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Teaching clinic conferences: Perceptions of supervisor and peer behavior
J. COMMUN. DISORD. 20 (1987), 119-128
TEACHING CLINIC CONFERENCES: PERCEPTIONS OF SUPERVISOR AND PEER BEHAVIOR SUSANN Universio
DOWLING of Houston-University
Park
Perceptions of supervisor and peer behavior during teaching clinic conferences, a group supervisory approach, were assessed. Four groups of graduate students participated in a total of 19 teaching clinics. Following each conference, they completed two Individual Conference Rating Scales to describe the supervisor and peer during the interaction. Peer behavior differed from that of supervisors. Differences were also found between supervisors and among groups of students participating in the conferences. A participant’s role had no impact on the participants’ perceptions of either the peers or supervisors. Variations in perceptions were noted as the number of clinics per group increased.
INTRODUCTION A substantial quantity of research has focused on the supervisory conference as a means to describe the interaction and to measure effectiveness. Cogan (1973) stressed the importance of a colleague1 relationship and active involvement of both the supervisee and supervisor in the conference. Blumberg and Amidon (1965) reported that the supervisee’s perception of conference effectiveness and satisfaction in the supervisory relationship was directly related to the supervisee’s involvement in the conference, When supervisors were direct, allowing minimal supervisee input, the supervisee perceived conferences as nonproductive and ineffective. Positively perceived conferences were indirect and included substantial supervisee input. Smith and Anderson (1982) have also isolated the factors direct and indirect as effectiveness variables in the individual supervisory conference. Brasseur and Anderson (1983), using a modified, validated version of the Smith (1977) Individual Supervisory Conference Rating Scale, which assesses conference perceptions, found that supervisors, graduate students, and undergraduate students were able to readily distinguish among direct, indirect, and direct/indirect videotaped conferences. In addition, Address correspondence
to Dr. Susann Dowling, 406 N. Wilcrest, Houston, TX 77079.
0 1987 by Elsevier Science Publishing Co., Inc. 52 Vanderbilt Ave., New York, NY 10017
119 0021~9924/87/$3.50
120
S. DOWLING
the supervisor and supervisees were found to categorize direct/indirect conferences similarly. The teaching clinic, a peer group method of supervision, was introduced to speech-language pathology by Dowling (1979). In this method, a peer brings a videotaped segment of therapy to the group for data analysis, problem solving, and strategy development. The six phases of the teaching clinic are structured by ground rules to maximize productivity and to protect the integrity of participants and the process. Previous research by Dowling (1983a), comparing teaching clinics to conventional supervisory conferences, indicated that the two methods varied significantly when talk behaviors during the conferences were coded with the M.O.S.A.I.C.S. observation system (Weller, 1971). Differences as well as similarities were noted. On a descriptive level only, the teaching clinics appeared to be more direct than conventional conferences. In a related study using the M.O.S.A.I.C.S. observation system, teaching clinics were examined in depth to consider the nature of the participants’ interaction. The supervisors and supervisees did not differ either in quantity or in categories of conference talk behavior. Both supervisors and supervisees actively participated in the conferences, problem-solved, and developed alternative strategies. The equality of interaction implied indirectness in the process (Dowling, 1983b). Johnson and Fey (1983) also compared the teaching clinic and individual supervision. In comparing participants’ anxiety levels, perceptions of the supervisory relationship, clinical self-concept, and clinical effectiveness, no differences were found between the two methodologies. The data collection tools, with the exception of the Sleight Clinician Anxiety Test (Sleight, 1985), were modifications of other instruments or were developed by the authors, Validity and reliability information were not presented for these tools. As a result, these tindings should be interpreted with caution. Participants’ views of teaching clinic conferences have not been measured systematically. Dowling (1983b) reported clinicians’ impressions of the process. But perceptions of supervisor and peer behavior during teaching clinic conferences could not be ascertained from the descriptive information. Perceptual data regarding individual conferences have been collected by Smith and Anderson (1982) and Brasseur and Anderson (1983). A gap remains in the literature in reference to group conferences and in particular to the teaching clinic. PURPOSE The purpose of this study was to assess perceptions of supervisor and peer behavior during teaching clinic conferences. The following questions were to be answered. Did participants in the teaching clinic perceive the behavior of the supervisor and peers similarly? Were differences among
TEACHING
CLINIC:
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OF SUPERVISORS/PEERS
121
supervisors observable? Did a participant’s role in the teaching clinic affect conference perceptions? Did perceptions change as the number of teaching clinics per group varied? Did various groups participating in the teaching clinics perceive the conferences similarly? Were differences along the parameter of direct/indirect conferences discernible in relation to observer types, supervisors, teaching clinic role, groups, and number of teaching clinics completed?
METHOD The subjects in this study were 24 graduate students and 2 supervisors certified in speech-language pathology. The teaching clinics occurred during the weekly meeting required for students participating in graduate practicum. The 24 students were grouped by the semester in which they were enrolled. Over four semesters, the groups consisted of 6, 7, 5, and 6 members, respectively. A total of 19 teaching clinics occurred but ranged in number from 4 to 6 per group. Group 1 participated in five clinics, group 2, four clinics, group 3, four clinics, and group 4, six clinics. Supervisor 1 was the facilitator for the teaching clinics for groups l-3 and supervisor 2 for group 4. For each clinic, a participant selected a segment of videotape of therapy or diagnosis for presentation to the group. The person sharing a segment of his/her work was called the demonstration clinician. The demonstration clinician stated the objectives for the segment to be viewed and requested specific areas of feedback from the other participants. After the viewing of the videotape, during which the teaching clinic members collected data, the demonstration clinician left the room to complete a self-analysis and to allow time for the remaining group members to analyze and interpret the data. Upon return of the demonstration clinician, group discussion focused on problem solving and strategy development. The demonstration clinician’s final responsibility, at the next teaching clinic, was to share the results of those ideas implemented. At the end of each teaching clinic, the graduate students completed two Individual Conference Rating Scales (Brasseur and Anderson, 1983). They rated their perceptions of their supervisor and peers. When completing the rating scale in regard to the peers, the participants were told to substitute the work “peer”for supervisor whenever it occurred on the form. The order in which they completed the forms was at the discretion of the participant. RESULTS The design of the analysis was a multivariate repeated measures split-plot factorial. The independent variables were Role (clinic leader, demonstration clinician, peer, group monitor), Observed (peer, supervisor, Su-
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pervisor (1, 2), Group (l-4), and Number of clinics per group (l-6). The dependent measures were the 18 items of the Individual Conference Rating Scale (Brasseur and Anderson, 1983). The SPSS-X (Spss Inc., 1983) statistical package Manova was used to analyze the data. The perceptions of supervisor and peer behavior were analyzed and found to be significantly different (F = 3.315, df 18,168; <.OOl) A post hoc univariate analysis was completed. Three factors differentiated supervisor/peer behavior. The peer were perceived as offering a greater number of suggestions for therapy (F = 15.45, df 1,185; <.OOl). The participants felt a teacher-student relationship was more characteristic of their interactions with the supervisor than the peer (F = 33.386, df 1,185; <.OOl). Similarly, the sense of a superior-subordinate relationship was more characteristic of the supervisor than the peers. In regard to the parameters direct/indirect, peers were perceived as more direct in regard to therapy suggestions and supervisors direct when they were seen as functioning as a superior in the conferences. Two of the univariate factors differentiating between the supervisor and peer were direct in nature but one identified the peer as more direct and the other the supervisor. The second question to be addressed was supervisor behavior. Were differences between supervisors identifiable? The two supervisors were found to be significantly different (F = 5.374, df 18,140; <.OOl). A post hoc univariate analysis identified seven variables differentiating the two supervisors. Supervisor 1 was more likely to state objectives for the teaching clinic (F = 16.64, df 1,157; <.OOl), help supervisees’ set realistic client goals (F = 11.58, df 1,157; = .OOl), use conference time to talk about ways to improve materials (F = 23.77, df 1,157; <.OOl), suggest therapy techniques. (F = 21.47, df 1,157; <.OOl), ask the supervisee to analyze or evaluate behaviors that either occurred or might arise in therapy (F = 29.266, df 1,157; <.OOl), and request the supervisee to think about strategies that might have been done differently in the past or future (F = 24.30, df 1,157; <.OOl). Supervisees verbalized their needs to a greater degree with supervisor 2 (F = 11.58, df 1,157; c.05). Of the variables that were found to significant, Supervisor l’s suggestion of therapy techniques was a direct behavior while the discussion of material improvement and objectives for the conference were neither direct nor indirect. The remaining four items were indirect conference behaviors. Supervisor 1 differed significantly on three and supervisor 2 on one. These same variables that had differentiated between the two supervisors were further considered on a descriptive level. A pattern became evident when the mean ratings, which appear in Table 1, for supervisors and peers were analyzed. The supervisor, with two exceptions, appeared to set the tone for the conference. If the supervisor engaged in a high volume of behaviors, so did the peers. A decrease in supervisor behavior resulted in a similar shift for peers. Two items did not follow this pattern
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Table 1. Impact of Supervisor Responses Differentiating between Supervisors
123
on Peer Behavior for Variables Supervisor 2: Mean ratings
Supervisor 1: Mean ratings
Dependent variable
Supervisor
Peers
Supervisor
Peers
3 4 10 11 16 17 18
6.07 6.09 5.69 5.73 5.75 5.86 5.56
6.12 6.58 5.73 5.87 5.85 5.68 5.31
4.15 4.69 4.66 6.51 5.33 4.30 3.63
4.94 6.11 4.73 6.02 3.79 3.82 3.94
for supervisor 2 as the peers had a high incidence of therapy suggestions while the supervisor provided a minimal amount. The second exception was noted when the peers made even fewer attempts to state objectives for the teaching clinics than did supervisor 2. The impression of the supervisor’s control of the tone of the conference was supported by the finding of a significant interaction between supervisors and the participants’ perceptions of the supervisor and peer (F = 1.758, df 18,140; C.05). A post hoc univariate analysis identified three variables that accounted for this difference. Variables 4 and 16 were described as exceptions for supervisor 2 to the parallel perceptions of the supervisor and peer. Variables 4 and 16, which are presented in Table 1, were found to be significant (F = 5.335, df 1,157; c.05, and F = 7.256, df 1,157; C.01, respectively). Variable 8, involving the perception of the supervisor and supervisee participating in a supervisory relationship, was identified as significant (F = 6.094, df, 1,157; c.05). But again when considering the mean scores on a descriptive level, the scores for the supervisor and peers were similar for supervisor 1 but discrepant for supervisor 2. The participants in the teaching clinic alternately served in a variety of roles in the teaching clinic. The potential roles were clinic leader, demonstration clinician, peer, and group monitor. The participant’s role had no impact on the perceptions of either the supervisor or peer during the teaching clinics (F = .754, df 54,414; NS). The interaction of role and person being rated, supervisor or peer, was also nonsignificant (F = .4.51, df 54,414, NS). The four groups of graduate students participated in a range of four to six teaching clinics. Groups 2 and 3 completed four clinics, group 1 had five, and group 4 had six clinics. The data were analyzed to determine if perceptions changed with increasing involvement in the teaching clinics. An overall difference was found (F = 1.486, df 90,710; c.01). A post
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hoc univariate analysis identified the discussion of ways to improve therapy materials as the significant contributor to this difference (F = 3.53 df 5,155; C.01). A post hoc one degree of freedom analysis using difference contrasts was completed to consider the varying number of teaching clinics within groups as a means to identify the source of significance. Teaching clinic 1 was found to be similar to teaching clinic 2 (F = 1.007, df 18,138; NS), as was teaching clinic 3 when compared to 1 and 2 (F = 1.148, df 18,138; NS). A significant difference was found when the first three teaching clinics were compared to the fourth (F = 1.956, df 18,138; <.05). The accompanying univariate analysis indicated the perceptions of the supervisor and supervisees’ participation in a teacher-student relationship (F = 4.998, df 1,155, ~0.5) and the supervisees’ verbalization of needs (F = 7.262. df 1,155; C.01) accounted for the differences. Both of these behaviors decreased with time. Two clinician groups completed five clinics. The fifth clinic was found to differ from the previous four (F = 1.767, d_f 18,138; c.05). Two variables contributed to that significance. They were the supervisor’s use of conference time to discuss the improvement of materials (F = 4.503, df 1,155; C.05) and the supervisee’s provision of feedback to the supervisor about the clinical session (F = 4.009, df 1,155; c.05). These behaviors both decreased as the number of teaching clinics increased from four to five. The final comparison compared teaching clinic 6 with all previous teaching clinics and was found to be nonsignificant (F = 1.549 df 18,138; NS). It should be noted that only group 4 completed six clinics. A consideration, in regard to the direct/indirect parameters, of the two variables found to differentiate clinic 4 from the first three and the two items causing clinic 5 to differ from the previous clinics was found to be inconclusive. The four variables decreased in frequency over time, but two of the items were not relevant to the direct/indirect parameter. The remaining two were both indirect behaviors, implying an increase in directness with time. The result should be interpreted with caution since only one indirect variable decreased per significant difference as variable 11 differed when comparing clinic 4 to 1, 2, 3 and variable 6 when comparing 5 to the previous four. The remaining question was related to the four groups of students participating in the teaching clinics. Did the groups perceive the process similarly? An analysis of the data indicated they did not, as the differences among groups were significant (F = 3.08, df 54,510; c.001). The post hoc univariate analysis identified 13 variables as contributors to the difference. The variables, F ratios, and related means appear in Table 2. The patterns of responses were complex owing to the number of items identified as significant and to the involvement of four groups. In considering the means for the groups for each of the significant variables,
TEACHING CLINIC: PERCEPTIONS OF SUPERVISORS/PEERS
125
Table 2. Variables that Differentiated among Groups Participating in the Teaching Clinics” Dependent variables 1
Direct/ indirect
Univariate F ratio
I
10.40 7.51 5.56 3.27 5.47 6.11 4.91 4.14 2.98 4.01 6.00 8.87 10.99
3 4 7 8 10 11 12 13 14 16 17 18
D I I I D D
I I
Significance level C.001 <.OOl = .OOl <.05 = .OOl = .ool <.Ol <.Ol <.05 <.Ol = ,001 <.OOl <.OOl
Group means 1
2
3
4
3.93 5.48 6.24 5.67 3.06 5.00 5.30 3.66 2.14 1.69 5.19 5.65 5.88
5.75 6.12 6.32 6.42 3.44 5.95 6.12 3.73 1.65 2.23 6.05 5.73 4.77
5.34 6.43 6.42 6.38 4.63 6.29 6.11 4.66 2.44 2.55 5.79 5.68 5.66
5.1 4.69 5.58 5.77 3.38 4.86 6.09 3.34 1.79 1.63 4.48 4.22 4.03
n Degrees of freedom 3,185.
generalizations did appear. When the means for the groups were rankordered from high to low, groups 2 and 3, overall, indicated that their perceptions of the conferences were higher than either group 1 or 4. Of all groups, group 4 reported the lowest perceptions of the teaching clinic process. A post hoc one degree of freedom analysis using difference contrasts was completed to identify the source of variation among the groups. Group 1 differed significantly from group 2 (F = 3.95, df 18,172; <.OOl). The univariate analysis that followed identified six variables that contributed to the differences between groups 1 and 2. Group 2 felt the supervisee asked more questions (F = 29.49, df 1,189; <.OOl), used conference time to present feedback about the session (F = 5.93, d_f 1,189; <.05), and verbalized needs (F = 10.677, df 1,189; c.001). Group 2 viewed the supervisor/peers as helping the supervisee set realistic client goals (F = 4.923, d_f 1,189; <.05), stating objectives for the teaching clinic (F = 8.699, df 1,189; c.05). Group 1 perceived more of the supervisor/ peers behaviors as encouraging the supervisee to generate strategies (F = 8.699, df 1,189; <.Ol). Five of the six items that differentiated group 1 from group 2 were indirect variables. The sixth was neither direct nor indirect. Group 2 viewed the teaching clinics as more indirect than did group 1 on four of the indirect items. A comparison of groups 1 and 2 to group 3 was found to be nonsignificant (F = 1.416, df, 18,172; NS). But the first three groups did differ from group 4 (F = 4.175, df 18,172; <.OOl). The post hoc univariate analysis identified eight contributing variables. Groups l-3 perceived a higher incidence of the supervisor and peers using conference time to
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S. DOWLING
discuss ways to improve materials (F = 20.234, df 1,189; <.OOl), suggesting therapy techniques (F = 15.490, df 1,189; <.OOl), helping the supervisee set realistic goals for clients (17 = 11,511, df 1,189; = .OOl), discussing weaknesses in the supervisee’s clinical behavior. (F = 6.72, df 1,189; = .Ol>, stating the objectives of the conference (F = 12.442, d.f 1,189; = .OOl>, asking the supervisee to analyze something that has or may occur in the clinical session (F = 26,455, df 1,189; <.OOl), and requesting the supervisee’s thoughts about alternate strategies that could have or might be implemented (F = 24.337, d.f 1,189; c.001). Similarly, groups l-3 felt the supervisee is more likely to request a written copy of the supervisor/peers’ behavioral observations than did group 4 (F = 6.504, df 1,189; q.05). On a descriptive level, each of group 4’s mean ratings for the significant items were lower than the mean for the combined three remaining groups. The direc~indirect parameter did not appear relevant for the comparison of groups l-3 to group 4. Three of the items that differed signi~cantly did not differentiate direc~~ndirect. Three of the signi~cant items were indirect items and two direct. Therefore, a pattern for comparison of direc~indirect did not emerge.
During a teaching clinic, the supervisor typically was the clinic leader, which is primarily a role of group facilitator. The chnic leader did not conference with the supervisee in the traditional sense but guided others as they analyzed data, solved problems, and selected feedback for presentation to the demonstration clinician, The typical su~e~iso~ role changed, but participants continued to perceive the supervisor as a teacher and superior, The reduction or elimination of perceptions of power in relationships, as described in Cogan’s (1973) colleague1 model, may be extremely diffrcnlt to obtain. In the teaching clinics, it was not achieved. The teaching clinic did cause a shift in roles, The peers were found to be the primary source of suggestions for therapy. Previous research by Culatta and Seltzer (1976) and Smith and Roberts (1982) indicated that conferences are typically direct and supervisor dominated with supervisees assuming a passive manner. The students serving in the role of peer clearly were not passive participants during the teaching clinics. As found in previous research by Dowling (t983b), the peers assumed supervisorlike behaviors. The finding of differences between the two supervisors suggested flexibility in the teaching clinic, as the process did not appear to force the supervisors into a fixed style, Supervisor 2 appeared to have adhered more strictly to the teaching clinic format than did supervisor 1. Super-
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visor 1 was more likely to offer therapy suggestions and to discuss ways to improve materials, which were deviations from the role of facilitator. The supervisor appeared to set the tone for the teaching clinic conferences. With few exceptions, the ratings of the supervisor’s behavior were mirrored by the graduate students’ behavior. If a supervisor, for example, requested strategy generation, so did the peers. In traditional conferences, the supervisor sets the stage for the interaction by assuming a conferencing style such as direct/indirect. It was interesting to note that tone continues to be manipulatable when groups are involved. This was supported by the finding that supervisors continue to be viewed as the superior in the teaching clinic interaction. A unexpected finding in this study related to the absence of variations in perceptions based on the individual’s role in the teaching clinic. In previous research by Dowling (1983b), participants indicated a feeling of apprehension when they assumed the role of demonstration clinician. Asch (1971) reported variations in perceptions as a function of anxiety and peer pressure. But in this study, serving as demonstration clinician did not alter students’ perceptions of either their peers or supervisors. The anxiety reportedly inherent in the role of demonstration clinician was not sufficient to cause perceptual distortion. The differences among groups of graduate students participating in teaching clinics appears to be healthy as the process was structured but allowed for the uniqueness of the members of the groups. This was a direct contrast to traditional conferences, which have been found to be direct and static (Smith and Anderson, 1982) even when levels of academic training and site vary (Ingrisano, Guinty, Chambers, McDonald, Clem, and Cory, 1979). The existence of teaching clinic flexibility was also supported by the finding in this study of differences between supervisors. In interpreting the graduate students’ perceptions of the teaching clinics, a strength of the methodology appeared to be the active involvement of students in the supervisory conference. They analyzed data, solved problems and generated clinical strategies. The identified flexibility of the process was also of note owing to the negatively identified rigidity of traditional conferences. Further research is needed to determine the impact of teaching clinics on the outcomes of the conference. Do teaching clinics result in the improvement of clinical skills and the quality of services provided to clients?
REFERENCES Asch, S. (1971). Effects of group pressure upon the modification and distortion of judgments. In B. Hinton and J. Reitz (eds.), Groups and Organizations: Integrated Readings in the Analysis of Social Behavior. Belmont, California: Wadsworth, pp. 215-222.
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Blumberg, A., and Amidon, E. (1965). Teachers’ teacher interaction. Admin. Notebook 14:1-4. Brasseur, direct,
J., and Anderson, and direct/indirect
perceptions
of supervisor-
J. (1983). Observed differences between direct, insupervisory conferences. J. Speech Hear Res.
26:349-355.
Cogan, M. (1973). Clinical Supervision.
Boston: Houghton-Mifflin.
Culatta, R., and Seltzer, H. (1976). Content and sequence analysis of the supervisory session. Am. Speech Hear Assoc. 18:8-12. Dowling,
S. (1979). The teaching clinic: A supervisory
Am. Speech
alternative.
Hear. Assoc. 21:646-649.
Dowling, S. (1983a). An analysis of conventional Clinical Supervisor
Dowling, S. (1983b). Teaching clinic conference mun. Disord.
and teaching clinic supervision.
1(4):15-29.
participant
interaction.
J. Com-
16:385-397.
Ingrisano, D., Guinty, C., Chambers, R., McDonald, J., Clem, R., and Cory, M. (1979). The relationship between supervisory conference performance and supervisee experience. Paper presented at the annual meeting of the American Speech, Language, and Hearing Association, Atlanta, Georgia. Johnson, D., and Fey, S. (1983). Comparative effects of teaching clinic versus traditional supervision methods. Supervision, 7(1):2-4. Roberts, J., and Smith, K. (1982). Supervisor-supervisee consistency of behavior in supervisory conferences.
role differences J. Speech
Hear.
and Res.
251428-434.
Sleight, C. (1985). Confidence visor 3(3):25-48.
and anxiety in student clinicians.
Clinical Super-
Smith, K. (1977). Identification of perceived effectiveness components in the individual supervisory conference. Doctoral Dissertation, Indiana University: Bloomington, Indiana. Smith, K., and Anderson, J. (1982). Relationship of perceived effectiveness to verbal interaction/content variables in supervisory conferences in speech-language pathology. J. Speech Hear. Res. 25:252-261. Spssx Inc. (1983). Spssx user’s guide. New York: McGraw-Hill. Weller, R. (1971). Verbal Communication York: Teachers College Press.
in Instructional
Supervision.
New
TEACHING CLINIC CONFERENCES: PERCEPTIONS OF SUPERVISOR AND PEER BEHAVIOR SUSANN Universio
DOWLING of Houston-University
Park
Perceptions of supervisor and peer behavior during teaching clinic conferences, a group supervisory approach, were assessed. Four groups of graduate students participated in a total of 19 teaching clinics. Following each conference, they completed two Individual Conference Rating Scales to describe the supervisor and peer during the interaction. Peer behavior differed from that of supervisors. Differences were also found between supervisors and among groups of students participating in the conferences. A participant’s role had no impact on the participants’ perceptions of either the peers or supervisors. Variations in perceptions were noted as the number of clinics per group increased.
INTRODUCTION A substantial quantity of research has focused on the supervisory conference as a means to describe the interaction and to measure effectiveness. Cogan (1973) stressed the importance of a colleague1 relationship and active involvement of both the supervisee and supervisor in the conference. Blumberg and Amidon (1965) reported that the supervisee’s perception of conference effectiveness and satisfaction in the supervisory relationship was directly related to the supervisee’s involvement in the conference, When supervisors were direct, allowing minimal supervisee input, the supervisee perceived conferences as nonproductive and ineffective. Positively perceived conferences were indirect and included substantial supervisee input. Smith and Anderson (1982) have also isolated the factors direct and indirect as effectiveness variables in the individual supervisory conference. Brasseur and Anderson (1983), using a modified, validated version of the Smith (1977) Individual Supervisory Conference Rating Scale, which assesses conference perceptions, found that supervisors, graduate students, and undergraduate students were able to readily distinguish among direct, indirect, and direct/indirect videotaped conferences. In addition, Address correspondence
to Dr. Susann Dowling, 406 N. Wilcrest, Houston, TX 77079.
0 1987 by Elsevier Science Publishing Co., Inc. 52 Vanderbilt Ave., New York, NY 10017
119 0021~9924/87/$3.50
120
S. DOWLING
the supervisor and supervisees were found to categorize direct/indirect conferences similarly. The teaching clinic, a peer group method of supervision, was introduced to speech-language pathology by Dowling (1979). In this method, a peer brings a videotaped segment of therapy to the group for data analysis, problem solving, and strategy development. The six phases of the teaching clinic are structured by ground rules to maximize productivity and to protect the integrity of participants and the process. Previous research by Dowling (1983a), comparing teaching clinics to conventional supervisory conferences, indicated that the two methods varied significantly when talk behaviors during the conferences were coded with the M.O.S.A.I.C.S. observation system (Weller, 1971). Differences as well as similarities were noted. On a descriptive level only, the teaching clinics appeared to be more direct than conventional conferences. In a related study using the M.O.S.A.I.C.S. observation system, teaching clinics were examined in depth to consider the nature of the participants’ interaction. The supervisors and supervisees did not differ either in quantity or in categories of conference talk behavior. Both supervisors and supervisees actively participated in the conferences, problem-solved, and developed alternative strategies. The equality of interaction implied indirectness in the process (Dowling, 1983b). Johnson and Fey (1983) also compared the teaching clinic and individual supervision. In comparing participants’ anxiety levels, perceptions of the supervisory relationship, clinical self-concept, and clinical effectiveness, no differences were found between the two methodologies. The data collection tools, with the exception of the Sleight Clinician Anxiety Test (Sleight, 1985), were modifications of other instruments or were developed by the authors, Validity and reliability information were not presented for these tools. As a result, these tindings should be interpreted with caution. Participants’ views of teaching clinic conferences have not been measured systematically. Dowling (1983b) reported clinicians’ impressions of the process. But perceptions of supervisor and peer behavior during teaching clinic conferences could not be ascertained from the descriptive information. Perceptual data regarding individual conferences have been collected by Smith and Anderson (1982) and Brasseur and Anderson (1983). A gap remains in the literature in reference to group conferences and in particular to the teaching clinic. PURPOSE The purpose of this study was to assess perceptions of supervisor and peer behavior during teaching clinic conferences. The following questions were to be answered. Did participants in the teaching clinic perceive the behavior of the supervisor and peers similarly? Were differences among
TEACHING
CLINIC:
PERCEPTIONS
OF SUPERVISORS/PEERS
121
supervisors observable? Did a participant’s role in the teaching clinic affect conference perceptions? Did perceptions change as the number of teaching clinics per group varied? Did various groups participating in the teaching clinics perceive the conferences similarly? Were differences along the parameter of direct/indirect conferences discernible in relation to observer types, supervisors, teaching clinic role, groups, and number of teaching clinics completed?
METHOD The subjects in this study were 24 graduate students and 2 supervisors certified in speech-language pathology. The teaching clinics occurred during the weekly meeting required for students participating in graduate practicum. The 24 students were grouped by the semester in which they were enrolled. Over four semesters, the groups consisted of 6, 7, 5, and 6 members, respectively. A total of 19 teaching clinics occurred but ranged in number from 4 to 6 per group. Group 1 participated in five clinics, group 2, four clinics, group 3, four clinics, and group 4, six clinics. Supervisor 1 was the facilitator for the teaching clinics for groups l-3 and supervisor 2 for group 4. For each clinic, a participant selected a segment of videotape of therapy or diagnosis for presentation to the group. The person sharing a segment of his/her work was called the demonstration clinician. The demonstration clinician stated the objectives for the segment to be viewed and requested specific areas of feedback from the other participants. After the viewing of the videotape, during which the teaching clinic members collected data, the demonstration clinician left the room to complete a self-analysis and to allow time for the remaining group members to analyze and interpret the data. Upon return of the demonstration clinician, group discussion focused on problem solving and strategy development. The demonstration clinician’s final responsibility, at the next teaching clinic, was to share the results of those ideas implemented. At the end of each teaching clinic, the graduate students completed two Individual Conference Rating Scales (Brasseur and Anderson, 1983). They rated their perceptions of their supervisor and peers. When completing the rating scale in regard to the peers, the participants were told to substitute the work “peer”for supervisor whenever it occurred on the form. The order in which they completed the forms was at the discretion of the participant. RESULTS The design of the analysis was a multivariate repeated measures split-plot factorial. The independent variables were Role (clinic leader, demonstration clinician, peer, group monitor), Observed (peer, supervisor, Su-
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pervisor (1, 2), Group (l-4), and Number of clinics per group (l-6). The dependent measures were the 18 items of the Individual Conference Rating Scale (Brasseur and Anderson, 1983). The SPSS-X (Spss Inc., 1983) statistical package Manova was used to analyze the data. The perceptions of supervisor and peer behavior were analyzed and found to be significantly different (F = 3.315, df 18,168; <.OOl) A post hoc univariate analysis was completed. Three factors differentiated supervisor/peer behavior. The peer were perceived as offering a greater number of suggestions for therapy (F = 15.45, df 1,185; <.OOl). The participants felt a teacher-student relationship was more characteristic of their interactions with the supervisor than the peer (F = 33.386, df 1,185; <.OOl). Similarly, the sense of a superior-subordinate relationship was more characteristic of the supervisor than the peers. In regard to the parameters direct/indirect, peers were perceived as more direct in regard to therapy suggestions and supervisors direct when they were seen as functioning as a superior in the conferences. Two of the univariate factors differentiating between the supervisor and peer were direct in nature but one identified the peer as more direct and the other the supervisor. The second question to be addressed was supervisor behavior. Were differences between supervisors identifiable? The two supervisors were found to be significantly different (F = 5.374, df 18,140; <.OOl). A post hoc univariate analysis identified seven variables differentiating the two supervisors. Supervisor 1 was more likely to state objectives for the teaching clinic (F = 16.64, df 1,157; <.OOl), help supervisees’ set realistic client goals (F = 11.58, df 1,157; = .OOl), use conference time to talk about ways to improve materials (F = 23.77, df 1,157; <.OOl), suggest therapy techniques. (F = 21.47, df 1,157; <.OOl), ask the supervisee to analyze or evaluate behaviors that either occurred or might arise in therapy (F = 29.266, df 1,157; <.OOl), and request the supervisee to think about strategies that might have been done differently in the past or future (F = 24.30, df 1,157; <.OOl). Supervisees verbalized their needs to a greater degree with supervisor 2 (F = 11.58, df 1,157; c.05). Of the variables that were found to significant, Supervisor l’s suggestion of therapy techniques was a direct behavior while the discussion of material improvement and objectives for the conference were neither direct nor indirect. The remaining four items were indirect conference behaviors. Supervisor 1 differed significantly on three and supervisor 2 on one. These same variables that had differentiated between the two supervisors were further considered on a descriptive level. A pattern became evident when the mean ratings, which appear in Table 1, for supervisors and peers were analyzed. The supervisor, with two exceptions, appeared to set the tone for the conference. If the supervisor engaged in a high volume of behaviors, so did the peers. A decrease in supervisor behavior resulted in a similar shift for peers. Two items did not follow this pattern
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Table 1. Impact of Supervisor Responses Differentiating between Supervisors
123
on Peer Behavior for Variables Supervisor 2: Mean ratings
Supervisor 1: Mean ratings
Dependent variable
Supervisor
Peers
Supervisor
Peers
3 4 10 11 16 17 18
6.07 6.09 5.69 5.73 5.75 5.86 5.56
6.12 6.58 5.73 5.87 5.85 5.68 5.31
4.15 4.69 4.66 6.51 5.33 4.30 3.63
4.94 6.11 4.73 6.02 3.79 3.82 3.94
for supervisor 2 as the peers had a high incidence of therapy suggestions while the supervisor provided a minimal amount. The second exception was noted when the peers made even fewer attempts to state objectives for the teaching clinics than did supervisor 2. The impression of the supervisor’s control of the tone of the conference was supported by the finding of a significant interaction between supervisors and the participants’ perceptions of the supervisor and peer (F = 1.758, df 18,140; C.05). A post hoc univariate analysis identified three variables that accounted for this difference. Variables 4 and 16 were described as exceptions for supervisor 2 to the parallel perceptions of the supervisor and peer. Variables 4 and 16, which are presented in Table 1, were found to be significant (F = 5.335, df 1,157; c.05, and F = 7.256, df 1,157; C.01, respectively). Variable 8, involving the perception of the supervisor and supervisee participating in a supervisory relationship, was identified as significant (F = 6.094, df, 1,157; c.05). But again when considering the mean scores on a descriptive level, the scores for the supervisor and peers were similar for supervisor 1 but discrepant for supervisor 2. The participants in the teaching clinic alternately served in a variety of roles in the teaching clinic. The potential roles were clinic leader, demonstration clinician, peer, and group monitor. The participant’s role had no impact on the perceptions of either the supervisor or peer during the teaching clinics (F = .754, df 54,414; NS). The interaction of role and person being rated, supervisor or peer, was also nonsignificant (F = .4.51, df 54,414, NS). The four groups of graduate students participated in a range of four to six teaching clinics. Groups 2 and 3 completed four clinics, group 1 had five, and group 4 had six clinics. The data were analyzed to determine if perceptions changed with increasing involvement in the teaching clinics. An overall difference was found (F = 1.486, df 90,710; c.01). A post
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hoc univariate analysis identified the discussion of ways to improve therapy materials as the significant contributor to this difference (F = 3.53 df 5,155; C.01). A post hoc one degree of freedom analysis using difference contrasts was completed to consider the varying number of teaching clinics within groups as a means to identify the source of significance. Teaching clinic 1 was found to be similar to teaching clinic 2 (F = 1.007, df 18,138; NS), as was teaching clinic 3 when compared to 1 and 2 (F = 1.148, df 18,138; NS). A significant difference was found when the first three teaching clinics were compared to the fourth (F = 1.956, df 18,138; <.05). The accompanying univariate analysis indicated the perceptions of the supervisor and supervisees’ participation in a teacher-student relationship (F = 4.998, df 1,155, ~0.5) and the supervisees’ verbalization of needs (F = 7.262. df 1,155; C.01) accounted for the differences. Both of these behaviors decreased with time. Two clinician groups completed five clinics. The fifth clinic was found to differ from the previous four (F = 1.767, d_f 18,138; c.05). Two variables contributed to that significance. They were the supervisor’s use of conference time to discuss the improvement of materials (F = 4.503, df 1,155; C.05) and the supervisee’s provision of feedback to the supervisor about the clinical session (F = 4.009, df 1,155; c.05). These behaviors both decreased as the number of teaching clinics increased from four to five. The final comparison compared teaching clinic 6 with all previous teaching clinics and was found to be nonsignificant (F = 1.549 df 18,138; NS). It should be noted that only group 4 completed six clinics. A consideration, in regard to the direct/indirect parameters, of the two variables found to differentiate clinic 4 from the first three and the two items causing clinic 5 to differ from the previous clinics was found to be inconclusive. The four variables decreased in frequency over time, but two of the items were not relevant to the direct/indirect parameter. The remaining two were both indirect behaviors, implying an increase in directness with time. The result should be interpreted with caution since only one indirect variable decreased per significant difference as variable 11 differed when comparing clinic 4 to 1, 2, 3 and variable 6 when comparing 5 to the previous four. The remaining question was related to the four groups of students participating in the teaching clinics. Did the groups perceive the process similarly? An analysis of the data indicated they did not, as the differences among groups were significant (F = 3.08, df 54,510; c.001). The post hoc univariate analysis identified 13 variables as contributors to the difference. The variables, F ratios, and related means appear in Table 2. The patterns of responses were complex owing to the number of items identified as significant and to the involvement of four groups. In considering the means for the groups for each of the significant variables,
TEACHING CLINIC: PERCEPTIONS OF SUPERVISORS/PEERS
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Table 2. Variables that Differentiated among Groups Participating in the Teaching Clinics” Dependent variables 1
Direct/ indirect
Univariate F ratio
I
10.40 7.51 5.56 3.27 5.47 6.11 4.91 4.14 2.98 4.01 6.00 8.87 10.99
3 4 7 8 10 11 12 13 14 16 17 18
D I I I D D
I I
Significance level C.001 <.OOl = .OOl <.05 = .OOl = .ool <.Ol <.Ol <.05 <.Ol = ,001 <.OOl <.OOl
Group means 1
2
3
4
3.93 5.48 6.24 5.67 3.06 5.00 5.30 3.66 2.14 1.69 5.19 5.65 5.88
5.75 6.12 6.32 6.42 3.44 5.95 6.12 3.73 1.65 2.23 6.05 5.73 4.77
5.34 6.43 6.42 6.38 4.63 6.29 6.11 4.66 2.44 2.55 5.79 5.68 5.66
5.1 4.69 5.58 5.77 3.38 4.86 6.09 3.34 1.79 1.63 4.48 4.22 4.03
n Degrees of freedom 3,185.
generalizations did appear. When the means for the groups were rankordered from high to low, groups 2 and 3, overall, indicated that their perceptions of the conferences were higher than either group 1 or 4. Of all groups, group 4 reported the lowest perceptions of the teaching clinic process. A post hoc one degree of freedom analysis using difference contrasts was completed to identify the source of variation among the groups. Group 1 differed significantly from group 2 (F = 3.95, df 18,172; <.OOl). The univariate analysis that followed identified six variables that contributed to the differences between groups 1 and 2. Group 2 felt the supervisee asked more questions (F = 29.49, df 1,189; <.OOl), used conference time to present feedback about the session (F = 5.93, d_f 1,189; <.05), and verbalized needs (F = 10.677, df 1,189; c.001). Group 2 viewed the supervisor/peers as helping the supervisee set realistic client goals (F = 4.923, d_f 1,189; <.05), stating objectives for the teaching clinic (F = 8.699, df 1,189; c.05). Group 1 perceived more of the supervisor/ peers behaviors as encouraging the supervisee to generate strategies (F = 8.699, df 1,189; <.Ol). Five of the six items that differentiated group 1 from group 2 were indirect variables. The sixth was neither direct nor indirect. Group 2 viewed the teaching clinics as more indirect than did group 1 on four of the indirect items. A comparison of groups 1 and 2 to group 3 was found to be nonsignificant (F = 1.416, df, 18,172; NS). But the first three groups did differ from group 4 (F = 4.175, df 18,172; <.OOl). The post hoc univariate analysis identified eight contributing variables. Groups l-3 perceived a higher incidence of the supervisor and peers using conference time to
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discuss ways to improve materials (F = 20.234, df 1,189; <.OOl), suggesting therapy techniques (F = 15.490, df 1,189; <.OOl), helping the supervisee set realistic goals for clients (17 = 11,511, df 1,189; = .OOl), discussing weaknesses in the supervisee’s clinical behavior. (F = 6.72, df 1,189; = .Ol>, stating the objectives of the conference (F = 12.442, d.f 1,189; = .OOl>, asking the supervisee to analyze something that has or may occur in the clinical session (F = 26,455, df 1,189; <.OOl), and requesting the supervisee’s thoughts about alternate strategies that could have or might be implemented (F = 24.337, d.f 1,189; c.001). Similarly, groups l-3 felt the supervisee is more likely to request a written copy of the supervisor/peers’ behavioral observations than did group 4 (F = 6.504, df 1,189; q.05). On a descriptive level, each of group 4’s mean ratings for the significant items were lower than the mean for the combined three remaining groups. The direc~indirect parameter did not appear relevant for the comparison of groups l-3 to group 4. Three of the items that differed signi~cantly did not differentiate direc~~ndirect. Three of the signi~cant items were indirect items and two direct. Therefore, a pattern for comparison of direc~indirect did not emerge.
During a teaching clinic, the supervisor typically was the clinic leader, which is primarily a role of group facilitator. The chnic leader did not conference with the supervisee in the traditional sense but guided others as they analyzed data, solved problems, and selected feedback for presentation to the demonstration clinician, The typical su~e~iso~ role changed, but participants continued to perceive the supervisor as a teacher and superior, The reduction or elimination of perceptions of power in relationships, as described in Cogan’s (1973) colleague1 model, may be extremely diffrcnlt to obtain. In the teaching clinics, it was not achieved. The teaching clinic did cause a shift in roles, The peers were found to be the primary source of suggestions for therapy. Previous research by Culatta and Seltzer (1976) and Smith and Roberts (1982) indicated that conferences are typically direct and supervisor dominated with supervisees assuming a passive manner. The students serving in the role of peer clearly were not passive participants during the teaching clinics. As found in previous research by Dowling (t983b), the peers assumed supervisorlike behaviors. The finding of differences between the two supervisors suggested flexibility in the teaching clinic, as the process did not appear to force the supervisors into a fixed style, Supervisor 2 appeared to have adhered more strictly to the teaching clinic format than did supervisor 1. Super-
TEACHING
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127
visor 1 was more likely to offer therapy suggestions and to discuss ways to improve materials, which were deviations from the role of facilitator. The supervisor appeared to set the tone for the teaching clinic conferences. With few exceptions, the ratings of the supervisor’s behavior were mirrored by the graduate students’ behavior. If a supervisor, for example, requested strategy generation, so did the peers. In traditional conferences, the supervisor sets the stage for the interaction by assuming a conferencing style such as direct/indirect. It was interesting to note that tone continues to be manipulatable when groups are involved. This was supported by the finding that supervisors continue to be viewed as the superior in the teaching clinic interaction. A unexpected finding in this study related to the absence of variations in perceptions based on the individual’s role in the teaching clinic. In previous research by Dowling (1983b), participants indicated a feeling of apprehension when they assumed the role of demonstration clinician. Asch (1971) reported variations in perceptions as a function of anxiety and peer pressure. But in this study, serving as demonstration clinician did not alter students’ perceptions of either their peers or supervisors. The anxiety reportedly inherent in the role of demonstration clinician was not sufficient to cause perceptual distortion. The differences among groups of graduate students participating in teaching clinics appears to be healthy as the process was structured but allowed for the uniqueness of the members of the groups. This was a direct contrast to traditional conferences, which have been found to be direct and static (Smith and Anderson, 1982) even when levels of academic training and site vary (Ingrisano, Guinty, Chambers, McDonald, Clem, and Cory, 1979). The existence of teaching clinic flexibility was also supported by the finding in this study of differences between supervisors. In interpreting the graduate students’ perceptions of the teaching clinics, a strength of the methodology appeared to be the active involvement of students in the supervisory conference. They analyzed data, solved problems and generated clinical strategies. The identified flexibility of the process was also of note owing to the negatively identified rigidity of traditional conferences. Further research is needed to determine the impact of teaching clinics on the outcomes of the conference. Do teaching clinics result in the improvement of clinical skills and the quality of services provided to clients?
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