Evaluating Clinical Supervision in Speech-Language Pathology Undergraduate Programs: Development and Validation of a Graduate Survey

Abstract

Background

Clinical supervision is a key component in the professional development of speech-language pathology students. However, little is known about the quality of supervision in Spanish undergraduate programs, the pedagogical strategies employed, and the extent to which clinical placements meet students’ expectations for competency development.

Aims

To evaluate clinical supervision during pre-professional internships in Speech-Language Pathology degrees in Spain from the perspective of graduates, analyzing the most valued aspects, areas for improvement, and the gap between lived experience and perceived importance.

Methods & Procedures

A total of 503 graduates completed a 20-item questionnaire assessing experience and perceived importance across five dimensions: supervisory strategies, supervisory style, autonomy, feedback, and therapeutic context. The instrument underwent content validation, internal consistency analysis, test–retest reliability, exploratory factor analysis, and comparisons between experience and importance.

Outcomes & Results

All importance ratings were significantly higher than experience ratings (p < 0.001). The largest discrepancies were observed in feedback and therapeutic context, followed by supervisory style and strategies; autonomy showed a smaller but still significant gap. Only 32% of participants felt professional at the end of their internships. Healthcare and social-healthcare settings were rated higher than educational settings.

Conclusions & Implications

Results highlight a systematic mismatch between what graduates experienced and what they consider essential for high-quality training. Improving clinical placements requires strengthening structured and reflective feedback, promoting rich and interprofessional learning environments, and adjusting supervisory style and strategies to levels of student autonomy. Findings support the implementation of evidence-based supervision models to enhance clinical training in speech-language pathology.

WHAT THIS PAPER ADDS

What is already known on this subject

• Clinical supervision is a critical component of speech-language pathology training, and high-quality supervision supports the development of clinical competence and professional identity. However, limited empirical evidence exists regarding the structure, quality, and characteristics of supervision in Spanish-speaking undergraduate programs, particularly from the perspective of graduates.

What this study adds to existing knowledge

• This study provides large-scale evidence—based on data from 503 graduates—of a systematic and substantial mismatch between the supervision students experienced and the importance they attribute to key supervisory dimensions, using a newly developed and psychometrically validated graduate survey. It identifies the dimensions with the largest discrepancies (feedback, therapeutic context, and supervisory style) and offers clear, empirically grounded priorities for improving supervision in speech-language pathology education.

What are the clinical implications of this work?

• Findings emphasize the need for supervision practices that provide structured and specific feedback, ensure diverse and supportive clinical environments, and adapt supervisory approaches according to students autonomy levels. These insights can guide program development, supervisor training, and quality assurance processes to improve clinical learning experiences and better prepare students for professional practice.