cgfns standards: for foreign-educated speech-language

FOR FOREIGN-EDUCATED SPEECH-LANGUAGE PATHOLOGISTS AND

AUDIOLOGISTS

CGFNS Standards

I C H P C O M M I T T E E O N S TA N D A R D S F O R S P E E C H - L A N G U A G E PAT H O L O G Y A N D

A U D I O L O G Y

Presentation Personnel

• R O B E R TA AU N G ST, Audiology

• R O B E R T F E L D M E I E R , ES Q . , Public Member

• J U L I A TO D U T K A , CGFNS Ex Officio

• P H I L I P L A N G L A I S , University Admissions Officer

• J AY LU B I N S K Y, Audiology, Chair

• M I C H A E L M O R A N , Speech-Language Pathology

• T H E R ESA R O D G E R S , Speech-Language Pathology

• R OY S H I N N , Audiology

• J E N N I F E R WAT S O N , Speech-Language Pathology

• R E B EC C A W EAV E R , Speech-Language Pathology

Learning ObjectivesAT T E N D E E S W I L L B E A B L E T O :

Describe the process used by CGFNS International to report to the Dept. of Homeland Security on qualifications of foreign-educated speech-language pathologists and audiologists.

Describe the process used by the ICHP Standards Committee in Speech-Language Pathology and Audiology to develop standards for foreign-educated speech-language pathologists and audiologists

Discuss issues faced in developing and applying the CGFNS standards

Disclaimer

Opinions presented today are those of the ICHP Committee on Standards in Speech-Language Pathology and Audiology. They do not necessarily represent the opinions of the Board of Directors of CGFNS International.

Issues in Standards Development

• Substantial equivalence to accepted U.S. standards

• Input- vs. outcome-based standards. CGFNS staff review issues.

• Communication competence

• General education

• Modification for SLP applicants from MMRA countries

VisaScreen®

VisaScreen® AnalysisVisaScreen® Overview ICHP Standards CommitteesVisaScreen® Requirements for Speech-

Language Pathologists and AudiologistsVisaScreen® Speech-Language Pathology and

Audiology Statistics

VISASCREEN®OVERVIEW

VisaScreen®: Visa Credentials Assessment Program (VS)

The VisaScreen®: Visa Credentials Assessment Program (VS) was launched in 1996 by the International Commission on Healthcare Professions (ICHP), a division of CGFNS International.

VisaScreen® is a federally-approved screening program forinternational healthcare workers seeking an occupational visa in theUnited States

Applicants who successfully complete the VisaScreen receive a certificate which is presented during the occupational visa application process with the United States Citizenship & Immigration Services (USCIS).

Who needs VisaScreen® (VS)?Section 343 of the Illegal

Immigration Reform & Immigrant

Responsibility Act (IIRIRA) requires

the following 9 healthcare

professionals who are educated

outside the United States seeking

temporary and permanent

occupational visa or Trade NAFTA

(TN) status to complete

VisaScreen®:

Audiologist

Clinical Laboratory Scientist

Clinical Laboratory Technician

Licensed Practical or Vocational Nurse

Registered Nurse

Occupational Therapist

Physical Therapist

Physician Assistant

Speech-Language Pathologist

VisaScreen® (VS) Components An assessment of an applicant’s education to ensure that it is

comparable to that of a U.S. graduate in the same profession.

A verification that all professional healthcare licenses ever held by an applicant are valid and without restrictions.

An English language proficiency examination.

For registered nurses only, a verification of the nurse passing the CGFNS Qualifying Exam® or NCLEX RN®.

ICHP (International Commission on

Healthcare Professions)STANDARDSCOMMITTEES

Overview of ICHP Professional Standards Committees

Each profession that the ICHP division of CGFNS International is authorized to certify for VisaScreen® (VS) has a Professional Standards Committee.

The role of each Professional Standards Committee is to develop, revise, and uphold the integrity of the profession specific standards. The Committee also reviews documents of applicants whose credentials pose unusual problems.

ICHP Speech Language Pathology & Audiology Professional Standards Committee Composed of seven (7) experts from the speech-language pathology

and audiology professions representing education and practice, one public member, and one university admission officer.

The Committee chair is Jay Lubinsky, PhD, CCC-A/SLP.

CGFNS International’s staff to the Committee is Julia To Dutka, Director of Global Assessments & Professional Services.

VisaScreen® Requirements

Audiologists

Speech-Language Pathologists

Speech Language Pathology & Audiology Requirements VisaScreen® applicants for these professions must graduate from

a program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology of the American Speech-Language-Hearing Association (ASHA) or from a program in a government-approved school in a country outside the United States and that the education received is deemed comparable to an entry-level professional education in the United States.

Speech-language pathologist and audiologist applicants must also meet course work, clinical observation, and clinical practicum requirements set by the ICHP Speech-Language Pathology & Audiology Committee.

Multilateral Mutual Recognition Agreement(MMRA) for Speech Language Pathology

ICHP recognizes the Multilateral Mutual Recognition Agreement (MMRA) for VisaScreen®. MMRA was signed effective January 1, 2009 between the American Speech-Language-Hearing Association (USA), the Canadian Association of Speech-Language Pathologists and Audiologists (Canada), the Royal College of Speech and Language Therapists (United Kingdom), the Speech Pathology Association of Australia Limited (Australia), the Irish Association of Speech and Language Therapists (Ireland), and the New Zealand Speech-Language Therapists' Association (Incorporated) (New Zealand) to mutually recognize the certification programs in speech-language pathology that they each conduct.

VISASCREEN®STATISTICS

VisaScreen® Applications Received for Speech Language Pathologists & Audiologists

1996 – 2010Profession Type

Applications Received

Certificates Issued

Audiologist (AUD) 55 50

Speech Language Pathologist (SLP) 1,256 1,043

Top 5 Countries of Education for Speech Language Pathologists & Audiologists

1996 - 2010Audiologist (AUD) Speech Language

Pathologist (SLP)

1. India 1. India

2. Canada 2. Canada

3. Hong Kong 3. Argentina

4. United Kingdom&Colombia

4. Peru

5. People’s Republic of China& Taiwan

5. Philippines

I C H P

Speech-Language Pathology Standards

S L P STA N DA R D S S U B - C O M M I T TE E

MICHAEL MORANJENNIFER WATSON

BECKIE WEAVER

SLP Standards -Background

The speech-language pathology standards developed by this committee are used by the International Commission on Health Care Professions (ICHP) to evaluate speech-language pathology applicants to its VisaScreen program.


The ICHP Speech-Language Pathology and Audiology Standards Committee developed the standards during a series of meetings held in Philadelphia and by conference call from October 2008 through March 2010.


This committee was composed of representatives from the speech-language pathology and audiology education and practice sectors, as well as a university admissions officer and a public member.


The Committee reviewed:

Federal requirements for entry into the United States, U.S. licensure and education requirements for speech-language pathologists,

The certification standards for speech-language pathology of the American Speech-Language-Hearing Association (ASHA).


The initial draft of the VisaScreen standards was based on the certification standards of ASHA.

The VisaScreen standards then were reviewed and revised based on the Committee’s evaluation of international transcripts using the newly developed standards.


The Committee addressed issues such as:

Comparability

Professional and regional accreditation

Curriculum content.


The Standards were then submitted for field-testing to:

ASHA Chief Staff Officers for Speech-Language Pathology and Audiology

Council for Clinical Certification (ASHA)

ASHA Advisory Councils for Speech-Language Pathology and Audiology

National Council of State Boards of Examiners for Speech-Language Pathology and Audiology

Council of State Association Presidents

Council of Academic Programs in Communication Sciences and Disorders


The committee revised the standards based on input from field testing.

The Committee will review the speech-language pathology professional standards yearly and on an as-needed basis, and whenever the ASHA standards are revised.


A critical point:

Meeting the professional standards developed by this committee does not ensure that the standards for speech-language pathology of other credentialing or licensing agencies (e.g., American Speech-Language-Hearing Association, state licensure boards) will be met.

The Standards

The specific standards are proprietary to the ICHP and cannot be revealed in detail.

However, an outline of the standards will be shared in this meeting.

Also, several comments from field testing and the committee’s response will be provided.

Standard I: Entry Level Professional Education

A speech-language pathologist educated outside the United States applying to the VisaScreen program must have completed a program of study for professional clinical practice in speech-language pathology, as evidenced by an earned degree, that is substantially equivalent to an entry level professional degree in the United States.

Comments Re: Standard I

Comment:It must be made clear that the applicant must also meet ASHA certification standards and that completion of an equivalent program of study does not assure that ASHA certification standards requirements will, necessarily, be met.

Committee Response: A statement was added in the preamble to the effect that these standards reflect federal requirements for a visa and that applicants should consult professional organizations (ASHA, state licensing boards) for their individual requirements.

Standard II: Program and Institutional Recognition

The degree and all clinical practicum must be initiated and completed under the aegis of a speech-language pathology program approved by the appropriate recognized authority in the country or countries of education.

Comments Re: Standard II

Comment: If some portion of the clinical practicum is absent, I think they should be able to secure that either within their original country of education or within another country.

Committee Response: Added “…initiated and completed under the aegis of program or programs in the country or countries of education.”

Comments Re: Standard II

Comment: Not all speech programs are completed under the aegis of a speech-language pathology program, e.g. within department of medicine.

Committee response: We did not view this as a problem as, regardless of the housing department, there will still be a speech-language pathology program that has responsibility for educating SLPs.

Standard III: Academic Coursework

Standard IIIA: Basic Science Course Work

Must include:

Biological sciences

Physical sciences

Mathematics

Social/behavioral sciences

Comments Re: Standard IIIA

Comment:Change heading from “Basic Science Course Work” to "Prerequisite Knowledge".

Committee Response: We do not discuss a sequence of courses for areas outside communication disorders and “prerequisite” implies that an applicant must have these courses before taking any courses in speech-language pathology.


Standard IIIB: Professional Coursework

Must Include:

Basic human communication and swallowing sciences and processes with transcript evidence of coursework in:

Anatomic and physiologic bases of speech, language, hearing, and swallowing.


Standard IIIB: Professional Coursework (Continued)

Physical and psychophysical bases of speech, language, hearing, and swallowing.

Linguistic and psycholinguistic aspects of speech, language, and hearing.

Standard III B: Professional Coursework

Standard IIIB: Professional Coursework (Continued)

Coursework substantially equivalent to graduate coursework in the United States addressing

Nature, prevention, identification, assessment, and intervention of speech, language, hearing, and swallowing disorders including:

Standard IIIB: Professional Coursework

Speech disorders, including articulation, fluency, and voice and resonance

Language disorders, including receptive and expressive language (phonology, morphology, syntax, semantics, and pragmatics)

Speaking, listening, reading, writing, and manual modalities

Swallowing disorders

Auditory impairment and its effect on speech and language

Communication modalities

Research bases of speech-language pathology

Ethics and other professional issues in speech-language pathology

Comments Re: Standard IIIB

Comment: This section specifies credit hours while the current ASHA SLP certification standards are broader and outcome based. The implication is that the Visa-screen requirements reflect current ASHA certification standards.

Committee Response: Insert a cautionary statement in the preamble (see Std. I).

After some discussion it was determined that many international programs are not set up to monitor outcomes; therefore, we did not change to an outcomes based set of criteria.

Standard IV: Clinical Observation and Clinical Practicum

The clinical observation and clinical practicum for a speech-language pathologist educated outside the United States must consist of a substantial number of patient contact hours.

Those contact hours must include: Supervised observation of speech and language

services prior to the clinical practicum


Practicum experiences (patient contact hours) must include:

Prevention, identification, assessment, and intervention

Speech, language, and swallowing disorders

Clients across the lifespan

The range of clinical severity.


At least 25% of each student’s clinical time with each patient must be documented as directly supervised by a speech-language pathologist who is qualified to practice in his/her country.

Comments Re: Standard IV

Comment:Suggest verified competence in the 9 clinical areas of practice

Committee Response: The current version requires practicum experience across the scope of practice in SLP. Also, the ASHA SCCC-SLP do not require practicum experiences in all nine clinical areas, but allow students to demonstrate competence through other means (e.g. class projects). Because this standard is specifically about practicum, we were hesitant to specify verification of competence by practicum in all nine areas.

Comments Re: Standard IV

Comment:What is the definition of a ‘qualified’ SLP?

Committee Response: Added “a speech-language pathologist who is qualified to practice in his/her country.”

Other Comments

Comment:These standards appear to be appropriate given the current standards for clinical certification in speech-language pathology. It will be important to make any necessary adjustments over time based on the practice analysis that is underway.

Committee Response :The Committee will review the speech-language pathology professional standards yearly and on an as-needed basis, and whenever the ASHA standards are revised.

A Final Comment

Although specific numbers of credit hours and practicum could not be revealed here, the committee attempted to use CFCC standards as a guide.

Adjustments to CFCC standards were made to reflect international educational procedures.

ROBERTA AUNGST

THERESA RODGERS

ROY SHINN

Audiology Standards

ICHP

AU D I O LO GY STA N DA R D S S U B - C O M M I T TE E

Limitations

Since audiology education isn’t graduate level in all countries, CGFNS standards use equivalence.

Documentation of acquisition of knowledge and skills in audiology is limited to passing grades on the academic transcript.

Development of Revised Standards

The policy of the ICHP is to review Audiology standards annually and whenever ASHA certification standards are revised.

Revised standards were based on 2007 ASHA certification standards for audiology.

The following slides provide a side-by-side comparison of the two sets of standards.

Peer Review

Draft standards sent for peer review in Fall 2009

Same organizations as for SLP standards, plus American Academy of Audiology

Peer Review Comments

Many comments essentially the same as those received for the SLP standards

Comments unique to Audiology standards: Std. III. B. Insert the word "graduate" semester credit hours of professional

education course work. Std. III. B. [Required] semester hours of evaluation/assessment of seems a

little low. I don't have other program data at my disposal for comparison, however.

Std. IV. Some percentage (majority) of direct patient contact should be specified.

Addressing these issues will become clearer in subsequent slides.

History of ASHA Certification

1993 Master's or doctoral degree required (equivalency no

longer accepted)

75 hrs of coursework (including basic sciences)

375 hrs of observation and practicum (25 observation, 350 practicum) with 250 at the graduate level

Periodic formal evaluation of specific skills during CF.

Basic Science Coursework (ASHA, 1993)

ASHA (1993) required:

27 semester hrs of coursework, including biological/physical sciences, math, social sciences (6), and communication sciences (15)

Professional Coursework (ASHA, 1993)


36 semester hrs of coursework (30 at graduate level)

21 graduate hours in audiology with 6 in hearing disorders/ evaluation, 3 in rehab, and 6 in hearing devices

Supervised Practicum (ASHA, 2003)


25 hours of supervised observation

350 clock hours of supervised practicum 250 hours at graduate level

Minimum of 20 hours in each of the following: Ped. Hearing Dx, Ped Hearing Tx, Ped Hearing Dx, and Adult Hearing Tx

20 hrs in speech and language

Successful completion of Clinical Fellowship

History of ASHA Certification

• 1997 (effective 1/1/07) 75 hours of post-baccalaureate studyo Knowledge and skills outcomes

Prerequisite material

Foundations of practice

Prevention and identification

Evaluation and treatment

12 months of full-time, supervised experience

o Doctoral degree (effective 2012)

Academic Degree

ASHA (2007) requires a graduate degree (doctoral degree starting 1/1/12).

CGFNS requires coursework substantially equivalent to graduate coursework in the U.S.

Program of Study

ASHA (2007) requires:

≥ 75 semester hours of graduate coursework

CGFNS reviews:

Academic transcript for professional education coursework

Knowledge and Skills


Prerequisite skills in oral and written and other forms of communication

CGFNS requires:

TOEFL score of ≥ 207

TWE score of ≥ 4.0

TSE score of ≥ 50

These are part of the VisaScreen requirements, not the audiology standards.



Life sciences, physical sciences, behavioral sciences, and math (amount unspecified)

CGFNS reviews:

Academic transcript credit for coursework in:

Biological sciences

Physical sciences

Mathematics

Social/behavioral sciences



Prevention and Identification (18 areas)

CGFNS reviews:

Academic transcript for coursework in prevention and identification of hearing and vestibular disorders



Evaluation (18 areas)

CGFNS reviews:

Academic transcript for coursework in evaluation of auditory and vestibular disorders, including behavioral assessment of audition, physiological assessment of audition, and assessment of vestibular disorders



Treatment (19 areas)

CGFNS reviews:

Academic transcript for coursework in treatment of auditory and vestibular disorders, including sensory devices for HL, AR strategies for children and adults, and management of vestibular disorders

Assessment (formative and summative)


Ongoing formative assessment and passing score on national exam

CGFNS reviews:

Not addressed

Supervised Practicum

ASHA (2007) requires: ≥ 12 months FTE supervised

practicum supervised by someone with CCC-A

CGFNS reviews: Documentation of supervised

clinical practicum across the scope of practice of audiology, including with newborns, children, and adults

Documentation of supervised clinical practicum for the equivalent of one full year of professional practice

Amount of practicum time in patient contact

Amount of patient contact supervised by qualified audiologist

Questions

cgfns standards: for foreign-educated speech-language

Documents