Building confidence and expertise: An SLP student’s transformative clinical rotation serving children with complex medical needs

Building confidence and expertise: An SLP student’s transformative clinical rotation serving children with complex medical needs
The Master of Science in Speech-Language Pathology (SLP) program at MUSC utilizes a lock-step progression that ensures students’ clinical experiences each semester mirror what they are learning in the classroom. During the final two semesters, students build on their past experiences to complete their final clinical rotation and externship. For Andreal Williams, SLP Class of 2025, her final clinical rotation at MUSC Shawn Jenkins Children's Hospital has affirmed her plans for a rewarding career focused on improving the lives of children with complex medical needs.

What are you enjoying most about your clinical rotation at MUSC Shawn Jenkins Children's Hospital (SJCH)?
I am really enjoying the opportunity to feed some of the babies in the NICU. I also love being involved in the Modified Barium Swallow Study (MBSS) process, scoring the study and discussing recommendations with my clinical supervisor. In an MBSS, a patient drinks a barium sulfate liquid mixture, and we use an x-ray and to evaluate swallowing function and safety. Additionally, I appreciate learning about various syndromes and disorders and the important role we play in these patients’ health care journeys.

What is a typical workday like for you?
Each day varies because my supervisor works in multiple settings, including the MUSC outpatient clinic, the MBSS at the Summey Medical Pavilion (SMP), and SJCH.

• On clinic days, I primarily provide therapy, plan activities for our patients, discuss progress, and offer recommendations to parents.
• On MBSS days at SMP, I prepare materials for the study, gather patient history from parents, and score the study once it’s completed.
• On SJCH days, I review charts for each patient we’re seeing, provide therapy, and assist with feeding.

In all settings, I am responsible for writing session notes.

Describe some of the challenging cases you’ve had the opportunity to experience during this clinical rotation. What strategies do you use to engage these patients?
I have had the opportunity to work with multiple children who are G-tube [A gastrostomy tube or G-tube is a tube inserted through the belly that brings nutrition directly to the stomach] dependent, helping them transition to eating primarily by mouth. These patients are often highly resistant to trying new textures, which can make progress slow. To engage them, we use a play-based approach, incorporating familiar toys and preferred activities to create a more relaxed feeding environment. We also introduce small, incremental steps toward oral intake, paired with positive reinforcement.

How do you collaborate with your clinical educator and other health care professionals to support your patients? How has their feedback helped improve your clinical practice?
Collaboration is a key part of my experience. I regularly discuss patient cases with my clinical supervisor, receiving feedback on therapy approaches, swallow study interpretations, and patient management. Additionally, I communicate with occupational therapists, nurses, and physicians to ensure a holistic approach to patient care. Their feedback has helped me refine my clinical decision-making skills, particularly in assessing swallow function and developing treatment plans. My supervisor’s guidance has also strengthened my ability to communicate findings and recommendations to families in a clear and supportive way.

How has the emphasis on active clinical experiences each semester during the SLP program shaped your confidence as a clinician?
The hands-on clinical experiences each semester have been invaluable in building my confidence. Having exposure to a variety of settings, schools, outpatient clinics, and hospitals, has allowed me to develop adaptability and clinical reasoning skills. Each semester, I have taken on more responsibilities, which has prepared me to think critically and independently as a clinician. By working directly with patients, receiving real-time feedback, and learning from different supervisors, I feel more prepared to enter the field after graduation.

You graduate in August; congratulations! What’s next for you?
After graduation, I plan to pursue a clinical fellowship in a pediatric medical setting, ideally in a hospital or outpatient clinic where I can continue working with children with diverse medical conditions. I’m especially interested in feeding and swallowing disorders, so I hope to further develop my expertise in that area. I’m excited to continue learning, growing, and making a positive impact on the lives of the children and families I serve.