Professional Documents
Culture Documents
*Supervisors Evaluation a report evaluating the outcomes against the original assessment, the
skills and competencies acquired relevant to the workplace and the Interns overall competency as a
clinician.
** Reflective Statement This will be a reflection on how you feel you have developed as a clinician
over the period of the Internship and how you think the profession of audiology can be advanced in
Australia in the future.
NOTE:
Remember to save your diary regularly.
Take your diary with you if you change locations/employers.
See the Audiology Australia website for examples of Supervision Diaries for ideas re number and
quality of entries.
Should there be a change in supervisor at any time during the internship, the finishing
supervisor needs to document and attest to your progress in sufficient detail on the Change of
Supervisor Notification Form for the new supervisor to be able to pick up where the
supervision left off.
Supervision is based on active interaction and development discussions between the supervisor and the
intern. Discussion/feedback with the intern about their clinical decisions for their cases is part of the
supervision process hours.
Table 1: Types of activities undertaken by the Intern and Supervisor that count as
supervision:
In House means that the supervisor is in the clinic and is available to be called upon as needed, so
must not be used as a descriptor for Type of Supervision
Mentoring is a development partnership through which the Supervisor shares knowledge, skills,
information and perspective to foster the professional and independent capabilities of the Intern.
The Supervisor
o A Supervisor must be a current Full Member or Fellow and hold a current Certificate of Clinical
Practice.
o Audiology Australia recommends that an Intern has a single supervisor throughout their entire
Internship program. However, Audiology Australia recognises that for some workplaces this
arrangement is impractical.
o If it is not possible for a single Supervisor to work with the Intern then they can apply to the
Audiology Australia office for approval of multiple Supervisors under the following circumstances:
1. A principal Supervisor is nominated and assumes responsibility for the design,
implementation and oversight of the supervision requirements of the Intern;
2. The principal Supervisor needs to specify how they will monitor the Interns development needs
and communicate with other supervisors (this should include a minimum of quarterly meetings
of the Intern and all supervisors);
3. The names of other supervisors who are significantly involved in the Interns supervision and
development (eg. who provide a month or more of supervision) are noted each quarter; and
4. Supervision must be continuous and documented in the Clinical Internship Supervision Diary.
QUARTER 1 (0 to 3 months)
Week No. Hours Type of Clinical Interns Comments
& Date Duration Supervision Development
Activity
Example
Week 1 2 Hours At Elbow Infant As well as familiarising myself with the equipment & performing my fir
5/1/13 Assessment OAE assessment on an infant, we outlined what needed to be discus
Adult with the Mother during the case history & how important it is to be car
Assessment & sensitive to new Mothers. Supervisor explained the need to insert t
probe deeply into the canal.
7/1/13 1 Hour Case Review Reviewed the difference between when to refit and when to replace a
aid with the supervisor explaining the requirement to show a real clini
need to refit.
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Week 12
Supervisor must submit this diary electronically to Internship@audiology.asn.au within 10 working days
from the end of Quarter 1 along with an updated Knowledge & Skills Matrix (with previous entries still
included, end of Q1 assessments and further Strategies to meet the learning goals added).
If diary is submitted to Audiology Australia in hard copy, please complete this section:
Supervisors Signature: Supervisors Name:
Date: //
Workplace:
QUARTER 2 (4 to 6 months)
Week Hours Type of Clinical Interns Comments
No. & Duratio Supervision Development
Date n Activity
Week 13
Week 14
Week 15
Week 16
Week 17
Week 18
Week 19
Week 20
Week 21
Week 22
Week 23
Week 24
Supervisor must submit this diary electronically to Internship@audiology.asn.au within 10 working days
from the end of Quarter 2 along with an updated Knowledge & Skills Matrix (with previous entries still
included, end of Q2 assessments and further Strategies to meet the learning goals added).
If diary is submitted to Audiology Australia in hard copy, please complete this section:
Supervisors Signature: Supervisors Name:
Date: //
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131
(Suite 7, 476 Canterbury Road, Forest Hill Vic. 3131)
Supervision Diary - v.4
Interns name:
Workplace:
QUARTER 3 (7 to 9 months)
Week Hours Type of Clinical Interns Comments
No. & Duratio Supervision Development
Date n Activity
Week 25
Week 26
Week 27
Week 28
Week 29
Week 30
Week 31
Week 32
Week 33
Week 34
Week 35
Week 36
Supervisor must submit this diary electronically to Internship@audiology.asn.au within 10 working days
from the end of Quarter 3 along with an updated Knowledge & Skills Matrix (with previous entries still
included, end of Q3 assessments and further Strategies to meet the learning goals added).
If diary is submitted to Audiology Australia in hard copy, please complete this section:
Supervisors Signature: Supervisors Name:
Date: //
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131
(Suite 7, 476 Canterbury Road, Forest Hill Vic. 3131)
Supervision Diary - v.4
Interns name:
Workplace:
QUARTER 4
From 10 months until you are assessed as Independent (minimum of 48 weeks from internship
commencement date).
Complete EITHER the diary for the last period of your Internship (OPTION A), OR write up two (2)
case studies which will demonstrate your understanding and application of your clinical and client
contact skills (OPTION B),
OPTION A
OPTION B
Case study #1
Case study #1
Supervisors comments:
Case study #2
Supervisors comments:
Once the Internship has been completed the following documents are to be submitted to the Audiology
Australia office from your Supervisors email:
Q4 supervision diary (Option A) OR two case studies (Option B), each with Supervisors comments, and
Supervisors final evaluation.
An updated Knowledge & Skills Matrix (with previous entries still included & end of Q4 assessments
added)
A signed and dated Reflective Statement from the Intern. This will be a reflection on how you feel you have
developed as a clinician over the period of the internship and how you think the profession of audiology can
be advanced in Australia in the future.
A completed and signed Certificate of Clinical Practice (CCP) Application Form
TO BE COMPLETED BY SUPERVISOR
Supervisors Name:
Name of Workplace (clinic):
Workplace address:
Supervisors email:
Supervisors phone number: