I have been doing this now for almost 7 years. Sometimes a clinical group will give me a thank you card or a little gift, sometimes not. I don't let this sway me one way or the other. I always do my best and realize that the only affirmation I need is the satisfaction in seeing my students grow and succeed over the course of the semester. Some students have so much on their minds (overwhelmed at the end of semester) that they don't even think to get their clinical instructor a thank you card. And in terms of gifts, many students think it is against school policy. Also, many students are struggling financially in today's harsh economic climate.