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Because today's workplace is changing so rapidly, employers are looking for new graduates who can hit the ground running. Reimbursement, technological developments and shifting needs of treated populations require new employees, including new graduates, to dive right in and function effectively in the job with minimal help.

"Employers are looking for entry-level professionals who have good problem-solving skills, are independent, and can take on leadership roles early in their careers," said Debra Busacco, PhD, CCC-A, director of Academic Affairs at the American Speech-Language-Hearing Association (ASHA) in Rockville, MD. While clinical skills are crucial in the workplace, entrepreneurial and managerial skills are becoming increasingly vital as well. Students need to integrate these skills in order to be successful in the workforce. Dr. Busacco and some of her colleagues in the professions and academe have identified nine skills that graduates must possess in order to thrive in a clinical environment. Learn on the Fly Graduates must be adept at learning on the fly. This is the ability to integrate new information into existing knowledge and apply past knowledge and experiences to solve problems not previously encountered. When faced with a new issue, challenge or problem, clinicians must strive to determine the underlying cause. New grads can learn clinical thinking and problem-solving skills by observing experts in the field. Learning on the fly is an important skill in today's work environment because technology and reimbursement are changing constantly, Dr. Busacco told ADVANCE. OTs, for example, need to keep abreast of new research and resources that affect their areas of practice. Conflict Management Conflict management is the ability to resolve conflicts so that all parties are satisfied with the outcome. Individuals must develop cooperative relationships with others and learn to attack the problem and not the other individuals involved. Negotiation A related skill is negotiation-the process of reaching a mutually agreed upon solution that comes at the least cost to all of the parties involved. Clinicians must evaluate each position, establish boundaries, keep emotions in check, and remain flexible. Priority Setting Priority setting is the ability to evaluate critical goals for an organization that must be achieved within a specified time frame. To be successful in this area, Dr. Busacco advised, new clinicians must be able to separate goals into mission-critical goals vs. those professional goals that would be nice to achieve. This process calls for reflecting on the pros and cons of accomplishing each goal. Time Management Time management falls under the same category because it relates to the ability to use time effectively to complete tasks and accomplish goals. Effective time managers work on a time line, delegate tasks to others when possible, and say "no" when asked to work on noncritical tasks. Time management is one of the most critical skills for health care professionals, Dr. Busacco stated. "With all the issues related to reimbursement, large caseloads and extensive documentation clinicians really need to be able to manage time effectively." Timely Decision-making Clinicians need to make decisions in a timely manner under tight deadlines and pressure. Strategies for timely decision-making include breaking down large decisions into a series of smaller ones, gathering information and obtaining feedback, and leaving more time than expected in order to complete a project. Process Management Process management is the ability to determine the most cost-effective way to complete a task that will result in the highest probability of success. To do this effectively, clinicians must learn how their place of employment operates on a day-to-day basis, develop patience to follow processes to completion, set up a plan to monitor the progress of the process, and modify the plan when necessary. "Most students do not have the experience of going into a facility and learning how the entire process works, how the organization works," said Dr. Busacco. "This may slow down service delivery. However, most individuals develop this skill within a one-year period." Political Savvy Another essential element for success is political savvy in the work environment. New clinicians must be able to get things accomplished in a complex organizational maze, achieving the maximum benefit while making minimum waves. Those with political savvy obtain feedback from others and are sensitive to their needs. Teamwork Finally, being able to build effective teams and work as a team player are essential skills for today's clinician. Team builders must be able to forge successful teams that bring together individuals with specialized skills to accomplish greater things as a unit than what could be done working alone. Strategies for effective team-building include allowing roles within the team to evolve naturally, establishing a common cause and a shared mindset, making each individual's strength work to the advantage of the team, and creating a climate that fosters innovation, fun and creativity. These intangible skills are interdependent, not independent, Dr. Busacco noted, and are required in addition to being competent in providing diagnosis and treatment. They are best developed beginning in the classroom setting and at clinical affiliations, and then further developing these skills in the actual work environment. To develop these areas, students should solicit feedback from faculty, clinical supervisors and peers about the level of their skills. Based on this input, they should create a plan with specific activities and time lines to develop targeted competencies and monitor their progress. Seminars, on-line courses and workshops related to developing these skills also are helpful to the new clinician, as is finding a role model and mentor who emulates these competencies. Holding brown-bag lunches with peers is a way that students can share experiences and resources in various skill areas and find a partner who is interested in developing similar competencies and can provide support and feedback. Ultimately, however, the best advice for students entering the work environment is to be flexible in seeking employment, Dr. Busacco said. "Students [can] have an idealistic perception when they get out of school, and they may become disillusioned after the first year or two because it's not quite what they thought it would be," she said. "Students need to look at the first three to five years of their career as a learning experience. Their initial employment setting may not be their first choice, but each job will provide the opportunity to develop clinical and managerial skills that will carry over into future positions." Nicole Klimas is on staff at ADVANCE. Resource Lombardo, M. & Eichinger, R. (1996). FYI: For Your Improvement. Minneapolis: Lominger Limited Inc.
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