Clinical Practicum Highlight- Mayo Clinic Health Systems

Katie McFarland shares about her Summer 2021 externship experience:

“My clinical off-site placement this past summer was located at Mayo Clinic Health Systems- New Prague and Mayo Clinic Health Systems- Rehabilitation Services. I worked with inpatients and outpatients at the hospital, as well as at the pediatric clinic located in the rehabilitation services clinic. The type of caseload at this off-site placement included a large variety of patients. I provided inpatient services that were focused on swallow evaluations and treatment, video swallow studies, and cognitive evaluations and treatment. For outpatients, the typical caseload included voice, CVA, dementia, traumatic brain injuries, video swallow studies, post-concussion syndrome, and more. At the rehabilitation services clinic I worked with pediatrics including articulation, language, and social communication therapy.

When looking at my typical days spent at off-site if varied depending on which supervisor I was with.

To summarize a Monday/Thursday:

            On these days I would start at the hospital in the morning where we usually only saw inpatients, but on occasion there may be an outpatient seen. Inpatients consisted of swallowing and/or cognition. Usually for swallowing it was a follow-up treatment session to assess diet tolerance and teach swallowing strategies/exercises for safe swallowing. If it was a cognition patient being seen, we were usually finishing up assessments and/or providing exercises in word retrieval, memory, etc. depending on each individual and etiology. Everyday there was rounds that we attended in the morning at the hospital with other disciplines including the MD on staff, nursing, PT, OT, Respiratory Therapy, pharmacy, dietician, etc. to discuss the inpatients and provide updates on each patient with the group. By 11:00am I would go over to the rehabilitation services building to see pediatric clients. On average, I would see five to six clients in a day. The caseload for pediatrics primarily consisted of articulation, language, and social communication with an age range of 2 years-old to 13 years-old. There was a lot of motivating activities, positive reinforcement, and play based therapy being used depending on each individual child. Each session would range from 30 to 45 minutes and some kids would come twice a week where others would come once a week or even every other week. I enjoyed working with a variety of ages and had a great supervisor who explained the purpose behind activities and what was being targeted and why based on previous assessments.

To summarize Tuesday/Wednesday/Friday:

            On these days I would spend all day at the hospital seeing inpatients and outpatients. Many outpatients were seen on these days including patients being seen for voice, post CVA, traumatic brain injury, post-concussion syndrome, dementia, and video swallow studies. These sessions ranged from 45 minutes to an hour in duration with patients who would come either once or twice a week depending on need. These sessions looked very different because of the variety of caseload being seen. I was able to be apart of many evaluations which was a great learning experience to see the “whole process” of having a patient come in and take case history, give assessments, and then formulate a treatment plan to provide therapy. I really enjoyed seeing outpatients and the progress some of them made in a six-week span while I was there. On these days we also did video swallow studies down in radiology. On average, there was usually at least one once a week, but sometimes up to three in a day. I was also lucky enough to see esophagrams be completed while in radiology following the fluoro video completed by the SLP. We also saw inpatients which consisted of the same caseload as Mondays and Thursdays, but we did more evaluations on these days due to having extended time at the hospital. We would do bedside swallow evaluations, follow-up swallow treatment, cognitive assessments, and cognitive treatment. This included making diet recommendations, recommending video swallow studies when needed, teaching swallow strategies/exercises, providing exercises pertaining to memory, aphasia, word retrieval, etc. depending on the patient. There were also rounds on these days at the hospital where the same disciplines gathered to discuss inpatient care. I had an excellent supervisor who really helped guide me in applying and gaining knowledge about dysphagia evaluations and treatment at this off-site.

Looking back at the previous classes I have taken over the last fall and spring, I can say that I was able to apply so much material and knowledge gained from those classes at this off-site. The classes that jump out to me that were most beneficial to have before going into this off-site placement include counseling, dysphagia, Birth to 5, and neuro anatomy and physiology. I was able to see how important counseling is when working as a speech pathologist. One of my supervisors who I saw most of the outpatients with was so so so skilled in this area. I had a great mentor to observe and guide me as we worked with our variety of outpatients and families who were working through emotional and challenging situations. I was able to apply so much knowledge learned from neuro anatomy and physiology and dysphagia on the inpatient side. I encountered many different disorders and diseases that I already knew about thanks to neuro anatomy and physiology and how that could be impacting a person’s cognitive status, swallow, and/or communication. Dysphagia evaluations, treatment, and video swallows were completed during this off-site and I was able to apply knowledge from my previous dysphagia course which was helpful during this experience. What I learned in birth to 5 helped me when working at the rehabilitation services center and I was able to give standardized assessments and provide treatment that would support the child based on age-appropriate skills.”

Thank you for sharing, Katie!

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