Common Ethical Issues That Arise with Student Supervision

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The most common complaints believe it or not that we see from a national organization are from students to believe it or not. They indicate a failure of their mentors to supervise them or to demonstrate appropriate ethical behavior. Maybe some of you didn't get the supervision that you needed when you were a student and unfortunately there are complaints about this happening.  Supervisors also have a lot of complaints that students are demonstrating careless attitudes, towards delivering treatment and professional services. So this is not only an ethical issue but this is also a professional issue.

If you are supervising students, you are bound to honor their responsibility to hold paramount the welfare of the persons that we serve professionally and ensure that services provided competently by those students under your supervision. You can't delegate the responsibility, for clinical decision making and management to the student that is still your responsibility. It remains with you, the certified individual, whether you are the PT or you are the physical therapist assistant. The student can though however, as part of the education process, make client management recommendations and decisions pending review and approval by the supervisor. Obviously, it's a collaborative approach but you're not going to delegate every single thing to your student. Furthermore, the supervisor needs to inform the client or the client's family of the qualifications and the credentials of the student's supervisee, involved in the provision of clinical services. What that means is that we can't go back to the patient or the patient's family and pass off this student as if they were a fully licensed and credential therapist. We have to be upfront that they're a student. You need to provide no less than the level of supervision that's outlined in your current professional standards, for the discipline. You need to increase that supervision if you need to, based on the student's knowledge, experience, and competence. That is extremely important. A guideline might say that the student does not require a line of sight supervision, but that doesn't mean you have to follow that if the student is not competent to be without your supervision. Again, you're still responsible for that patient and you have to make sure that the student is doing what they should. You also need to document the amount of direct and indirect supervision provided and design and implement procedures that will protect client confidentiality for services provided by students under supervision. It's unethical for you as a supervisor or a therapist to approve or sign off for clinical hours where you didn't actually provide the supervision.