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exit criteria are met. There is the impression that APPCN programs have
tended to drift to 2-year programs regardless of prior experience. Lastly,
the results of a survey of APPCN programs (Association of Postdoctoral
Programs in Clinical Neuropsychology, 1993) were reviewed with respect
to the issue of time allocation during the residency. The survey respondents
indicated that all programs had 50% or more of their resident s time devoted
to clinical activities with a minimum of 10% time devoted each to research
and didactic activities. Within these parameters, the remainder of time
might be allocated so as to meet an individual resident s interest or needs.
Delegates were reminded not to be preoccupied with protecting
their own turf but rather to focus on the best model for the profession.
Before the deliberations started, a delegate suggested an additional distinction
be made between the terms education (which can be gotten from an individual),
training (which typically occurs within a defined setting), and program
(which generally connotes a combination of faculty, setting, and curriculum).
B. HOW SHOULD THE DIFFERENT LEVELS OF EDUCATION AND TRAINING BE INTEGRATED?
CHARGE TO THE DELEGATES
Bruce A. Crosson
The delegates were told that the goal of the Houston Conference was to develop a fully integrated model for education and training at the doctoral, internship, and residency levels. Why a fully integrated model? It was pointed out that our specialty has evolved to the point that it has been recognized formally by APA. It was the first specialty area to be recognized. With this recognition has come some responsibility both to ourselves, to our students, and to the general public to define ourselves and how we get to be who we are. It is very difficult to express who we are to other people when we have so many different models for education and training in the field. It was suggested that it is time, in the development of our profession, for us to speak with a unified voice with respect to education and training. The flexibility available in the past in terms of education and training models should not be lost. However, what constitutes a clinical neuropsychologist and what steps have to be gone through to become a clinical neuropsychologist needed to be articulated. This would be a first. New ground would be broken if the goal of the conference were to be achieved. New ground would be broken not only for ourselves but for other specialties. It was noted that there is the possibility that the model produced at this conference could act as a model for other specialties, although that was not the intent of our discussions. As Dr. Meier had indicated earlier, however, when the American Board of Clinical Neuropsychology (ABCN) formulated a structure for boarding clinical neuropsychologists, it eventually affected the whole board structure of the American Board of Professional Psychology (ABPP). ABCN was the first specialty board and the ABPP reorganized its structure around the idea of specialty boards.
The development of a fully integrated model was said to be an aspiration
of this conference. The INS-Division 40 Task Force guidelines (Reports
of the INS-Division 40 Task Force on Education, Accreditation, and Credentialing,
1987) were published 10 years ago and have been guiding the development
of education and training models since then. It was suggested that the
integrated model that is developed could have the same impact. The model
should be aspirational. A transitional period in terms of implementing
the model was expected. An important consideration in an integrated model
is the knowledge and competencies to be mastered at each level and thus
the entry and exit standards for the different levels of training. It was
considered important to think about the exit standards at each level as
being minimal standards since they become the entry standards for the next
level. For instance, the minimal standards for entry into a residency might
be a doctoral degree and an internship. Some other points were made. Practitioners
in the field, including ourselves, would not be disenfranchised by the
development of an integrated model of training. The standards that would
be a part of an integrated model would not be applied to current practitioners
but to future practitioners. Also, one integrated model needed to be developed,
not several. The model did need to contain some flexibility; it should
not be overly specific. For instance, precisely what is done at the University
of Houston and the University of Florida differs, even though both places
are providing doctoral level training in clinical neuropsychology, and
this should continue to be the case. One of the keys to maintenance flexibility
would be to specify only minimal exit criteria for each level. Time to
completion of the education and training requirements given in the model
needed to be considered. A model in which the student spends 10 years at
the doctoral level and 10 years at the internship and residency levels
is impractical. Time to completion of each level of training within the
model as well as time to completion of the entire model needed to be thought
about. Flexibility in interfacing with the external environment also needed
to be considered. The model could not he overly specific or adaptation
to a changing environment would be difficult. For instance, there will
be a shift in the populations seen by neuropsychologists as the baby boomers
gray. Neuropsychologists are already having to adjust to the demands of
managed health care. Functional neuroimaging is likely to have an impact
on our practice, as will other technological developments. Adjustments
to changing roles will have to be made. It was reiterated that the model
should not be overly specific so that it can be used for the next 10 or
20 years. Probably the constitution of the United States has survived as
long as it has because it is not overly specific. With these issues in
mind, the charge was to develop a fully integrated model of education and
training at the doctoral, internship, and residency levels.
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