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SUMMARY OF BREAKOUT GROUP SIX
Question III A and B
Residency Emphasis
Melissa A. Friedman and Wilfred van Gorp
Members: Wilfred van Gorp (Chair), Melissa A. Friedman (Recorder), Ida
Sue Baron, C. Munro Cullum, Anne L. Hess, Neil H. Pliskin, Robert J. Sbordone,
Barbara C. Wilson
The group first discussed what prior training experiences should
be required of students entering the residency. It was acknowledged that
there is often a wide distribution of trainees prior experience, with some
students having extensive training and some having little or no prior training
in neuropsychology. After much discussion, it was concluded that even a
broad-based residency program offering diverse training in clinical neuropsychology
would not provide sufficient training for a student with little or no prior
education and training in neuropsychology to practice at the independent
level upon completion of the residency. It was noted that greater uniformity
in the training of clinical neuropsychologists at all levels is likely
in the future. Therefore, it is reasonable and necessary to consider uniform
entry criteria for a neuropsychology residency program.
Members agreed that the residency should be based upon a multiple
faculty model, and not a single mentor model, such as an independent practitioner
in private practice. The director of the program should be a board certified
clinical neuropsychologist. There should be access to a variety of medical,
neurologic, and psychiatric patients across the life span. There must be
didactic, experiential, and academic components to the program.
The group adopted the didactic training guidelines for the residency
level discussed on pages 19-20 of the Division 40 Petition (Meier et al.,
1995) to the Commission for the Recognition of Specialties and Proficiencies
in Professional Psychology (CRSPPP). The group agreed to include all 11
items from the document. Examples include training in neurological and
psychiatric diagnosis, exposure to methods and practices of neurological
and neurosurgical consultation such as grand rounds, bed rounds, seminars,
observation of neurosurgical procedures, and training in neuropsychological
techniques, examination, interpretation of test results, and report writing.
Group members emphasized that didactic training should include knowledge
and skills training concerning both children and older adults.
Regarding the experiential training component of the residency
program, the group again agreed with items on page 20 in the Division 40
Petition (Meier et al., 1995) that address experiential aspects of residency
training. Members agreed that residents should participate in clinical
activities with neurologists and neurosurgeons such as grand rounds, Wada
testing and fMRI. It was believed that residents also should be involved
in a specialty clinic, such as a dementia, memory disorders, or epilepsy
clinic, which emphasizes a multi-disciplinary approach to diagnosis and
treatment. The group also agreed that residents should gain experience
providing direct consultation to patients regarding their neuropsychological
assessments, and should gain experience intervening directly with patients
by such means as cognitive rehabilitation, psychotherapy or family therapy,
whenever possible.
The group also discussed the academic component of residency
training, and agreed that research methods and research experience in neuropsychology
should be a part of the residency, as well as teaching and supervising
graduate students and interns. Group members raised various questions regarding
training at various levels of development: Should students be required
to have completed their dissertation before beginning an internship? What
should be the minimal didactic requirements at the doctoral level What
should be recommended for the student who decides after their second year
in graduate school to become a neuropsychologist? Will this student find
an internship that provides sufficient course work to fulfill fundamental
didactic and course work requirements? If he or she cannot, then are the
criteria rigorous to the point of exclusivity, or are they merely appropriately
rigorous in a field requiring comprehensive training ?
The group referred to the Reports of the INS-Division 40 Task
Force on Education. Accreditation, and Credentialing (1987), which contain
a section discussing entry and exit criteria at the postdoctoral (i.e.,
residency) level. Group members agreed that residency training should be
designed to provide clinical, didactic, and academic training sufficient
to produce an advanced level of competence in the practice of clinical
neuropsychology. Group members concluded that entry and exit criteria represent
an appropriate model to ensure adequate training at this level.
Entry Criteria:
Entry into a clinical neuropsychology residency program should be based
upon completion of a regionally accredited doctoral training program, or
an equivalent re-specialization after obtaining a doctoral degree in another
area of psychology. Residents will have successfully completed an internship
program, as described above. They will have demonstrated clinical training
and competence with research methodology to meet equivalent criteria as
a health services delivery professional in the scientist-practitioner model.
Exit Criteria:
Residents completing the training program will meet the following exit
criteria:
A. Advanced skill in the evaluation, treatment, and consultation to
patients and professionals, on an independent basis
B. Demonstrated scholarly activity, e.g., submission of a study or
literature review for publication, presentation, submission of a grant
proposal, or outcome assessment
C. Eligibility for licensing in the state or province in which the
residency program is located
D. Eligibility for board certification in clinical neuropsychology
by the American Board of Professional Psychology
THE CRISIS
Friday Afternoon and Evening Sessions
On Friday afternoon, the breakout group chairs met in a series of sessions.
There was considerable frustration on the part of the delegates since they
sat around for several hours while the chairs tried to reach consensus.
There was considerable frustration on the part of the chairs since they
were under pressure, based on the discussions of their groups, to bring
about a consensus on Question III A and B, which would move the field forward
and result in an integrated model of education and training. The chairs
had worked on the outline of an integrated model that was presented to
the delegates and thought to need some further revisions before it met
these goals. Except for the chairs and the planning committee, the delegates
were released for the evening. The chairs first met Friday evening by themselves.
Then they asked to meet with the planning committee and much uneasiness
was expressed about the progress of the conference with respect to producing
an integrated model. After a half hour of discussion, Dr. Rourke suggested
that an hour
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