When the Playbook Disappears: Joy McKenzie on Leading a University Clinic Through COVID-19

Joy McKenzie still remembers the exact moment everything shifted. March 12th, 5 a.m. She opened her email and saw the first notification: students at local hospital and outpatient sites were being pulled from their internship placements.

Within days, all 20 second-year students at St. Cloud State University's speech-language pathology program were removed from their sites. Some never even started their next rotation. And Joy, the clinic director in only her second full year in the role, suddenly had to figure out how to get them all to graduation.

This episode of Clinic Chats captures a real-time conversation during one of the most chaotic periods in clinical education history. Joy doesn't sugarcoat it. She's honest about the stress, the improvisation, and the week-by-week reality of leading when there's no playbook.

32 Students Signed Up for One Simucase Session

With telepractice requiring 100% supervision and only a handful of faculty available to provide it, St. Cloud State made a practical call: lean into clinical simulation first.

They adopted Simucase, a platform with roughly 72 cases spanning the nine disorder areas. Each case breaks down into defined hours students can count toward their clinical requirements. Faculty members chose cases matching their specialties. Joy took a pediatric feeding assessment. Other faculty covered aphasia, language, and AAC.

The structure follows three steps: a pre-brief where faculty share "points to ponder," real-time feedback through Simucase's faculty dashboard, and a debrief session over Zoom. Joy also added a written component as a cross-check on student learning.

Then 32 students signed up for her single case in the first week.

"That was a little overwhelming, to be honest," Joy says. But she extended her time blocks and kept going. The team committed to evaluating every Friday and adjusting the following week. No long-term promises. Just honest, iterative progress.

That willingness to say "we're working in week mode" might be the most important thing a clinic director can communicate during a crisis.

The Math Problem Behind Graduation

Not every student needed the same thing. One had already hit 400 clinical hours and was set. The other 19 ranged from needing 18 hours to needing over 100. Students from medical placements were hit hardest since those sites couldn't support telepractice at all.

Simucase allows up to 75 hours toward the 400-hour graduation requirement. For students needing fewer hours who still had cooperative internship supervisors, that was plenty. For those who lost medical rotations entirely, it wasn't enough on its own.

Joy's plan was phased. Run clinical simulation through early May. Reassess. Then, once summer contracts kicked in mid-May, shift to telepractice for the students still short on hours. The university approved extending internship timelines into June if needed.

She was transparent with students about the possibility that not everyone would graduate in May. Some might finish in June instead. "In the big scheme of things," she told them, "does that month make that big of a difference?" For students already hired with August start dates, it didn't. For those with June 1 commitments, the team would prioritize accordingly.

No extra tuition. No penalties. Just an honest timeline.

"I Said No Way. And Then It Made Sense."

Joy didn't set out to become clinic director. She started at St. Cloud State as an adjunct, working full-time at an outpatient pediatric rehabilitation clinic. She knew she wanted to pursue a doctorate and get into academia eventually, so when a full-time faculty opportunity opened, she took it, even though it was year-to-year.

Then the previous clinic director's position was cut due to budget constraints. Joy's colleagues looked at her.

"No way," she told them. She was in a doctoral program. Her mother had just been diagnosed with stage four ovarian cancer. Her kids were six and nine. She had too much on her plate.

But over time, it clicked. Her dissertation focused on clinical supervision. The role aligned with her research. The outgoing director mentored her through the transition, meeting weekly during her final semester.

The steepest learning curve wasn't logistics or scheduling. It was figuring out what kind of leader to be. When to build consensus. When to just make a decision and say, "This is what we're doing. We'll adjust as we go."

"There were times when I felt like I was herding cats," she says, laughing. "And I mean that respectfully."

Accreditation Is Accountability, Not a Threat

Joy also pulled back the curtain on something most practicing SLPs don't think much about: how university programs maintain their accreditation.

St. Cloud State's CSD program is accredited through CAA and earned the full eight-year approval, a mark of strong faculty and leadership. But accreditation isn't a one-time event. The program director files an annual report demonstrating that students are meeting the standards for clinical certification across curriculum, assessment, and faculty qualifications.

At the university level, St. Cloud State is accredited by the Higher Learning Commission (HLC). When Joy served on the university's assessment steering committee, she saw firsthand that many programs struggled not with doing assessment work, but with documenting it. Accredited programs like CSD were ahead of the curve because their yearly reports already required that documentation.

The real gap was "closing the loop": identifying a problem, implementing a change, then measuring whether the change actually worked. Joy's accredited program became a model for other departments across campus.

"Assessment can be scary for people," Joy says. "They misunderstand it as an assessment of them. That's not what it is."

The Job That Never Turns Off

Ask Joy what she loves most about being clinic director and the answer comes fast: relationships. Students, families, community SLPs who mentor interns, referring clinicians. The web of connections is what keeps her energized.

Ask what's hardest, and the answer is just as quick: it never stops.

Teaching has a rhythm. Prep, lecture, grade, semester ends. The clinic director role is a constant cycle. Get spring clinic running. Place second-year interns. Start planning summer. Before one phase wraps, the next one needs attention.

"I think about my job every day," Joy says. "I've had to learn how to shut it off." She's still working on not checking email at dinner. It's a work in progress, she admits, not a problem she's solved.

Her closing advice lands simply: "We're probably perfectionists by nature because of the work we do. Be kind to ourselves. Take one day at a time."

Leading a university clinic means managing students, placements, documentation, and accreditation all at once. ClinicNote is an EMR built for university clinics and private practices, designed to handle scheduling, documentation, and billing so clinic directors can focus on the people, not the paperwork. See how ClinicNote works.

Transcript

Kadie: You are listening to Clinic Chats. Clinic Chats is a multidisciplinary therapy podcast that was created for students, professionals, clinic directors, and supervisors. Clinic Chats is bridging the gap between graduate programs and professionals, sharing personal journeys of the smallest of private practice startups, large and expanding practices, as well as university clinic triumphs and tribulations. We hope you'll find our podcast informative and helpful in your career endeavors.

Kadie: Clinic Chats is sponsored by ClinicNote, an electronic medical record company for private practice and university clinics. ClinicNote was designed to make scheduling, documentation, report writing, and billing effective, efficient, and HIPAA compliant. Our featured sponsor this week is Therapy Marketing Kit, the perfect solution to creating professional marketing materials for your business.

Kadie: So today I have a special guest, Joy McKenzie from St. Cloud State University, where she is the clinic director. Hi, Joy. How are you?

Joy: I'm good. I'm good. Good morning. Thank you so much for having me.

Kadie: This is where our podcast is taking a bit of a turn, where we will start to alternate with university guests as well as our private practice guests. So I've been super excited to get a university podcast guest on. After Joy had committed to meeting with me, we ran into the whole coronavirus situation. So Joy and I are first going to discuss how coronavirus has affected their speech department, which I'm sure all the programs are affected across the United States. So Joy, can you tell me a little bit about when you all started to take action in some way whenever you got the news of this novel virus coming to the US?

Joy: Yes. And just to give a brief background of our department. So we have seven full-time faculty in our department, two of which are on phased retirement. So one of those faculty is not working this semester, and the other one is only very part-time this semester, very limited credits. So there's five of us, and then one of those is the audiologist, who's also the chair, program director, grad director. And then the other one does not currently have her C, so she does more of the research. So there's three of us that are heavy clinic people in addition to our other teaching roles. And my role as clinic director, I'm also responsible for all the internship placements as well.

Joy: So I suppose it was the beginning of March when I was paying a little bit more attention to the coronavirus and what was happening across the nation. I'm also on a Midwest Clinical Directors Discussion Group, which has been just an absolute blessing to have all of those fellow colleagues for support and bouncing ideas off, and also just to see what was happening first as far as the timeline with the coronavirus and other institutions.

Joy: So our spring break started the week, I believe it was March 5th. During that week, I was hearing a little bit more, hearing some rumblings about some things going on. And I still remember March 12th, 5 a.m., I got my first, saw my first email where our students in our local hospital and outpatient clinics were being pulled from their sites. So we had 20 students out in their internships. So 22 second-year students and 21 first-year students.

Joy: And then in a matter of about, I believe from Thursday to Monday or Tuesday, all 20 students were, for the most part, pulled from their site, or they knew that they would be pulled very quickly, especially those in the medical site.

Kadie: And at that time, we were transitioning, the way that you did internships this semester is students had the option of doing two 10-week internships?

Joy: Yes. And so the first one ended March 13th, and then they would start their new one March 16th. And then others either opted to do all educational or all medical. So it was right at the time where the internship was wrapping up that then for most students, they were just told that they couldn't start their next internship, or they maybe went for a couple of days, and then they were done.

Joy: And so for them, and for us, it was immediately trying to figure out how to plan for those students. For our first-year students, we have 20 students in our on-campus clinic, and we do have an additional two adjunct faculty that support the clinical supervision in addition to the three.

Joy: Right away, we were listening to our administrators, our university leaders, as far as what the plan was. We knew our spring break was extended by an additional week. And then another week, as we were told, we would be going to a remote learning process. And so that gave us time to try to figure out if we were going to do clinical simulation, if we were going to do telepractice.

Joy: And so now, rather than having our second years pretty much taken care of by their internship sites and their hours, now we were absorbing them as well to help them meet their requirements for graduation in May.

Kadie: So your first-years still in university clinic, and then second-years are pretty much completely off into their internships. Is that what I'm gathering?

Joy: Yes. Yep.

Kadie: So the second-years, you were more, maybe feeling a little bit more panicky about thinking how are we going to meet all of these hours when they're working full-time? Then in the meantime, your own campus clinic is also shut down?

Joy: Yes. Yeah.

Kadie: Wow. Okay. So you're thinking simulation or teletherapy, what are we going to do?

Joy: Right. Right. And all of the clinical faculty, we also teach undergrad and grad classes, including myself. And so it was, I need to think about how to turn my class to an online or a remote learning plus clinic, plus communicating with students to just be supportive in this time of stress and listening to them and trying to be the calm in the storm, I guess, kind of the anchor to just say, we will figure this out.

Kadie: Wow. I feel like you have a calming voice anyway, just getting to begin speaking with you, but thinking about all of this that the faculty is experiencing and trying to juggle, I'm sure you felt a sense of stress and franticness. And like you said, though, you didn't want to portray that to the students because I'm sure they were just so worried about all this hard work they were putting in being taken away from them.

Joy: Yes. Yes.

Kadie: So in those first couple of weeks, now, where are you in that process?

Joy: Okay. So first, to speak to the second-year interns, first, I have to say how fortunate we are to have such a strong community of workforce speech-language pathologists who know the importance of their roles as mentors to student interns. So a number of the sites, and these were mostly educational sites that the students were in, they are going to be doing telepractice with their clients in the school. And so many of them have said that they will continue to work with the student with telepractice in order for the student to get their hours and graduate.

Kadie: And that's great.

Joy: I know. I know. And there's been, we've just had open communication because for some, they've said, I don't know, this is new to me too. Can I be an effective mentor? Can you give me a couple of weeks for me to get a handle on it? And let me check with administration. Just really making sure that in the chaos of all this, that we're still following best practice, that we're being ethical, that we're following ASHA guidelines, especially with telepractice and just all of the, state by state, there's different regulations. And then we've got our accrediting body and we've got the Council for Clinical Certification, the CFCC.

Joy: So it was trying to keep all of that information straight to number one, see if our students could do telepractice as interns. And then definitely working with the internship site supervisors and basically saying whenever you're ready, if or when, yes, please take them and just thank you.

Kadie: Yeah, so that's been a huge relief.

Joy: And then we are doing clinical simulation. So we're using Simucase. And then we are doing two things with that to support our second years. A part of the issue with our second years is that there's a range of hours that they all need. So one student, she has met her 400 hours. She's completely set. And so that's one less student that I have to worry about. The other 19 or so, they range from needing 18 hours to about 100 hours still.

Joy: And some of those that are needing the higher numbers, they were in medical sites. And they know that they won't be able to go back. And with the telepractice, they just can't support them at this time, which I completely understand.

Joy: So we are doing clinical simulation. And with the guidelines for that is 75 hours can go towards the 400 hours for graduation. And so students who don't need as many hours and who are still working with their internship supervisors, they are taking week by week and trying to doing a couple as a just in case something happens. Others that need more hours, they're taking advantage of everything that we can offer.

Joy: And we've been upfront with them that we're taking this week by week because our load has now increased. Because again, we have absorbed the second years with our clinic. And we just, things can look great on paper. But then when you roll it out, then you see all the glitches. And the things that work and don't work. So we just said, you just got to understand we're working in this week mode. And at the end of the week, we'll take feedback and look at things and change things as needed.

Kadie: So Simucase will definitely be a very helpful tool as long as they're under that 75 hour mark. And can you explain, do supervisors assign specific simulation clients? Do you assign everyone the same client? How does that look in Simucase?

Joy: Right. So what we did is that, and again, the Midwest Clinical Directors Group, there's a lot of conversation on how to do this. So I really took a lot of suggestions from there and then shared it with faculty. And then we took what was out there and then created what we thought would work for us.

Joy: And for this first week, we have four cases. And really looking at the faculty's areas of specialty. So mine is pediatric speech sound disorder, dysphagia, adult voice, et cetera. So this week, I am doing a pediatric feeding assessment Simucase. And then three other faculty, one is doing one on aphasia, I believe one is doing one on language, and then AAC.

Joy: And we said, here are the blocks of times that we will be available for the debrief. And so I believe that's Thursday and Friday this week. Mine is Friday afternoon. And we just left it open and said, whoever wants to sign up can sign up. And then using Simucase and guidelines there, they've done a really nice job of really laying out how you do the debriefing with smaller groups or larger groups. Then we'll figure out what my blocks of time will look like and how many students would be in each block.

Joy: So right now, I think the last time I checked, I have 32 students that signed up for my case, which was a little overwhelming to be honest, but it's the first week. And just if my block of time needs to be longer to meet their needs, I'll do that this week to help them. And then again, just always modifying as we go.

Kadie: So does Simucase have these cases that you can pull from and then you debrief your own students on that specific patient's profile?

Joy: Yes, so there are, this might not be exact, but I believe there's around 72 cases on Simucase. And then they also break down each case into how many hours students can count for clinic. So for example, the case that I'm doing, it's a pediatric feeding assessment. So the max time that they can get is 75 minutes for that case.

Joy: And as part of the supervision, to meet the 25% supervision criteria, there's three processes. There's a pre-brief, there's feedback, and then there's the debrief. So the pre-brief, that is where I can give them information, which, and it's also found in the case too, the background information.

Joy: But what I do is I do the case first and then I write notes that might pertain to, pay attention to what the collaborators are saying before you do this part. Or really think about what's your priority in this case when you could really address all nine areas of disorders. So just giving them those points to ponder is what I call them, to help guide them through the process.

Kadie: Okay, yeah, that's definitely helpful for me to understand that process.

Joy: Yeah, and then the feedback is while they're doing it, I can go in and see how they're doing. So through Simucase as a faculty, there's a faculty dashboard and I can just give them feedback, especially if they're stuck or if they need help. And then the debrief, that is where we meet and we'll meet through Zoom and have that oral conversation. So really just talking through the case.

Joy: So there's that component. And then for me and how I teach and assess students and just as a check to make sure that I'm, I guess as a cross check, I also have them do a written portion too. And whether it's a smaller group or a bigger group, that I just feel more comfortable about that.

Kadie: I think that's very, very helpful information because I believe a lot of universities might already utilize Simucase, but just especially during this time, I think they're going to be heavily dependent on those simulation cases. So it's helpful to hear how you all have outlined that for your students.

Joy: Yeah.

Kadie: Can you remind me, do students have to receive a certain amount of hours, say directly in the school or directly in the medical placement, or is that not a criteria?

Joy: No, that's an old criteria, but that has changed and I'll just throw out in the last 10 years, I don't remember exactly which standard update they changed that. But right now, students just need experience across the lifespan and across all nine disorders.

Kadie: That is definitely a plus then for the students that are, thought that they were going to complete a school placement. And like you said, some are still able to do teletherapy, but then if they're in the medical setting, they're not necessarily able to get that.

Joy: Right.

Kadie: And then for the students that are still above that 75 hour mark, is that where you're trying to incorporate them into teletherapy from your clinic?

Joy: I'll say yes. And just to backtrack a little bit, so originally when, well, I'll just say a couple of weeks ago, when we knew that we were going to more of a remote or online learning platform for on campus as well, we thought we would do both telepractice and Simucase.

Joy: And because we have so few faculty that are able to do clinical supervision and with telepractice, that requires 100% supervision, whereas a Simucase, because of the pre-brief and the feedback and then the debrief, you can supervise more students than just one at a time, if that makes sense.

Kadie: It does, yeah.

Joy: Okay, so to be the most efficient and knowing that we again had more students that needed our support, we decided to wait on telepractice and to just focus on clinical simulation through May, I believe, 7th, and that we would try to get as many hours for the second years that we could, and then also for our first years.

Kadie: So you'll maybe reevaluate at that time how many hours everyone is still needing as far as before graduation?

Joy: Yes, yep. And then right now the plan is, because there's also the contractual piece of faculty, our contract for spring semester ends, and this isn't the exact date, but I'll just say May, maybe like May 15th or something like that. And then those of us who are working in the summer, then that's when our summer contract starts.

Joy: So that is nice because then I can say I can work in the summer and do clinic and then in May I can work with and incorporate telepractice for those second-year students who still need hours. I think we're teachers and our heart is in supporting our students and getting them what they need.

Joy: At the same time, we're all ready. We were already very stretched thin prior to this. And so it's that balance of how much more do I stretch myself to meet their needs versus doing what I can do now. And then just waiting until May when I have a new contract and getting compensated for the work that I'm doing.

Joy: And a little bit hopefully, I'm sure in May I'll still be stressed, but my thinking will be a little bit clearer as to how can I now implement telepractice because our students, our second-year students, do have usually until May 22nd. And we've gotten approval from administration that we can go a little bit longer with their second-year students if needed so that they can get their hours.

Joy: I could potentially have a good month from mid-May to mid-June or early June to meet their needs through telepractice.

Kadie: Right, right. That's totally understandable and I understand what you're saying. Of course, you have a passion for teaching and student learning and getting them everything they need. But like you mentioned, if you're having to supervise 100% of a teletherapy session, how can you make that happen while also doing your online courses and all of your other tasks that you already have to do?

Joy: Right, right.

Kadie: Is there any hiccup as far as graduation for those second years or not at all for graduation? It's just simply for ASHA?

Joy: Well, I'll answer and if it doesn't get to what you're asking, then just let me know. As far as the physical graduation, all ceremonies and hooding ceremonies have been, and at first they were canceled and now they're postponed and we don't really know what's happening. But they will not have that traditional graduation on May 8th. That was in the plan.

Joy: I believe students asked us that, the second years asked, will we graduate in May? And the answer that they were given is there's a chance that not all of you will.

Kadie: Oh, wow.

Joy: And then later I met with the second-year students again just to follow up just because we had a number of meetings and there was that question again and that worry and that concern. And so I really had to pull back and I said, in the big scheme of things, if you graduate in spring semester, which would be May, or if you graduate in June, which would be summer, does that month make that big of a difference?

Joy: And if it's a, yep, I've already been hired by a job and I need to start June 1st, then that's a little bit different than if you've been hired for a job and you're not starting until August 1st. And they were reassured that they would not have to pay extra money or extra tuition.

Joy: So one, putting it in the big picture of a May versus a June finish time, does that really matter? Other than it's different than the original plan. The original plan was I'm going to be done on this date, graduate this date, and that's all changed.

Joy: And the other thing that I just said, we don't know what's going to happen week to week. We can have things outlined for telepractice and Simucase, but unfortunately this coronavirus, this is real and I could get sick next week or they could get sick or their students if they're doing telepractice could get sick.

Joy: We can plan as much as we want, but I think what we've learned in the last month is things can change very quickly day to day. And in the big scheme of things, what is our priority?

Joy: What I've learned in the past month with everything happening worldwide is just things can change very quickly day by day. And we can have our plan for the week and we just adjust as we need to. And we take little chunks of time as we can with what we know and what we can control and the things that we don't know or we can't control yet, then that's where we have to be flexible.

Kadie: That is a very good takeaway and reminder. I know myself as well, learning that you are not in control of every aspect right now, but like you said, all that matters right now is getting through this time and everyone's staying safe. So hopefully the students can realize that too. I just really feel for them, and the staff who's bombarded and overwhelmed with trying to keep everyone calm.

Joy: Yes. Yep.

Kadie: Well, thank you for debriefing all of us on the coronavirus situation within the university setting. Before we continue with the second portion of this episode, a word from our sponsor, Therapy Marketing Kit. Therapy Marketing Kit creates custom marketing materials such as brochures, flyers, postcards, and more that are unique to your business. With professional templates and content written by an SLP, you can skip the exhaustive back and forth part of the design process. Listeners can use code CLINICNOTE and get $20 off any of the kits on Therapy Marketing Kit's website, therapymarketingkit.com.

Kadie: And now if you have some more time, do you mind kind of backtracking and we can really get to know you and how you became clinic director?

Joy: Oh, so when I started, I'm trying to think, this is my ninth year at the university. And when I started, actually I started as an adjunct and then I was working full-time as a speech therapist in our outpatient pediatric rehabilitation clinic in town here. And I knew that I always wanted to get into academia and wanted to get my doctorate, et cetera.

Joy: And so when the opportunity came up for me to go to St. Cloud State full time, I went knowing that it was really a year to year contract. And then I loved it. I love teaching. And then I also started the higher education and administration doctoral program at St. Cloud State.

Joy: Which has been great because I've been able to align everything in our field with higher education. So doing a lot of research on CSD across the years and so forth, learning about curriculum and leadership and assessment practices and all of that.

Joy: And throughout this time, it was a great time to be in that kind of a program because that's when nationwide, a lot of higher ed institutions were running into budget issues and were having to downsize programs or staff and so forth.

Joy: So the person who was our clinical director, she was full time, had the 8 to 4:30 hours, Monday through Friday. And it was a year long contract. And the decision was made, unfortunately, for her position to be cut due to budgetary constraints.

Joy: And I still remember originally when we got this news and it was who's going to take over. And people looked at me and I said, no way. No, no way. I am in a doctoral program. And around that time, my mom was diagnosed with stage four ovarian cancer. My kids were, they're nine and 12 now, so they were probably six and nine or something like that. And I said, I have way too much stuff on my plate to take anything new.

Joy: But then over time, it made sense for me to take it, especially I'm doing my dissertation on clinical supervision. And it just made sense.

Joy: So the clinical director, the previous one, I highly respect her. She was a mentor to me when I started and she was very gracious. And in her last semester, we met weekly and she was helping me learn the job and to help with the transition.

Kadie: As you learn the job, what were some of the things that you had to learn how to handle and take over as far as keeping the clinic running, placements running, et cetera?

Joy: I think the main thing was learning what type of a leader to be and along with that comes how do you communicate and how with that communication, how do you listen to the needs of the faculty that are supervising, the needs of the students, and the needs of the community members who are our clients.

Joy: And being able to flex and balance and listen and to make decisions, whether it's leading to make a uniform decision about clinic or having to be the person that just says, I hear everybody, and for sake of moving on, this is the decision. I need to be decisive, and this is what we're going to do. And then we just try it. And then we can always make changes as needed.

Joy: So I think that was the steepest learning curve. And I remember, and this is in all due respect to everybody, that faculty, and students, and clients, but there were times when I felt like I was herding cats. There was just a lot to manage. And again, I mean that respectfully.

Kadie: Right, yeah.

Joy: And looking back, there's things that I would definitely do over, and it was a very tough learning time. But at the same time, life is always a process. And any new job or task that you have, there is a process to it. So I can say, or I feel like I've definitely grown as a leader. And for saying, no way, I would never do this, I do really enjoy this role, and this position, and how I get to work with people.

Kadie: Absolutely. So can you touch a little bit on the universities and speech departments accreditation process? I think that's an unknown area for me, and maybe lots of our listeners.

Joy: Right, yes, yes. So I'll start with our department. So we are accredited through CAA. And with that, when a program gets their accreditation, they can get it for a full time, or for a certain number of years. Our last accreditation, we did get it for the full eight years. So that was really exciting. We've got strong faculty, strong leadership.

Joy: And so that was a really positive note. So with that accreditation, even though we are accredited for eight years, every year, the program director needs to complete a report that they send, really making sure that we're hitting the different benchmarks, or the standards for clinical certification for our students.

Joy: And I will say, when I went from the workforce into academia, I really had to bring myself up to speed with what those standards were. Because I thought, standards, what is everyone talking about? I mean, that's embarrassing to say. But when you're working, you're working. You're focused on your patients.

Kadie: Yeah.

Joy: And so with academia, it's like, oh, okay, there are these. Yep, now I remember. I kind of think from grad school, I remember this stuff. And so our job is to make sure that those standards are being met. And there are standards that are across curriculum, across assessment, across faculty. And I think those are the main areas.

Joy: So there's curriculum, and I think it's broken down to curriculum for audiology, curriculum for speech-language pathology. Our program only has speech-language pathology. But anyway, there's five main points. And it's curriculum, assessment, and then I believe faculty.

Joy: And so even things like, do you have enough doctoral-level faculty within your department to support the needs of the students? Are your faculty doing professional development? And so it's really holding everybody accountable to make sure that we are at a level where we can be training and mentoring future SLPs.

Kadie: Absolutely. You mentioned the requirements for curriculum. I'm sure they tell you the types of courses and topics that need to be covered. But after that, how much guidance is there really?

Joy: That is a good question. And I'm trying to pull from my memory here with the curriculum piece. The one thing that I can say I feel with certainty is that if you look across universities, there are going to be some core courses. But there's also flexibility beyond that.

Joy: So for example, our dysphagia class or course, it is three credits. And we cover both pediatric and adult. But I know other institutions, they might have a two credit where it covers both. Or they might have three classes covering it. So there's flexibility within that.

Joy: The main thing is that when students graduate, that we can say that they have met or have experience in all of the nine disorders. And so that's where we are. We're currently looking at our curriculum and looking at what classes do we feel that we really absolutely have to have versus what classes are nice for students to have, and then looking at our credit load and so forth.

Kadie: Oh, it's very helpful. So you covered the clinic's accreditation process. And then there is also one at the university level?

Joy: Yes, yep. So St. Cloud State is accredited by the Higher Learning Commission, which is HLC. And we went through our review probably about, I'll say, four years ago. And at that time, I was on the university's assessment steering committee.

Joy: And basically, again, this was a nationwide trend, is that a lot of universities were not great at doing assessment. Well, let me say that again. They were not great at showing the assessment work that they were doing. We're always assessing. I think that, or I would hope that we're always assessing, assessing how effective we are as teachers or instructors, assessing if students are getting out of the courses what they're supposed to, how many are passing, all of that. But we didn't have the documentation to show that at the university level.

Joy: Now, the programs that are accredited, we have that information because that's that yearly report that the director has to send in. But one area that we were lacking was really showing how we close that loop. If we're saying, oh, okay, here is something we identify that we need to make changes on, then you implement those changes. And then you determine, were those changes effective?

Joy: And so for a number of programs that were accredited, that's where we were at, was really showing or documenting how we were closing the loop. A number of other programs, and they were anywhere between at the same level as accredited programs with just showing how to close the loop to the very basic of, how do I even document or put down what our student objectives are? So it was a huge learning curve across the university.

Joy: And we, I think I can say this, that assessment was identified by HLC as an area of need at St. Cloud State. And that's when things really ramped up. And assessment can be scary for people. So there is culturally, people misunderstand assessment as it's an assessment of them and that they could get in trouble if they're not showing what they're doing. And that's not what assessment is.

Joy: And so that was quite the process for the university to understand that and to make changes. But I think we're definitely in a better place. And HLC is going to be reviewing our assessment stuff, I think, either this year or next year.

Joy: And so I felt really proud to be a part of an accredited program and that we were doing so much and that we could really be leaders and show and talk about the work that we were doing and also explaining what we were doing as part of this whole process.

Kadie: To the other programs across the university?

Joy: Yes, yep.

Kadie: Wow, very good. Well, I appreciate all of that insight. It's super helpful. So some fun stuff. Let's get to know some of the great aspects of being clinic director.

Joy: Yeah, I think what I love most is just all of the connections that I get to make with people. And that is our students. Even though I might not be supervising them directly, I'm still a part of their care as a student who needs clinic and I'm thinking about them. And reaching out to clients and listening to families and their needs. Working with community members or our speech-language pathologists out in the workforce who want to work with us and take our students and mentor our students as well as refer clients to us. So I think it's all that relationship with the people that I really, really enjoy.

Kadie: Have there been connections across other universities just for some sort of guidance or camaraderie for speech departments?

Joy: Yeah. So there's the Midwest Clinical Directors Discussion Group, which is, and that's just through, it's their own site, but it comes up through email where people can post comments, questions. And there's definitely a collaboration with them, which has been great.

Joy: And then I think that my style or who I am as a person, I sit back a little bit more and just absorb and process. This is my, I have to think, is this my second full year as a clinical director? I think so. And so just getting to know, I think people, even through that discussion group, I don't post a lot, but I read a lot. I've been posting a little bit more because I just like to listen and learn.

Joy: And now that I'm feeling a little bit more comfortable, just knowing that I really can reach out to people. I think that there is more opportunity for collaboration with me and actually picking up a phone and calling somebody or texting. Where I went to school at University of Minnesota Moorhead, and I've been in touch with some of the people there, which is just nice to connect that way.

Kadie: Absolutely. And like you said, I do think it takes a solid two years in any setting really because that first year, you're just learning so, so much like head above water. In second year, you're really starting to feel more comfortable. So now is probably the point where you're feeling like a confident leader and, of course still learning, but you're really getting in the groove of things.

Kadie: Has there been anything, I don't want to say negatives, but things that might have been unexpected or even expected that aren't really the great parts of your job?

Joy: Right. Yeah. I'm trying to think. I think the things that started out as real challenges and barriers, partly again, going back where we're at in higher education and just the constraints that we're feeling and how our program, again, positions have been cut due to budgetary issues, which means fewer people to supervise, but the expectation is to increase our cohort size. So we're meeting more student needs with fewer people.

Joy: And that is absolutely a challenge and a barrier and a frustration and a stressor. But at the same time, it provides opportunities to think in different ways than we've done things. And by doing so, we're finding just new opportunities. We're finding different formats that are working better than previous formats.

Joy: But I think with that and just this job, I think about my job every day. And that's different, I think, than being an instructor, because when I'm teaching, it's, okay, I need to prep for my class, I did my lecture, and I need to prep for the next one or assign, but I feel like I can shut that off even for a little bit and just focus my attention on other things, or especially at the end of the academic year or the semester. It's okay, finals, grading, grades are in, I'm done.

Joy: Whereas clinical director, it's just this constant cycle. And once I, it's like, okay, get spring clinic up and running. Okay, we got that. Well, and actually, let's get second-year students out on internship. Okay, they're all there. Great. Now we've got spring clinic starting. Okay, that's kind of starting. Now I need to think about this next thing. And it's just constant.

Kadie: Oh, my goodness, I imagine you are always working ahead.

Joy: Yes, always. Yes, yes. And so I think that is more wearing. And I've had to learn how to shut it off or how to focus myself or prioritize my work, in a sense. And then, of course, balance my family. And I'll be honest, that's been a struggle to not be sitting with my family and checking my emails on my phone or that kind of stuff. But it's a work in progress.

Kadie: Right, to let something go. If you're in the middle of dinner, like you said, and you want to handle something, there has to be moments of it can wait, you can wait till the morning.

Kadie: Well, I appreciate all of your time. Is there anything you'd like to add that I didn't get to today?

Joy: No, I just really appreciate your willingness to have me on. And I've really enjoyed talking to you. And hopefully some of the stuff that I said is helpful to others.

Joy: And I think just especially now reminding everybody that, we're probably perfectionist by nature, because of the work that we do. And to be kind to ourselves and forgiving and to others, we're all in a more heightened state of stress. And to just pause and take time as we need to and take one day at a time, as cliche as that sounds. But I think that's where we're at. Slow down a little bit, I think.

Kadie: I appreciate that. I think I needed to hear that myself. I told you we've got the four-month-old and the two-year-old here. Me and my husband are both trying to clock 40 hours a week still.

Joy: Yes, yeah. Take it one day at a time.

Kadie: But I will say it's nice to also look at some positives and enjoy the extra family time that we have together as much as possible.

Joy: Right, right. Absolutely. That is, I mean, this is just an absolutely unfortunate situation that we're all in. And at the same time, it's given me the opportunity to really be with my kids. And I realized just how fast I was going every day. And now it's like, wow, I can actually get a 10-minute walk in when it's nice out with my kids or with the puppy or go out for a couple minutes and talk to the kids or help them with their schoolwork. Those are really precious moments.

Kadie: I know. Well, we just, we're both very fortunate if we're able to continue work, no matter how stressful it is to make these transitions, just to appreciate that we're all still able to work remotely because some people are not that fortunate. So I find myself going to bed so thankful, like you said, for the family time and for having a job that can turn remote. Well, I'm always remote. But anyways, I sure appreciate it. And I'm excited to get to share this with the whole university community. And hopefully everyone can gain some insight or just appreciate someone going through a similar journey.

Joy: Yes.

Kadie: Thank you for joining me and listening to Clinic Chats. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey, please email me katie at clinicnote dot com. That's K-A-I-D-E at clinicnote dot com.