2-Goal Setting Presentation Final

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10/24/2019Learning Objectives Compare goal setting skills used for novice geneticGoal Setting in StudentSupervisionCarly Siskind, MS, CGCTracey Oh, MS, CGCSara Fisher, MS, LCGCErin Ash, MS, LCGCcounseling students versus advanced geneticcounseling students in supervision Evaluate skills demonstrated in role plays to integratePractice Based Competencies in goal settingGoal Setting CompetenciesGoal SettingCompetencies inClinical SupervisionGoal Setting in Clinical SupervisionEubanksHigginset al,2012Reciprocal Engagement Model ofSupervision Findley et al (2015) evaluated GC self‐efficacy aroundGoal Setting Competencies. Goal setting competencies receiving the lowest meanratings were: “I can use the ABGC practice‐based competencies to setgoals” (83.7) “I can identify learning needs of a student at various levelsof experience” (84.4)1

10/24/2019Goal Setting in REM-SGoal Setting in Supervision “Establishment of goals and expectations for studentsis also essential for the student’s ongoing growth anddevelopment. Contracting, clarifying expectations, andgoal setting are important strategies for establishing aworking relationship between a student andsupervisor. The prevalence of this supervisor strategysuggests goal setting is not limited to the beginning ofthe clinical rotation; it is an ongoing process asdescribed in the REM‐S” Clear learning goals and/or objectives providetangible indicators which help to engage learnersin the activity and enable the determination ofprogress toward the expected level of knowledgeand skills to be gained. Allowing students to alsodevelop their own personal goals and objectives,will also provide a sense of ownership andfacilitate deeper engagement with their learning.(Wherley et al., 2015)(Wherley et al., 2015)REM-S on Goal Setting Two key strategies promote general and tailored instruction insupervision:– Contracting: establishing a supervision agreement– Engaging the student in a goal setting processStrategies to EstablishGoals With YourSupervisee Establishing concrete learning goals with sequential steps for theirattainment helps to focus both teaching and evaluation processesin supervision. Goal setting competencies incorporate students’ developmentallevel, feedback from previous supervisors, past clinicalexperiences, and self‐identified growth areas.(McCarthy Veach and LeRoy 2009)(Borders et al. 2006)Mentoring Competencies and Clinical SupervisionMentoring Competencies and Clinical Supervision Agree on working together toward improving thesupervisee’s counseling skills. The learning goal must be clearly defined, and there needsto be agreement to work together to help the counselorattain competency in the skill chosen. Break goal into constituent parts: The supervisor needs to elicit from and negotiate withthe student their preferred styles and methods oflearning. Contract how progress will be observed andevaluated. The supervisor needs to know how to give feedbackwhich guides, corrects, and at the same timeencourages.– a) the knowledge– b) the skills– c) the attitudes necessary to attain competencyIn Lindbloom, Ten Eyck and Gallon (2005)‐‐Adapted from Stiehl, R. and Bessey, B (1994). The Green Thumb Myth:Managing Learning in High Performance Organizations – A Success Strategy for Trainers and Managers. Second Edition,Corvallis, Oregon: The Learning Organization.Lindbloom, Ten Eyck and Gallon (2005)‐‐Adapted from Stiehl, R. and Bessey, B (1994). The GreenThumb Myth: Managing Learning in High Performance Organizations – A Success Strategy forTrainers and Managers. Second Edition, Corvallis, Oregon: The Learning Organization.2

10/24/2019Effective Goals are SMARTSMART GoalsHere is an example of a SMART learning goal that might be part of a student’s learningplan. Where is the learner in terms of their learning,the level they have reached, past experience,and understanding of learning needs andgoals? What are the learning goals in terms ofknowledge, technical skills and attitudes? Youmay be observing more than one of theselearning domains at the same time.“By the end of this placement, I will be able to correctly identify the most appropriategenetic testing strategy and laboratory utilized in a prenatal case 80% of the time withoutassistance from my supervisor.”This goal is: Specific because it states exactly what is to be achieved Measurable because the outcome can be observed Attainable because the student has the necessary knowledge, skills and/or experience toachieve the goal Realistic because it relates to what is expected of the student; and Time-bound as it has a specific timeline and deadlines. PBC Aligned Domain 1.4Six Stages of the Supervision ProcessGoal Setting forNovice vs. AdvancedStudentsIntegrated Developmental ModelSelf/Other AwarenessLevel 1BeginnerMotivation Skills acquisition Very dependent Little self-evaluation “Correct” approach StructureLevel 2Intermediate Still struggles withbalancing focus Can exhibit empathyLevel 3AdvancedStay focused on client whilekeeping self in checkExcitement and Anticipatory AnxietyDependency and IdentificationActivity and Continued DependencyExuberance and Taking ChargeIdentity and IndependenceCalm and Collegiality Friedman, D & Kaslow, NJ (1986). The development of professional identity inpsychotherapists: Six Stages in the supervision process. In FW Kaslow (Ed.)Supervision and training: Models, dilemmas and challenges, 29‐50. New York:Haworth Press.Grow Staged Self-Directed Learning Model Positive reinforcement Unable to tolerate directevaluation “Am I doing it right?" More focus on clientSix Stages of the Supervision Process ‐ Adapted for Genetic Counseling Autonomy Focus on self Anxiety about supervisor confrontationConfidence Incompetence ConfusionAutonomy Dependence confidenceSupervisor consultant orcolleaguePossible resistanceSome self-doubtGrow 1991(Falender & Shafranske, 2004; Haynes, Corey, & Moulton, ervision/TheoriesofSupervision9.html3

10/24/2019Potential Conflicts in Supervision StyleClinical ScenariosGrow, 1991Clinical Scenario 1: The Novice GCStudent A clinical supervisor in a cancer clinic is meeting with a geneticcounseling student who is starting their first formal rotation in thesummer between 1st and 2nd year. The student and supervisor metthe prior week to provide orientation to the clinic, discuss rotationexpectations and evaluation structure. The student’s prior clinicalrotation was observation only at a different cancer setting. Thestudent was asked to come the first day of clinic with goals for thissummer rotation, and completed a goal setting worksheet.Scenario 1: The Novice GC StudentDuring the video: What tenets of REM‐S are supported by theGC Supervisor? How does goal setting align with the PBC? How does the supervisor align with thestudent’s developmental stage?Scenario 1: The Novice GC StudentDebrief REM‐S Tenet 1 – Contract and engage student in goalsetting REM‐S Tenet 1 –Assist student in adjusting counselinggoals based on ongoing assessment ‐ remind student wecan adjust goal as needed REM‐S Tenet 3 ‐ Make a plan for progression fromobservation to participation in genetic counseling session4

10/24/2019Clinical Scenario 2: The Advanced GCStudentDuring the video: A clinical supervisor in a prenatal clinic is meeting with a geneticcounseling student who is starting their last rotation beforegraduation. The student and supervisor met the prior week toprovide orientation to the clinic, discuss rotation expectations andevaluation structure. The student has already had one prenatalrotation during the prior year. This is the first day of the rotationand the student was asked to come with a completed goal settingworksheet. What tenets of REM‐S are supported by theGC Supervisor? How does goal setting align with the PBC? What SMART goals do you observe?Scenario 2: The Advanced GC StudentScenario 2: The Advanced GC StudentDebrief Insert Video hereScenario 2: The Advanced GC StudentDebrief PBC Domain II, #12 – Adapt GC skills to variedservice delivery models PBC Domain III, #15 – write concise medicalrecord documentation. PBC Domain I, #4 – identify testing, ordering andfacilitation of testing. REM‐S Tenet 1 – Goal 1: contract and engage student ingoal setting REM‐S Tenet 1 – Goal 3: assist student in adjustingcounseling goals based on ongoing assessment ‐ remindstudent we can adjust goal as needed REM‐S Tenet 3 ‐ Goal 3: make a plan for progression fromobservation to participation in genetic counseling sessionSummary Goal setting is a critical competency in theREM‐S, and an area where genetic counselorscan increase their self efficacy and competency Strategies to facilitate goal setting includesetting SMART goals, and engaging students inthe goal setting process Novice and advanced genetic counselingstudents differ in their developmental needsfor goal setting in clinical supervision5

10/24/2019THANK YOU! Megan Kluver, ST, AAS (Advanced SimulationSpecialist) and Brian Monaghan, MPA, NRP andtheir team at the Interprofessional ExperientialCenter for Enduring Learning (iEXCEL) at theUniversity of Nebraska Medical Center for theirassistance with the videos Terri Blasé, MS, LCGC, Kristen Fishler, MS, LCGC,and Andrew Schmanski, MS, LCGC.Click link below to complete evaluation and submit CEU requesthttps://indstate.qualtrics.com/jfe/form/SV 89cHJJ0n8YcyaRD6

setting SMART goals, and engaging students in the goal setting process Novice and advanced genetic counseling students differ in their developmental needs for goal setting in clinical supervision. 10/24/2019 6 . Microsoft PowerPoint - 2-Goal Setting Presentation Final

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