Clinicians make significant contributions to the profession by taking on the role of student supervisor and CASLPA is committed to highlighting this aspect of our scope of practice.

Profile of a Clinician

Brenda Lewson- University of Toronto
by Susan Wagner

To be an effective clinical educator one needs to possess a variety of skills, behaviours and attitudes. Among these are clinical wisdom and insight, flexibility, patience, innovation, excellent communication skills, dedication to and interest in clinical education and learning, enthusiasm and a positive attitude!

Brenda Lewsen is one such outstanding clinical educator in the Graduate Department of Speech-Language Pathology at the University of Toronto. Brenda is employed as an audiologist at Sunnybrook and Women's College Health Sciences Centre (SWCHSC) - Sunnybrook Campus in the Long Term and Veterans Care Directorate. Her dedication and skill in clinical education have most recently been recognized with the presentation of the 2004 Professional Advisory Committee/ Nursing Advisory Committee Clinical Teaching/Supervision Award at SWCHSC. This wealth of knowledge and skills have been acquired through a reflective and evolving journey as a clinician and clinical educator.

Brenda has supervised students at SWCHSC for the University of Toronto for 12 years. In that time she has mentored over 50 students in clinical placements in aural rehabilitation. As the enrollment in the Master's of Health Science program doubles to 40 students by 2005, Brenda has increased her activity with 21 students in the past four years alone.

The quantity of students Brenda has taken is rivalled only by the quality of the clinical experience that she provides. She is open to exploring, developing, implementing and refining the clinical education process and new models of clinical education. The group model of clinical education is the model Brenda consistently utilizes. In this model, two students are taken for placement at the same time, which initially may present challenges, but also ultimately yields many opportunities that serve to enhance learning. Brenda engages students in the clinical journey as they develop their entry-level skills, behaviours and attitudes about aural rehabilitation with the elderly population. Students continually report that Brenda has the 'right stuff' when it comes to clinical teaching. She is able to effectively guide the students and impart her knowledge through a positive coaching and discovery process. Students enjoy Brenda's calm, open, non-direct style and feel they learn enormously under her tutelage. She is understanding, patient and is able to maximize their potential and to invigorate them with her enthusiasm.

Part of Brenda's success lies in her ability to utilize the principles of client-focused care not only in modelling professional practice, but also in teaching. Initially, she asks students to identify their learning needs and to suggest strategies for meeting them. She listens for underlying issues that may affect the placement and then moves forward to address these. Brenda feels that using these principles of client-focused care reduces student anxiety, promotes openness and fosters a positive and supportive approach. This ensures that things get off on the right foot at the start!

Brenda also uses other teaching/learning strategies to aid student understanding of hearing loss, the aging process and how to help clients manage their losses. These include:

" Strong organization before and during the placement. Students are given a written schedule of planned experiences when they arrive which includes a wide variety of optional experiences that they appreciate. This includes, for example, a visit to the Cochlear Implant Clinic or the delivery of a workshop to nursing students.
" A pre- and post-placement private reflection on attitudes and thoughts towards the elderly.
" Experiential learning opportunities to simulate client conditions (e.g., dark glasses with gauze to simulate cataracts, earplugs to simulate hearing loss, gloves with sticks to simulate arthritis) with a follow-up reflection on "take-home messages" and evaluation.
" Comparison of two approaches to client self-evaluation of quality of life.
" Ongoing constructive and balanced feedback.

Brenda is also forward thinking in terms of clinical practice and clinical education, as evidenced by her thoughts:
"Students bring new ideas and ask questions which open up other avenues of thinking."
"When you have a student, it makes you reflect on your own practice."
She therefore utilizes student experiences to evaluate and develop her own clinical skills and deliver exceptional clinical services through this continuous quality improvement process.

But perhaps student feedback says it best:
"My clinical educator is able to teach clinical skills while increasing the confidence of students."
"Your experience and enthusiasm for your work shone through each week."
"Your time, compassion, and positive feedback gave me the confidence I needed to grow as a clinician."
"You …….sincerely understand so many of the issues and fears that run close to my heart. Thank you for all your kind words, all your knowledge and understanding and sharing your time."

Brenda has also been an active clinical faculty member of the Graduate Department of Speech-Language Pathology. She is always keen to participate on relevant committees and to contribute her wisdom in developing the clinical curriculum. Brenda has participated on clinical education committees in developing the course outlines and clinical evaluation tools for the aural rehabilitation placements in both the old and new curricula in the department. Her knowledge and experience, both clinically and with students, has been a huge asset to our program. We have come to rely on her in the aural rehabilitation and clinical education areas!

Brenda started her career in South Africa where she obtained a B.A. Sp.& H.T. (Speech and Hearing Therapy) degree from the University of the Witwatersrand (affectionately known as Wits!) in Johannesburg. After graduating, she spent three years in the hospital system where, through absolute necessity, she learned to do audiograms in Zulu! Then she returned to Wits University for three years where she was employed as a clinical tutor. Brenda says:

"that was the point when I knew that I really enjoyed working with students. I was really fortunate to have those years under the rigorous and meticulous leadership of Professor M.L. Aron and many very experienced, caring clinical and academic teachers who were great role models. The department at Wits runs a huge and diverse teaching clinic on site so, in fact, I had a complete immersion in the field of clinical teaching. While I was there we went through a revision of our methods of tutoring and evaluation and I was lucky enough to be involved in much discussion and decision-making."

Brenda practiced as an audiologist and speech-language pathologist for a number of years prior to moving to Canada in 1982. Since then she decided to pursue audiology alone and has devoted her career to aural rehabilitation with the elderly. Because clinical education was a part of her life that she enjoyed before coming to Toronto she was quite pleased when the opportunity to continue in clinical education came along!
"I am also fortunate that Sunnybrook - both the institution (as a fully-affiliated teaching hospital with the University of Toronto) and the audiology service, particularly the Acting Professional Leader, Marlene Cashman - highly value teaching and that students are made welcome here. Other disciplines and the patients are very open to students and frankly enjoy them. We have students from all the other disciplines.....and one of the most constructive opportunities that I am sometimes able to provide (when all the students are available) is to have the speech-language pathology students teach nursing students about hearing loss and aural rehabilitation issues."

Brenda says to others considering becoming clinical educators:
"It's very stimulating and it's great to have contact with the University to keep in touch with developments in the professions. I feel challenged by having students in a good way - it's fun working with the new generation of clinicians!"

Personally, Brenda has an active life outside of work that also exemplifies her dedication to life-long learning!
"I live with one husband, three kids, three cats and one guinea pig. It bothers me that there isn't enough time in the day to read everything I want to read, nor is there enough time to play the piano as much as I would like to get better at it."

She is winging her way off to Sweden this spring for the first-ever international conference on geriatric audiology where she is enthusiastically looking for new information to learn and apply to her practice and clinical education experiences!