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and nonmedical professional domains. They also felt that the emphasis
during the internship year should be on clinical experiential training,
with the intern providing direct clinical service to patients under close
supervision. Training in clinical neuropsychology should be supervised
by a clinical neuropsychologist during this internship year. In addition,
the prior guidelines did not include continued teaching and training in
ethics and language and cultural diversity issues, which the group thought
must be included in future documents. The consensus statement from the
group as to the content of the internship training year was as follows
and included a purpose statement:
The purpose of a clinical internship is to bridge the period of development
from the academic role/academic graduate school experience to the professional
role of independent practitioner. Within the internship year, the student
should receive both didactic and experiential training in clinical psychology
and clinical neuropsychology.
Didactic Training
A. Training in neurological and psychiatric diagnosis
B. Training in consultation to neurological, neurosurgical, and other
medical/professional services
C. Training in direct consultation to psychiatric, pediatric, or general
medical professional services
D. Exposure to methods and practices in neurological and neurosurgical
consultation (grand rounds, bed rounds, seminars, etc.)
E. Training in neuropsychological techniques, examination, interpretations
of test results and report writing
F. Training in consultation to patients and referral sources
G. Training in methods of intervention specific to clinical neuropsychology
H. Training in issues of professional ethics and issues of language
and cultural diversity
Experiential Training
A. Neuropsychological examination and evaluation of patients with actual
and suspected neurological diseases and disorders
B. Neuropsychological examination and evaluation of patients with psychiatric
disorders, and/or pediatric, and/or general medical patients with neurobehavioral
disorders
C. Participation in clinical activities with neurologists, neurosurgeons,
other medical/other professionals (bed rounds, grand rounds, seminars,
etc.)
D. Direct consultation to patients involving neuropsychological issues
E. Consultation to referral and treating professions
F. Practical implications of neoropsychological conditions
In the discussions about the second half of Question III, the
group again focused its efforts on trying to determine how internship training
should be integrated with prior graduate school training, and future residency
training. As previously described, the group viewed the internship year
as an important transition from full-time student to evolving practitioner
in clinical neuropsychology. The group felt that an integrated model that
allows for flexibility as far as which specific level of training specific
skills and knowledge to be attained is ideal. Such a model would naturally
also capture the essence of training in clinical work, in which further
refinement and fine tuning of skills and knowledge is a never ending process,
building upon prior knowledge and skills, which should continue throughout
the career. By the end of residency, however, the resident should be competent
to practice in clinical neuropsychology in an independent manner.
Specific attention was then turned to the task of reviewing what
entry and exit criteria should be established for students at the clinical
internship level. The group reviewed Division 40 Task Force on Education,
Accreditation guidelines from the Reports of the INS and Credentialing
(1987). These guidelines were found by the group to offer a sound base
from which to develop their own guidelines, which are summarized below.
Areas of knowledge and skills with which the intern should enter and exit
were derived from those listed in section VI of the policy statement.
Entry Requirements
Entry into a psychology internship program is a minimum qualification
in a neuropsychology internship. Such entry must be based on completion
of at least 2 years in a recognized psychology doctoral training program,
most often in an area of health services delivery (e.g., clinical, clinical
neuropsychology, counseling, or school psychology). Alternatively, entry
into a psychology internship program could be based on completion of an
approved re-treading program designed to meet criteria equivalent to those
of a health services delivery program. Within the training programs described
above, the student must have also completed a designated track, specialization,
or concentration in neuropsychology.
The entering intern already must have attained knowledge in the
generic psychology core and the generic clinical core, have attained a
working knowledge of foundations for the study of brain-behavior relationships,
and have documented experience in research design and analysis as listed
in section VI of the policy statement. The entering intern also must have
the approval of their doctoral program. The group did not specify in its
deliberations whether completion of the doctoral dissertation should be
a necessary entry criteria for internship training
Several exit criteria were outlined for the internship training
year. The intern should have attained extensive knowledge in the foundations
for the study of brain-behavioral relationships outlined as well as all
of the foundations for the practice of clinical neuropsychology, both of
which are outlined in section VI of the policy statement. At the end of
internship training, the intern should also have attained certain skills
including assessment: both clinical psychological and neuropsychological,
neuropsychological interventions, and consultation skills at least at the
introductory level.
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