end of each semester to
solicit practicum planning information from students(Appendix D). Students are instructed to answer planning
questions and return the information via e-mail to the appropriate person. These requests are considered in
relation to the students’ needs for knowledge and skill development as well as previous clinical assignments. Clinic
assignments are sent to students via email.

Student Expectations

• Students will contact the supervisor prior to the first day of clinic to set up an initial staffing/orientation at the
  clinical site. Some sites will provide different instructions for orientation, and site-specific directions supersede
  this guideline. Each clinical site will have its own procedures for how and where students access clinical
  information and what policies and procedures are used at that site. Appropriate manuals and checklists will be
  provided to assist the student in managing these responsibilities in each clinical setting.
• Students are expected to arrive prior to each clinical appointment(based on the clinic’s expectations of
  appropriate arrival time) and to be prepared for the clinical assignment. Since supervisors are professional
  clinicians with primary patient care obligations, students will be guided and instructed through all phases of
  clinical service in an apprentice-type model.
• Students are expected to fulfill all clinical assignments.
• Students will maintain a clinical clock hour record and enter clock hours into CALIPSO on a daily basis. Clock
  hours are submitted to the appropriate supervisor for approval at a frequency designated by the supervisor
  (daily or weekly).(Appendix E, Appendix F)
• At the conclusion of each semester, students complete the following in CALIPSO:
  • Self-evaluation – Complete a self-evaluation upon request of supervisor(s). Print out completed self-evaluation and provide a copy to requesting supervisor.
  • Supervisor Feedback Form – One form for each of the main supervisors for the semester. (Appendix G)
  • Student Evaluation of Clinic Placement: One form for each of the on- and off- campus practicum sitesfor
    the semester.(Appendix H)
  • Students are expected to adhere to all policies and procedures, and confidentiality and privacy guidelines for all sites where they are placed for clinical assignments.
  • Students are required to abide by all PPE guidelines. (Appendix I, Appendix J, Appendix K) Students are requiredto follow all Vanderbilt University guidance and requirements related to COVID- 19 protocols: https://www.vanderbilt.edu/healthwellness/public-health/covid19/. This webpage is regularly updated and students should refer to it first for information about testing, monitoring symptoms, etc

All students in the Master of Science program in speech-language pathology and in the Doctor of Audiology
program are required to engage in practicum as part of their enrollment. The skills and knowledge successfully
obtained from the academic and clinical curricula will qualify the student for the Certificate of Clinical
Competence from the American Speech-Language-Hearing Association (ASHA) as well as state licensure, where
applicable. Audiology graduates will also qualify for American Board of Audiology Certification.

A sequence of clinical education is designed for each student to provide them with a comprehensive clinical
experience and to lead to the development of the desired skills and knowledge for successful practice in each
profession.

The clinical and academic components of the training programs are designed so that all students will achieve the
skills and knowledge outcomes delineated on the Knowledge and Skills Acquisition forms (Appendix L, Appendix
M). Each student will receive updates of their progress toward achieving the required skills and knowledge
outcomes as they progress through the program. Students use CALIPSO and have access to KASA information
through that system. While students may be exposed to opportunities for learning from both professions,
regardless of major, clock hour credit and the emphasis in professional training will be given to those clinical
activities associated with the recognized Scope of Practice for the profession in which the student is majoring. The
ASHA Scopes of Practice documents for audiology and speech-language pathology are provided in the following
links:

• Scope of Practice in Audiology: https://www.asha.org/policy/SP2018-00353. (2018).
  Available from www.asha.org/policy..
• Scope of Practice in Speech-Language Pathology: https://www.asha.org/policy/SP2016-00343. (2016). Available from www.asha.org/policy.

In addition to the knowledge and skills outcomes within their own scope of practice, students will meet the other
clinical and academic requirements for the Certificate of Clinical Competence awarded by ASHA.

Audiology

General Information
All Au.D. students are expected to participate and make consistent progress in developing clinical skills through
clinical practicum assignments throughout their program. Enrollment in clinical practicum is required during
each semester of the student’s enrollment. The first semester of the clinical program in audiology includes a weekly
clinical case conference survey combined with observations, guidance, and limited hands-on clinical experience.
After completion of laboratory competencies, students engage in one or two half-days per week in one of the
primary clinical sites (Odess Clinic, 9th Floor Audiology clinic, Green Hills Audiology Clinic, or Franklin ENT
Clinic) of the department during the semester.

A grade of Pass (P), Fail (F) or In Progress (IP) will be awarded for all semesters of practicum. The first-year
grading is primarily based on attendance, punctuality, professionalism, and active engagement in the learning
process. In subsequent semesters, clinical performance and learning will be the main areas of grading in addition
to areas mentioned above. The Director of Clinical Education assigns grades based on the average of all evaluation
scores completed by clinical supervisors. Clinic grades will be reduced for unexcused absences from either clinic or
clinical case conference according to prevailing departmental guidelines.

Students should expect to have the following time commitments to clinic during enrollment in the Au.D. program.
Amounts might be adjusted in years 1-3 based on supervisor availability and class schedule:

4th-Year Externship
During the summer of the second year, Au.D. students begin the application process for 4th-year clinical
externship placements. Students are guided through the externship application process by the Director of Clinical
Education and faculty and staff in the audiology program. The Director of Clinical Education meets with all rising
3rd-year students prior to the summer of their second year and provides detailed information regarding 4th-year
externships and the assistance provided by the department.

Following this meeting, students complete a Request for 4th-Year Externship Form (Appendix N) where they
generally describe the type of placement they are seeking (VUMC vs. external, city, state, employer, pediatrics/
adults, private practice, schools, VA, outpatient, etc.) and list up to 6 sites in order of preference. Students may
not contact sites directly at this point in the process. The Director of Clinical Education meets with each student
individually to review their preferences and list of sites. The Director of Clinical Education then contacts sites
to obtain detailed information regarding availability of externships and the application process. The Director of
Clinical Education completes this process and meets with students individually, again, to discuss the information
and sites they wish to submit applications. It is recommended that students apply to at least 5 sites. Students are
responsible for completing the applications and gathering all documentation needed for the applications. All
placements are contingent upon a fully executed affiliation agreement.

Externships begin on or about July 1 (during the summer of the third year) and continue for a minimum of ten (e.g. through Fall and Spring of the 4th year). Typical end dates for externships are around April 30 of the
fourth year. Students may receive financial support from the externship facility during the fourth-year externship.
Financial support provided by externship sites varies greatly, and this support is solely the responsibility of the
externship site. Students are responsible for all expenses related to externship (travel, housing, transportation,
background checks, etc. 

Speech-Language Pathology

General Information
All M.S. SLP students are expected to participate and make consistent progress in developing clinical skills through
clinical practicum throughout their program. Enrollment in clinical practicum is required during each semester of
the student’s enrollment.

Entering speech-language pathology students are enrolled in SLP 5883, a weekly case conference survey, and SLP
5305, a clinical practice course, to develop a foundation of skills and knowledge to permit clinical participation.
Additionally, a typical weekly clinical assignment for the first-semester student is 2 -3 half-days (9 to 12 clock
hours) of clinical practicum under the 100% direction of a certified supervisor. While the course content in SLP
5883 is expected to be sufficient to allow a student to have some information on which to base clinical activities,
all clinics assess students’ preparation for their clinical assignments and provide one-on-one instruction, readings,
demonstration, and modeling as appropriate until the student can demonstrate skills for limited engagement in
hands- on therapy. This procedure is used for subsequent semesters if classes have not been completed that would
underpin the clinical experience. After the first semester, speech-language pathology students engage in 4-5 half-days (14-20 hours) per week of clinical assignments. The 5th semester (or 6th semester, depending on admission
qualifications) includes a 10-week full-time externship.

Students complete 25 clock hours of guided clinical observation supervised by a licensed clinician who holds the
Certificate of Clinical Competence (CCC) in Speech-Language Pathology from the American Speech-Language-Hearing Association during clinical assignments and meets the requirements for supervisors established in
the 2020 Standards for the Certificate of Clinical Competence in Speech-Language Pathology(www.asha.org/
certification/2020-slp-certification- standards). Guided observation is integrated into each clinical placement prior
to the student engaging in direct patient care.

A grade of Pass (P), Fail (F) or In Progress (IP) will be awarded for all semesters of practicum. The first- semester
grading is primarily based on attendance, punctuality, professionalism, and active engagement in the learning
process. In subsequent semesters, clinical performance and learning will be the main areas of grading in addition
to areas mentioned above. The Director of Clinical Education assigns grades based on the average of all evaluation
scores completed by clinical supervisors.

Externship
During the final semester of enrollment students will complete a 10-week, full-time externship experience in a
facility to be determined based on the student’s interest and on facility availability. Students do not receive payment
or salary during the externship period, but financial support (remitted tuition) in place for the regular academic
semester will continue during the externship. Students are responsible for all expenses related to externship (travel,
housing, transportation, background checks, etc.). Students are expected to have completed approximately 300
clinical clock hours (including guided observation hours) prior to initiation of the externship.

Externship planning begins in the spring of the first year of the program. The Director of Clinical Education and
Director of Student Community Engagement meet with all 1st-year M.S. speech-language pathology students in
February or March and provide detailed information regarding externships and the assistance provided by the
department. Following the meeting, students complete a Request for SLP Externship Form (Appendix O) where
they generally describe the type of placement they are seeking (VUMC vs. external, state, city, employer, pediatrics/
adults, private practice, schools, VA, outpatient, etc.) and list at least three sites in order of preferences. Students
may not contact sites directly at this point in the process. The Director of Student Community Engagement meets
with the students individually to discuss their completed form and the specific sites where they wish to pursue a
placement. The Director of Student Community Engagement then contacts sites to obtain detailed information
regarding availability of externships, the specific patient populations and clinical specialties, and the application
process (if any). Students may only consider sites that will provide an experience that will lead to ASHA
certification. Students are responsible for completing applications (if applicable) and gathering all documentation
requested by the externshipsite for consideration for placement. They update the Director of Student Community
Engagement on the status of their applications and offers. If there is not a formal application and the Director
of Student Community Engagement is notified that a site would like to host a student, the Director of Student
Community Engagement notifies the student of confirmation of placement. All placements are contingent upon a
fully executed affiliation agreement between Vanderbilt University and the clinical externship site.

All students are placed in VUMC clinics for their first semester. Students must have demonstrated expected
performance for their level of study in the program to be placed at an external site (outside of VUMC). Students
are placed at external sites when the clinical experience is sequenced with coursework and they have had
experience in a VUMC clinic.
The Director of Clinical Education and the Director of Student Community Engagement contact potential external
sites to investigate willingness to host students for clinical experiences. When possible, the Director of Clinical
Education and/or the Director of Student Community Engagement tour sites to meet with clinic leadership and/or
staff and discuss the patient population seen at the site, patient volume, equipment used, and procedures that are
performed at the site. The website for the facility is reviewed and credentials of staff who would potentially work
with students are verified. If it is not possible to visit a site, a phone conversation with clinic leadership and/or staff
is conducted to obtain similar information that would be gathered at an onsite visit.

External placements begin only after information is obtained to determine the educational needs of a student will
be met and an affiliation agreement has been executed between Vanderbilt University and the facility. Students
must be in compliance with all health screening, training, background and/or drug screening requirements and
provide any documentation necessary to be onboarded by an external site prior to beginning their assignment.

Student progress is monitored by the Director of Clinical Education via e-mail and phone communication while
completing clinic assignments at external sites. External supervisors are granted access to CALIPSO and receive
training material and support from the Director of Clinical Education on the application. The information
described in “Responsibility of Supervisors” above applies to internal and external supervisors.

Feedback regarding supervIsors and external sites is provided by students in CALIPSO using the Supervisor
Feedback Form (Appendix G) and Student Evaluation of Off-Campus Placement Form (Appendix H).

Professionalism is difficult to define precisely, although almost everyone can recognize it when they see it— and,
perhaps more importantly, perceive its absence. The characteristics of professionalism which are more readily
discussed include such aspects as clinical dress, promptness, preparedness, and responsibility for tangible items
like materials and equipment. However, those characteristics that set a professional apart from a technician are the
more intangible aspects of professionalism. The application of accepted theoretical and ethical principles, the use of
evidence-based practice, a commitment to the welfare of the patient, cooperation with other professionals, respect
for patients and family members and their privacy, and a willingness to accept direction from those who are more
experienced are integral aspects of professionalism. During the clinical practicum experience, students will have
the opportunity to observe clinicians, faculty, and other students providing examples of professional behavior. It is
expected that students will emulate those who provide the best examples.

The CALIPSO Evaluation Form guides supervisors in evaluating the professional behaviors of students (Appendix B, Appendix C). However, students are also expected to demonstrate the less measurable aspects of professionalism
which are not listed on the form but which nonetheless will be evaluated.

Professional ethics and ethical conduct have moved to the forefront of the thinking of patients and service
providers in recent years. This may be a reaction to a period when it appeared that professionals were only giving lip-service to their ethical responsibilities. For whatever reason, the increasing emphasis on ethics and
the relationship of ethical conduct to evidence-based practice is extremely positive. All individuals who teach or
provide services in the Department of Hearing and Speech Science are expected to abide by a Code of Ethics. The
Code of Ethics of the American Speech- Language-Hearing Association (ASHA) is provided in the following linkS: ASHA Code of Ethics, AAA Code of Ethics.

In its preamble, the code is described as both inspirational and aspirational. While we aspire to abide by the Code’s
tenets, it should also inspire us to better practice than even that which is described in its principles and rules. The
ASHA Code of Ethics delineates our responsibility to the welfare of our patients, our responsibility to behave as
a professional, as well as our responsibilities to other professionals and to the public. While this code describes
principles and rules for the professions of audiology and speech-language pathology, it is clearly based on the
ethical values of autonomy, beneficence, confidentiality, harm avoidance, justice, professional responsibility, and
truth.

All students, as well as faculty members and clinicians, are expected to abide by the Code of Ethics of the
American Speech-Language-Hearing Association in their conduct of clinical and academic responsibilities in the
department. It is assumed that those values which are practiced here will continue to guide the student as they
enter the profession upon graduation

Vanderbilt University Medical Center and its departments and clinics have a strong commitment to patient rights.
Our Center provides treatment without regard to race, nationality, religion, beliefs, age, disability, sex, sexual
orientation, gender identity or expression, or source of payment. Our patients are entitled to safe, considerate,
respectful, and dignified care at all times. Patients are encouraged to ask questions about their rights if they do not
understand. If patients have concerns about the quality of care received, they are encouraged to contact the Office
of Patient Relations: 615-322-6154.

At intake each patient is given the Vanderbilt publication “Patient Rights and Responsibilities,” which provides
details about patients’ rights. This publication is available in Spanish upon request. Students should be familiar
with this document and be prepared to explain it to patients who have questions (Appendix P).

Vanderbilt University Medical Center is committed to patient privacy. Information about patients and their health
is personal and private. The Vanderbilt Bill Wilkerson Center is also committed to protecting the documents and
records of the care and services we provide. While documentation is an extremely important part of quality care,
the Center and its representatives must comply with requirements regarding the ways in which clinical information
can be used and shared. Patients will receive information in the form of a Notice of Privacy Practices (Appendix
Q), which further describes their legal rights to confidentiality. This notice is available from all clinical sites.
Students should read and be aware of the contents of this document and be prepared to answer patient questions
about it. Additionally, an internal VUMC document on HIPAA (Appendix R) is available to all clinicians and
students to further amplify the effect of HIPAA on clinical activities within the center.

All students must engage in the medical center’s HIPAA training program upon enrollment in the department.
This training is conducted as part of pre-orientation, on-line activities. Additionally, students must read and sign
the Vanderbilt Confidentiality Agreement (Appendix S).

Introduction

Documentation of a patient encounter is as important when a graduate student assists a qualified provider
(supervisor) in providing the care as when care is rendered by the qualified provider only. Requirements for
accurate and comprehensive documentation are essential when student learning is involved. Documentation
justifies why a patient was seen, the assessment or treatment procedures used, the results of assessment and
treatment, and the recommendations for follow-up. To become a competent professional, students-in-training
must learn how to complete assessments and treatments and also, how to record clinical activities for the benefit of
the patient, for continuity of care, and to obtaining reimbursement for the services rendered.

Medicare allows limited billable interactions between students and beneficiaries. Guidelines for line-of- sight
supervision and responsibility for clinical decision making by the qualified professional maybe accessed and
are applicable to Medicare Part A (hospital and skilled nursing facility patients), Medicare Part B, and Medicaid
patients. While all services to patients governed by CMS guidelines must adhere to those rules, the purpose of
this document is to address only issues associated with documentation in the electronic medical record regarding
student-authored reporting.

Policy

It is accepted policy in the Department of Hearing and Speech Sciences (DHSS) that graduate students in speech-language pathology and audiology may participate in the submission of documentation to the electronic medical
record. The supervisor and primary provider of the service should determine the student’s role in documentation
based on knowledge of the student’s level of clinical competency and familiarity with the electronic record system.
The supervisor must sign all documentation. The student can author the documentation and, optionally, can sign
in addition to the supervisor. The supervisor’s signature is necessary for billing/reimbursement and to verify the
accuracy of the information that has been documented (Pub 100-02 Medicare Benefit Policy Manual, Chapter15
[Covered Medical and Other Health Services], sections 200 and 230). The qualified professional is responsible for
the services and, as such, signs all documentation.

The supervisor’s signature, when the student has contributed to the report, indicates that the supervisor has
reviewed, edited, and approved all entries into the medical record and that the record accurately reflects the care
and recommendations for the patient on the date of service. To alleviate concerns about plagiarism of student-authored notes, one of the following descriptors may be used to clarify authorship in the medical record:

1. Treatment was conducted with one-on-one supervision of co-signing therapist
2. Co-signing therapist provided onsite supervision during the course of today’s care. Treatments rendered were
determined to be appropriate for patient’s current status.
3. Co-signing therapist provided onsite supervision during the course of today’s care (with added comments).

(Message from C. Lackey, Informatics Center, to M. Fino-Szumski, 9/14/2010, re: Co-sign notations) In most
instances it appears that Option #3 above would best reflect the typical scenario when a student assists in the
evaluation/treatment session, prepares some or all of the report of the session which is edited by the supervisor, and receives final approval from the supervisor for the report to be submitted. In all instances, all guidelines or use
of the electronic medical records system must be observed, notably that a student or a supervisor must be signed in
under their own name and password to enter information into the record.

Departmental policies which comply with Medical Center policies for student access to the electronic medical
record system are given below.

Use of eStar/Audbase/TIMS

eStar, Audbase, and TIMS are the electronic record keeping programs used within the Department of Hearing
and Speech Sciences. All patients will have information regarding intake and treatment in the medical record
system. Only qualified providers (certified clinicians) are able to enter information independently into any of the
healthcare documentation systems. However, learning an electronic charting system is considered to be a desirable
component of student clinical education. As such, guidelines have been developed for student/supervisor use of
the systems. Additionally, all students must engage in the appropriate eStar, Audbase, and/or TIMS training as
part of their orientation program in order to understand the regulations for accessing and sharing information
within the system. The use of electronic patient care information is also governed by patient privacy guidelines and
HIPAA requirements.

Student Access to Electronic Medical Records – Departmental Policy

1. Security clearances: All MS-SLP and AuD graduate students will be expected to have completed basic training
   for eStar and to have signed an annual confidentiality agreement and received security clearance prior to
   having received their personal eStar access.
2. Competencies: Beyond basic eStar training, unit-specific training for students may be provided as needed.
   Audiology students will receive training and access to Audbase and TIMS where required and appropriate.
   Competencies maybe evaluated according to the guidelines in each division/program.
3. Passwords: At no time is any supervising clinician to allow a student to access the electronic medical record via
   his/her password. Sharing the password with another person is considered to be a HIPAA violation, requiring
   suspension.
4. Access to the records: Students will be allowed to access, via their own passwords, any record that directly
   relates to a case within their current clinical assignments. They may review and access information in the
   records only when they have a legitimate “need to know” that information. Access is monitored and must be
   directly related to patient care.
5. Inputting documentation: Students are not to document any information within the medical record without
   direct instructions from a supervisor and only in the following conditions:
   • Treatment was conducted with one-on-one supervision of co-signing therapist
   • Co-signing therapist provided onsite supervision during the course of today’s care. Treatments rendered
     were determined to be appropriate for patient’s current status.
   • Co-signing therapist provided onsite supervision during the course of today’s care (with added comments).
6. Protection of Health Information: At no time is a medical record to be printed by students for review. At no time is the medical record to be accessed from home (requires a security clearance), and at no time are any paper clinical records of any kind to be duplicated, Xeroxed, and/or removed from the facility.
7. Limitation to the medical record system: Protected health information may not be developed in Word
   Documents or e-mailed, faxed, or transmitted in hard copy outside of the electronic medical record.
8. Use of medical records for Clinical Case Conference/Class Case Presentations: Students may access the entire
   electronic record for a patient to whom they have been assigned for purposes of a clinical case conference or
   class case presentation. However, all patient identity that is part of the protected health information must be
   removed prior to the presentation. Photographs, videos, and recordings of patients may only be used in case
   conference after completion of a release form by the patient or designated representative.
9. Research: Medical records cannot be accessed for research purposes unless the protocol for the study and
   medical record access has been approved by the Institutional Review Board (IRB).

Student attendance is required at every clinical session throughout the duration of each practicum assignment
unless otherwise scheduled by the supervisor. Only those absences due to illness or similar unanticipated
emergencies may be excused; these should be reported immediately and directly to the supervisor. In rare
instances, a student may be excused from attendance at a clinical appointment for a compelling reason. When this
occurs, the student must work with the supervisor to makeup the session. Patient appointments should never be
cancelled without consultation with the supervisor. If the supervisor cannot be reached directly, then a voice mail
message should be left or using any other preferred communication method specified by the supervisor. Clinical
attendance may be rescheduled for limited reasons (ex: special presentation by guest speaker, conference, etc.) at
the direction of the Director of Clinic Education. These cases will be communicated to students and supervisors
in advance of the event. Clinical practicum and class instruction are viewed as equally important components of
graduate education.

Student clinician absences do impact clinical/supervisory operations in several ways. If absences are repeated,
they may leave supervisors, clients, and/or parents with the impression that clinical work is less important to the
student than are classes or other activities. If clients need to be cancelled, clinic revenue is lost. If a supervisor
needs to rearrange the day’s schedule, cancel another commitment, find someone else to assist, or conduct a
substitute treatment session with a lesson plan, valuable time is lost to the patient involved and the continuity of
service maybe disrupted. Finally, if projected skills and knowledge outcomes are not achieved by the end of an
assignment, a student’s future clinical placement options may be limited, and they may not make expected progress
in skills acquisition.

The role of a student clinician, whether at the beginning or advanced levels, should be undertaken as responsibly
and seriously as that expected of a certified clinician in any work setting. The purpose of supervised practicum is
not only to develop clinical skill but also to instill professional responsibility.

It is the policy of the Medical Center to provide qualified interpreter services (either in-person or by telephone) for
patients whose primary language is other than English. If you are scheduled for a patient who requires interpreter
services, consult with your supervisor on the interpreter services that have been arranged for the patient visit.

Bilingual Workforce Members must take a language fluency and healthcare terminology assessment in both
English and the target language in order to communicate (within the key functions of his/her role), directly with
patients in the target language. For nonmedical communication, Workforce Members are given an appropriate
assessment coordinated by Vanderbilt Interpreter Services. None of these assessments result in permission
for bilingual Workforce Members to interpret for other people, family members, colleagues, or patients. Once
language fluency skills are assessed, if a passing score is received, the Workforce Member will be credentialed as
a “Qualified Bilingual” (with language noted) and can then communicate directly with their own patients in the
target language when facilitating care. This is not considered interpreting and does not enable that Workforce
Member to interpret for his/her own patients or the patients of other Workforce Members.

Students should familiarize themselves with the guidelines for the use of interpreters in clinical settings by
accessing this information on the ASHA website, as well as in print and other materials in the clinical areas.
Supervisors can also provide valuable guidance in these instances.

Vanderbilt University Medical Center Interpreter Services:
https://www.vanderbilthealth.com/information/interpreter-services

ASHA Resources:
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935334&section=Overview

Students may be placed for educational experiences in clinical sites located away from the Vanderbilt University
campus and may be locations in counties surrounding Davidson County (Nashville). Generally speaking, students
should be prepared to drive up to 60 miles (one way) from the Vanderbilt University campus to reach off-site
placements. External placements maybe up to three days per week for an entire semester. Students are responsible
for their own transportation to and from all clinical sites for educational experiences, including all costs associated
with that travel.

Students seeking accommodations for any type of disability are encouraged to contact Student Access Services.
Accommodations are tailored to meet the needs of each student with a documented disability. Specific concerns
pertaining to services for people with disabilities or any disability issue should be directed to the Disability
Program Director, Student Access Services. Mailing address: PMB 407726, 2301 Vanderbilt Place, Nashville,
Tennessee 37240-7726. Walk-in address: 108 Baker Building. Phone(615) 343-9727; fax (615) 343-0671; https://
www.vanderbilt.edu/student-access/. Step-by-step instructions for applying for accommodations through the
Commodore Access Portal’s student application page can be found here: https://www.vanderbilt.edu/studentaccess/how_to/get_accommodations/index.php.

Equal Opportunity and Access (EOA) and handles all discrimination issues for faculty, staff and students. EOA
also processes disability accommodation for faculty and staff, as well as religious accommodation requestsfor all.
Its website is: https://www.vanderbilt.edu/eoa/.

The Title IX and Student Discrimination office has changed its name to Title IX and handles sexual harassment
issues. Its website is: https://www.vanderbilt.edu/title-ix/.

Student Access Services remains responsible for student accommodation, excluding religious accommodation: https://www.vanderbilt.edu/student-access/.

The Center for Student Wellbeing seeks to create a campus culture that supports students in cultivating lifelong
wellbeing practices. The center also works closely with campus partners, including the University Counseling
Center (https://www.vanderbilt.edu/ucc/), the Student Health Center, the Office of Housing and Residential
Education, and the academic deans to provide resources and support for students who may be facing personal or
academic challenges. The Center for Student Wellbeing is centrally located on campus at 1211 Stevenson Center
Lane, across from the Student Health Center, and is open Monday through Friday, 8:00 a.m. to 5:00 p.m. For more
information, please call (615) 322-0480 or visit https://www.vanderbilt.edu/healthydores/.
Additional resources are found in Appendix T.

Students who have a grievance regarding performance evaluations or other matters that they have been unable
to resolve with a supervisor or professor, should take their concerns to a third party. If the complaint is with a
supervisor, then the student should confer with the Director of Clinical Education. If the complaint is regarding
an academic grade, then the student should meet with the academic advisor (unless the advisor is the person
involved in the complaint; then the student should meet with the Vice Chair for Graduate Studies). If the advisor
is unable to help the student resolve the grievance, then the student should meet with the Vice Chair for Graduate
Studies. In instances in which there are both academic and clinical concerns, the student may ask to meet with
both the Vice Chair of Graduate Studies and the Director of Clinical Education. If resolution still is not achieved,
the student may go to the Chairman of the Department. Students may then follow university procedures for
complaining to the Medical School as appropriate. The student may seek guidance or communicate directly with
the Council on Academic Accreditation (CAA) if they choose.

Vanderbilt University Complaint and Grievance Procedure:
https://www.vanderbilt.edu/student_handbook/university-policies-and-regulations/#complaint-and-grievance-procedures.

If students have concerns regarding sexual harassment, discrimination, or intimidation, they are referred to the
Vanderbilt University website for Title IX and Student Access. These sites provide procedures for filing a complaint
or formal grievance:

• https://www.vanderbilt.edu/student-access/grievances.php
• https://www.vanderbilt.edu/title-ix/

This manual is a tool to help students to navigate their clinical responsibilities. Students should become familiar
with its content as well as the appended documents and listed resources. This manual is a useful reference tool
through the graduate program. If there are questions regarding the content of this manual, the student is urged to
ask the Director of Clinical Education for clarification.

vanderbilt University Medical Center complies with applicable federal civil rights laws and does not discriminate
on the basis of race, color, national origin, age, disability or sex. VUMC does not exclude people or treat them
differently because of race, color, national origin, age, disability, or sex.
The Medical Center:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • qualified sign language interpreters
  • written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as:
  • qualified interpreters
  • information written in other languages

If you need these services, contact Employee and Labor Relations.

if you believe that VUMC has failed to provide these services or discriminated in another way on the basis of race,
color, national origin, age, disability, or sex, you may file a grievance in person, by mail, fax, or email. If you need
help filing a grievance, Rochelle Johnson, Director, Employee and Labor Relations, is available to help you. File
your grievance with:

Rochelle Johnson, Director, Employee and Labor Relations 2525 West End Avenue, Suite 500
Nashville, TN 37203
615.343.4759 (phone)
615.343.2176 (fax)
Email: employeerelations.vumc@vumc.org

You may also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil
Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Ave., SW
Room 509F, HHH Building Washington, D.C. 20201
1-800-368-1019, or 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

The following are fall practicum planning instructions for all 1st year SLP students and 1st and 2nd
year audiology students on CALIPSO.
Dr. Barbara Jacobson and Dr. Fino-Szumski cannot begin scheduling clinic assignments until everyone
has completed fall class registration and we have an e-mail from each student regarding practicum
planning.

To facilitate FALL practicum scheduling, please do the following:

Send an e-mail with the subject line “Practicum Planning Fall 2023 for YOUR NAME” no later than July
31 to the designated person below:

• Speech Pathology Students: Dr. Barbara Jacobson
• Audiology Students: Dr. Mary Sue Fino-Szumski

Cut and paste the following into the e-mail with your replies to the questions:
Considerations for scheduling:
NOTE: It is assumed that all students have transportation.
_____ I have met all of training grant stipend support commitments.
_____ I have not met my training grant stipend support commitments; (DESCRIBE)

Other comments:

• Specify any personal or other concerns that could potentially be taken into consideration with
  practicum scheduling.
• specify any need for clock hours in a specific area of practice/setting/population for placement for next semester.

SPECIAL NOTE: The start date for fall clinic assignments will be August 28.
Thank you for your attention to these matters and thank you for your help in completing another
successful semester as well as the necessary documentation for your clinical records.

Please let me know if you have questions.

Effective July 20, 2020 healthcare personnel must wear eye protection and surgical/procedural masks with direct, prolonged patient interactions.

Frequently Asked Questions

Who must wear eye protection and surgical masks?
Anyone entering a patient-occupied clinic exam or hospital room or having direct, prolonged (>5 min) contact with a
patient. This guidance does not replace recommended PPE for other specific isolation precautions.
Can I reuse the surgical mask and eye protection between patients?
Yes, with a few exceptions. The surgical mask and eye protection must be worn across multiple patient encounters
without disposal. Surgical masks must be discarded if they become wet, torn, or soiled. Eye protection must be cleaned
if they become contaminated or soiled. When exiting a contact or droplet precaution room, masks must be discarded
and eye protection cleaned.
When must a cloth mask be worn?
Anyone not providing direct, prolonged patient care and not entering patient rooms must wear a cloth mask.
A cloth mask must be worn outside of patient care areas including the cafeterias, parking garages, hallways,
administrative offices, and by valet.
What is considered “eye protection”?
Eye protection includes goggles, face shields, mask/splashguard, safety glasses, or shields that clip onto the sides of
personal eyeglasses. Personal eyeglasses alone are not considered adequate eye protection.
Do I still need to wear eye protection and a surgical mask if a patient has tested negative for SARS-CoV-2?
Yes.
What led to the change in PPE recommendations?
If persons to whom you are exposed are wearing masks, then their respiratory droplets will be contained by their mask;
however, patients are not always fully compliant with wearing masks properly. Though SARS-CoV-2 spreads primarily
through a respiratory route, it is possible the virus could land in the eye and lead to infection even if your mouth and
nose are covered by a mask. Rates of COVID-19 community transmission are increasing in our region, and CDC has
recently recommended the addition of eye protection in this setting.
How do I clean my eye protection?
Do not touch your eye protection during direct patient care. If your eye protection becomes contaminated or soiled,
promptly remove, wipe down with hospital approved disinfectant, and allow to air dry. Store your eye protection in a
bag, labeled with your name, and continue to use across multiple shifts while in good condition.
How do I store my surgical mask?
Do not touch your surgical mask during direct patient care. If your mask becomes wet, torn, or soiled, remove your mask
holding the straps and discard. Store your mask by folding it in half in a brown bag, labeled with your name, and
continue to use across multiple shifts while in good condition.
How do we obtain PPE?
Supplies will be available in outpatient clinics and inpatient floors.

Personal protective equipment (PPE) is recommended to be worn to reduce the risk of contamination and germ
dissemination. Masks, gowns, gloves, and eye protection are all PPE components that when used appropriately provide
protection to everyone at VUMC.

Masks should be worn at all times, this guidance applies to everyone at VUMC. The type of mask will depend on the
environment and situation. Eye protection should be worn in all patient rooms, regardless of time spent with the
patient.

It is important to note that PPE stocks continue to be secured to maintain a good supply; however, we should all do our
part to prevent PPE waste. PPE must be worn according to Standard and CDC Isolation Precautions. Below are answers
to Frequently Asked Questions with some examples on how to best optimize our PPE supplies.

• Surgical/procedure masks must be worn at all times in any clinical areas of VUMC.
• Eye protection must be worn by any personnel entering patient-occupied clinic exam/hospital rooms for any length of time regardless of COVID test results OR in other locations where the individual will have direct, prolonged (>5 min) contact with a patient.

What Type of Mask Should be Worn?
• Non-clinical, Research, and Public Areas: Wear a paper mask or cloth face covering
• Clinical Areas where one enters a patient room or has prolonged (>5 mins), direct patient contact: Wear a
surgical/procedural mask and eye protection (see Eye Protection & Surgical Mask)
• Other Clinical Areas/Situations: Wear a surgical/procedural mask.
• N95 respirators should NOT be worn in general clinical areas or for non-approved indications. For additional
information refer to the N95 Reminders document.
Why are we recommending a procedure/surgical or cloth mask and not an N95 respirator?
Similar to influenza and other respiratory viruses, COVID-19 appears to be transmitted primarily through large
respiratory droplets. Surgical/procedure masks provide protection against respiratory droplet spread. In contrast, N95
respirators provide a higher level of filtration and are important in clinical situations where infectious particles could
become aerosolized. This primarily occurs in specific clinical situations such as when a patient is intubated or undergoes
bronchoscopy. N95 respirators are also difficult to wear for long periods of time. As the N95 respirator supply must be
reserved for approved high-risk procedures, N95 respirators should NOT be worn in general clinical areas or for nonapproved indications.
What is the difference between a surgical and a procedural mask?
Both provide bacterial, particle, and pathogen filtration at comparable levels. Surgical masks, however, have a higher
degree of impermeability to prevent blood/body fluid exposures one would anticipate in a surgical setting.
How can I eat/drink when I am supposed to wear a mask?
Perform hand hygiene, remove the mask, eat or drink in an approved location, and then replace your mask. Please
follow the guidelines on appropriate doffing and maintain social distancing (e.g. space out in break rooms, at dining
tables).
What if I feel like I cannot wear a mask?
You can request a medical accommodation through Employee Relations at employeerelations.vumc@vumc.org or you
can call 615-343-4759 if you have questions. The following link provides information about the accommodation process
https://hr.vumc.org/Employee-Relations/Accommodations.
Can masks or N95 respirators that have an external valve or vent (see picture) be used as
part of universal masking at VUMC?
No. These types of masks do not protect others if the wearer has COVID-19 infection, and
they are not permitted by CDC guidelines. The external valves/vents are designed to release
unfiltered air and do not effectively remove the virus from exhaled breath in the event the
wearer has COVID-19 infection. This vent does not impair the device’s filtration of inhaled
air when worn as personal protective equipment to protect the wearer. For VUMC:
• A face mask with an external valve/vent should not be used. If any workforce member, patient, or visitor does
not have a mask without a valve/vent, one will be provided to them.
• A VUMC provided N95 respirator with an external valve/vent should only be used if no other N95s are available,
and, if used, a surgical mask should be worn over the vented N95.
What if I experience a burning sensation or skin irritation while wearing an N95 mask?
If you notice this type of discomfort from any PPE use, remove yourself from patient care, take off the PPE, fill out a
VERITAS Report, and call Occupational Health for further instructions.
Who must wear eye protection with surgical masks?
• Anyone entering a patient-occupied clinic exam or hospital room for any length of time regardless of COVID test
results.
• Anyone in other locations having direct, prolonged (>5 min) contact with a patient (i.e. outside of a patient room
such as in the hallway, ancillary testing).
• This guidance does not replace recommended PPE for other specific isolation precautions.
Can I reuse the surgical mask and eye protection between patients?
Yes, with a few exceptions. The surgical mask and eye protection must be worn across multiple patient encounters
without disposal. Surgical masks must be discarded if they become wet, torn, or soiled. Eye protection must be cleaned
if it becomes contaminated or soiled. When exiting a contact or droplet precaution room, masks must be discarded and
eye protection cleaned. Staff should use a dedicated set of eye protection and should not share their eye protection
with anyone else.
How do I store my surgical mask?
Do not touch your surgical mask during direct patient care. Store your mask by folding it in half (clean interior sides
together), place in a paper bag, labeled with your name. Continue to use across multiple shifts while in good condition. If
your mask becomes wet, torn, or soiled, remove your mask holding the straps and discard.
What is considered “eye protection?”
Eye protection includes goggles, face shields, mask with splashguard, safety glasses, or shields that clip onto the sides of
personal eyeglasses. Personal eyeglasses alone are not considered adequate eye protection.
Why are patients not required to wear eye protection?
Healthcare personnel have more interactions with individual patients who are sometimes unable to wear a mask due to
intolerance or a need to remove the mask for patient care examinations; therefore, additional PPE is used by healthcare
personnel. Patients do not have the same amount of interactions and will be protected from spread by the universal use
of surgical masks and eye protection by our healthcare personnel.
How do I clean my eye protection?
Do not touch your eye protection during direct patient care. If your eye protection becomes contaminated or soiled,
promptly remove, wipe down with hospital approved disinfectant, and allow to air dry. Perform hand hygiene. Store
your eye protection in a bag, labeled with your name, and continue to use across multiple shifts while in good condition.
How do we obtain PPE?
Supplies are available in outpatient clinics and inpatient areas. You can be request PPE through the area leadership
teams or staffing leaders.
If my patient is in a double occupancy COVID + room, how does that change PPE use?
• Don PPE and provide care for patient #1
• At the end of that care, doff gloves, perform hand hygiene, don new gloves and provide care to patient #2.
• For dedicated COVID units, follow “Cohorting PPE Guidelines” remembering to change all PPE after 4 patient
encounters (not 4 rooms).
If my patient is in a double occupancy COVID – room, how does that change PPE use?
• Don PPE (mask and eye protection) and provide care for patient #1
• At the end of patient #1’s care, perform hand hygiene, and provide care to patient #2.
• When exiting the room, your masks can remain on unless damp, soiled or damaged.
• Eye protection is cleaned if soiled or contaminated.
When should someone wear a nitrile glove instead of a vinyl glove? Is there a difference?
Vinyl gloves provide standard barrier protection from COVID-19, are soft and comfortable, and are latex and powder
free, whereas nitrile gloves are chemical and puncture resistant and have a higher degree of tactile sensation for
sensitive work such as starting IVs.

There are patient encounters where vinyl gloves are a suitable and safe option, including transport, valet, guest services,
and EVS. These departments have been asked to utilize vinyl gloves to help us use our nitrile glove supply properly going
forward and ensure the safety of everyone.
When should gloves be worn?
Medical gloves are recommended to be worn to reduce the risk of contamination of healthcare workers hands when
blood and other body fluids are present. Wearing gloves also reduces the risk of germ dissemination.

Gloves should therefore be used during all patient-care activities that may involve exposure to blood and all other body
fluid (including contact with mucous membrane and non-intact skin) and for patients on contact precautions.

Gloves must be worn according to Standard and Contact Precautions. The pyramid below describes situations when
sterile and examination gloves should be worn and when gloves are not necessary. It is important that gloves are never
reused between two patient encounters and are changed when they become soiled or torn.

Rationale for Universal Masking Guidance
Our knowledge regarding COVID-19 is rapidly expanding. This allows us the opportunity to update PPE policies to
incorporate the best evidence about issues like masking. Given what we have learned about COVID-19, universal
masking, in addition to social distancing and frequent hand hygiene, will help prevent spread secondary to presymptomatic or asymptomatic infection.

To be successful, this approach will require support from all of us across the enterprise and will require the following:
• Strict adherence to extended use/reuse of masks
• Meticulous adherence to hand hygiene (including before and after touching or removing masks)
• Proper mask use and hygiene including wearing the mask as directed to cover the mouth and nose
• Strict avoidance of manipulation/touching the mask to reduce the risk of contamination
Where is Masking Required?
Masking is required in all areas of VUMC (including all clinical, non-clinical, research and public areas). This includes
common public areas such as cafeteria/food courts, break rooms, research labs, conference rooms, bathrooms,
elevators, and waiting rooms.
Masks should be worn while walking outdoors to and from VUMC buildings from parking areas, from the time of
entering or exiting one’s car. Masks may be removed ONLY if a person is sitting in their assigned workspace (e.g.
office, cubicle, lab bench desk) AND can maintain at least 6 feet distance from all others.
What Type of Mask Should be Worn?
• In non-clinical, research, and public areas: Wear a paper mask or cloth face covering
• In clinical areas where one enters a patient room or has prolonged (>5 mins), direct patient contact: Wear a
surgical/procedural mask and eye protection (see Eye Protection & Surgical Mask)
• In all other clinical areas/situations: Wear a surgical/procedural mask.

As our current N95 respirator supply must be reserved for approved high-risk procedures, N95 respirators
should NOT be worn in general clinical areas or for non-approved indications.

N95 Reminders:

DO:
• Wear masks in all VUMC areas as noted
• Follow guidance on reuse, donning and doffing
• Conserve masks
• Wear and store masks correctly

DO NOT:
• Wear N95 respirators unless performing an
approved high-risk procedure
• Wear or store masks incorrectly

Email Template:

STUDENT INFORMATION
Name:
Address:
Phone Number:
Vanderbilt Email:
In general, describe your preferred placement (ex: VU vs. external, state, city, employer, pediatrics/adults, private practice, VA,
school, outpatient, etc.):

PREFERRED PLACEMENT SITES (List up to 6 sites in order of preference.)
#1
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#2
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#3
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#4
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#5
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#6
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

NOTES: Submit this form electronically to Dr. Fino-Szumski before or during your scheduled appointment.

Email Template:

STUDENT INFORMATION
Name:
Phone Number:
Vanderbilt Email:
Check One:
_____ I came into the program with a background and will complete my externship in the spring semester of 2022
_____ I came into the program without a background and will complete my externship in the summer semester of 2022
In general, describe your preferred placement (ex: VU vs. external, state, city, employer, acute, rehabilitation, school, outpatient, etc.):

PREFERRED EXTERNSHIP SITES (List up to 3 sites in order of preference.)
#1
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#2
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

#3
Name of facility:
Name of contact (if known):
Address:
Website:
Phone #:

NOTES: Submit this form electronically to Dr. Jacobson before or during your scheduled appointment. Scheduled meetings will
begin on 03/11/2022.

Duration = 10 weeks (some sites require 12 weeks)
*School placements start earlier to allow for school closings for break.
Early start or late end dates, must be approved by Dr. Fino-Szumski.

PROCESS
1. describe your preferred placement (VU vs. external, city, state, acute, rehabilitation, schools, outpatient, etc.).
2. identify top 3 sites and research them.
3. fill out Request for M.S.-SLP Externship form (Please type information).
4. sign up for a time to meet and discuss your preferred sites with Dr. Jacobson.
5. submit Request for M.S.-SLP Externship form electronically to Dr. Jacobson.
6. meet with Dr. Jacobson.
7. Dr. Jacobson will make contact with sites and notify you if placements are available.
8. for available sites, Dr. Jacobson will advise of next steps (resume, cover letter, interview, application, etc.).
9. if we cannot secure a placement from initial list of preferred sites, Dr. Jacobson will setup another meeting to
strategize next steps.
10. first offer for an externship is the one you are advised to take.

REQUIREMENTS (Dr. Fino-Szumski)
Must have the following in place to finalize/confirm an externship:
1. state authorization (no longer issue)
2. active affiliation agreement with VU.

DOCUMENTATION
This is the usual documentation required by our affiliation agreements:
• immunization records (Student Health)
– PPD tuberculin skin test or chest x-ray within one year of clinical experience;
– positive serology of immunity to Rubella and Rubeola or MMR vaccination;
– Hepatitis B vaccinations or waiver indicating refusal;
– positive serology of immunity to varicella or immunization.
– COVID vaccinations
• CPR Training (check expiration date)
• health insurance in effect during the entire externship
• training: OSHA/Blood Borne Pathogens
• training: HIPAA regulations
• background check within 1-year
• fingerprint check – Varies and may be required for another state
• 10-panel drug screen – Varies and may need to be done in a specified timeframe
• VU liability insurance – Provided by VU as specified in the agreement

Other costs that may also be responsibility of student:
• worker’s compensation insurance
• liability insurance
• onboarding fee
• additional background screenings
• drug testing