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Central Region Community Network For Specialized Care
Allied Health Clinical Placements Study

The Central Region Community Network for Specialized Care is carrying out a study to review the current capacity of Central Region Specialized clinical providers and network partners to provide placements for students in Allied Health disciplines. The goal of this project is to look at the potential for the enhancement and expansion of placements from university programs. Your responses to this questionnaire are sent directly to the research consultant. Please complete no later than January 31, 2007.

1.

First, please provide the following background information:

Name of Agency:  

Specialized Services Provided: (Check all that apply)

Hospital administered inpatient/day/outpatient/outreach
Community-based clinical services/supports
Community based residential treatment
Case management
Crisis response and transitional community support
Specialized day treatment
Other (please specify):

What percentage of the population you serve has a developmental disability along with mental health needs and/or challenging behaviours? (Dual Diagnosis)
 % (Give your best estimate)

2.

Does your agency sponsor any university student placements in any of the following allied health disciplines?

CHECK ALL THAT APPLY.

Audiology
Dietetics/Nutritionist
Kinesiology
Medicine - General
Medicine - Psychiatry
Nursing
None of the above 		Occupational Therapy
Physical Therapy
Psychology
Psychometry
Social Work
Speech Language Pathology

If you do not provide placements in any of these areas, go to Question 8.

3.

Please complete the following table, providing information for all the Disciplines checked above.

LEGEND
Format*:
   Obs. = Short periods involving observation only
   PT = Regular part-time placements of one or two days a week over a semester
   FT = Full time placements several weeks in duration

Formal Agreement**:
Indicate if your agency has a formal agreement (such as a written contract, affiliation agreement or statement of understanding) with the university that provides the students

Discipline
University or Universities
 Placements
per Year		 Number of
Placements
Format*
 Formal Agreement**
Obs.
PT
FT
1st Discipline from
Question 2

please specify:
First Year Yes
No

Second Year Yes
No

Third Year Yes
No

Fourth Year Yes
No

Masters Level Yes
No

Doctors Level Yes
No

If this is your only Discipline, proceed to Question 4.
Discipline
University or Universities
 Placements
per Year		 Number of
Placements
Format*
 Formal Agreement**
Obs.
PT
FT
2nd Discipline from
Question 2

If applicable
please specify:
First Year Yes
No

Second Year Yes
No

Third Year Yes
No

Fourth Year Yes
No

Masters Level Yes
No

Doctors Level Yes
No

If this is your final Discipline, proceed to Question 4.
Discipline
University or Universities
 Placements
per Year		 Number of
Placements
Format*
 Formal Agreement**
Obs.
PT
FT
3rd Discipline from
Question 2

If applicable
please specify:
First Year Yes
No

Second Year Yes
No

Third Year Yes
No

Fourth Year Yes
No

Masters Level Yes
No

Doctors Level Yes
No

If this is your final Discipline, proceed to Question 4.
Discipline
University or Universities
 Placements
per Year		 Number of
Placements
Format*
 Formal Agreement**
Obs.
PT
FT
4th Discipline from
Question 2

If applicable
please specify:
First Year Yes
No

Second Year Yes
No

Third Year Yes
No

Fourth Year Yes
No

Masters Level Yes
No

Doctors Level Yes
No

If this is your final Discipline, proceed to Question 4.
Discipline
University or Universities
 Placements
per Year		 Number of
Placements
Format*
 Formal Agreement**
Obs.
PT
FT
5th Discipline from
Question 2

If applicable
please specify:
First Year Yes
No

Second Year Yes
No

Third Year Yes
No

Fourth Year Yes
No

Masters Level Yes
No

Doctors Level Yes
No

If this is your final Discipline, proceed to Question 4.

More disciplines? Check here and we will contact you.

This next series of questions deals with the in-house staff and resources available in your agency to support student placements.

4. 

Use the table below to indicate the number of staff you have available to supervise students in the various disciplines and also indicate if they are members of a health regulatory college (RHC).

Only complete for the programs you reported on in the previous section.

Discipline # of Supervisors RHC Members?
Audiology Yes      No
Dietetics/Nutritionist Yes      No
Kinesiology Yes      No
Medicine - General Yes      No
Medicine - Psychiatry Yes      No
Nursing Yes      No
Occupational Therapy Yes      No
Physical Therapy Yes      No
Psychology Yes      No
Psychometry Yes      No
Social Work Yes      No
Speech Language Pathology Yes      No

5. 

What resources do you have available in your agency to assist in supporting students on placement? (Check all that apply)

Comprehensive agency policies and procedures
Practice guidelines
Evidence based models and best practices
Current practice journals
Experienced preceptors
Regular individual clinical supervision
Regular peer/student group supervision
Staff with expertise to support student research in degree programs
Internal specialists to act as mentors
Access to external specialists
Equipment for students such as computers, videotaping equipment, etc.
Dedicated office space for students
Other (please specify):

6.

Does your agency have a designated staff member who coordinates placements?
Yes      No

If you answered Yes, please provide contact information below:

Name:
Title:
Email:

7. 

What have been the single most important benefit and the greatest drawback of your agency's experience with student placements?

Most Important Benefit
       Greatest Drawback

ALL RESPONDENTS PLEASE COMPLETE THE REMAINING QUESTIONS.

8. A number of potential obstacles or barriers to agencies offering clinical student placements are listed below. Indicate the extent to which each of these is or has ever been a problem in your agency:

Not a problem at all
Not too much of a problem
Somewhat of a problem
A large problem
The time required to organize and supervise placements
Availability of clinical staff for supervision
Finding suitable projects or assignments
Additional financial costs incurred

9. 

Are there any other obstacles or barriers?

10. 

Would your agency be prepared to take on additional student placements?

Yes - complete the chart below No Don't Know

Program and/or Institution
Number of Additional
Students per Term
1.
2.
3.
#4.

11. 

What would have to be done to increase your agency's capacity to accept student placements?

This final series of questions pertains to research activities and interests in your agency. The information will assist the Network in planning future events and initiatives.

12.

Is research part of the mandate of your agency?

Yes      No      Don't Know

13.

Is your organization engaged in any of the following:
Current involvement in research projects or initiatives
Dedicated staff and/or financial resources to support research activities
Formal linkages with academic or other research institutions for the purposes of
       collaborative research
Other (please state):
No current involvement in research

14. 

What types of research are of most interest to staff in your agency??

Research related to the developmentally disabled population and their needs
Research related to clinical interventions with particular groups/populations
Research related to clinical interventions with particular mental health issues
Research related to quality of life
Research related to family and community functioning
Research related to service delivery models and practices
Research related to other health issues with this population
No particular interest in research

15. 

Feel free to elaborate on any of the research interests indicated in Question 14.

16. 

Do people in your organization have any other research interests? (Please specify)

17. 

Please identify the person or persons in your organization who are most interested and/or involved in research:

18. 

Would your agency be interested in increasing its research capacity?

Yes No

If Yes, what would need to be done to accomplish this:

19. 

Please feel free to make any other comments or suggestions about this study, student placements, or research activities in your organization.

Completed by:

Name:
Title:

If necessary, may the consultant contact you directly for clarification or elaboration?

Yes - Please complete Contact Information below
No

Contact Information

Phone:
Email:

Thank you for your cooperation.

     
     

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