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2002 COMPETENCIES CONFERENCE: FUTURE DIRECTIONS IN EDUCATION AND CREDENTIALING IN PROFESSIONAL PSYCH

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Title: 2002 COMPETENCIES CONFERENCE: FUTURE DIRECTIONS IN EDUCATION AND CREDENTIALING IN PROFESSIONAL PSYCH


1
  • 2002 COMPETENCIES CONFERENCE FUTURE DIRECTIONS
    IN EDUCATION AND CREDENTIALING IN PROFESSIONAL
    PSYCHOLOGY
  • Nadine J. Kaslow, Ph.D., ABPP
  • nkaslow_at_emory.edu

2
AM I COMPETENT TO GIVE THIS TALK?
  • Limited literature, except in the multicultural
    area
  • More attention on practice than science domains
  • Dearth of empirical evidence
  • Diversity of models reflected in the audience
  • Considerable tension regarding let a 1000
    flowers bloom versus consensus building
    regarding core or foundational competencies
  • Interesting topic?????

3
ZEN AND THE ART OF MOTORCYCLE MAINTENANCE
  • Quality isnt something you lay on top of
    subjects and objects like tinsel on a tree… it is
    the core from which the tree must start

4
WHAT DOES COMPETENCY MEAN?
  • Websters Dictionary
  • Competent properly or sufficiently qualified
    capable, adequate for the stipulated purpose
  • Competence (1) the state or quality of being
    adequately well-qualified ability (2) a
    specific range of skill, knowledge, ability
  • Competent (adj) Connotes public understanding
    of certification
  • Latin Origin Compete to strive against
    another or others to attain a goal, such as an
    advantage or victory

5
WHAT DOES COMPETENCY MEAN? (cont.)
  • Competence (noun) Connotes professional
    judgment of an individuals ability or capability
    (to do certain things) based on education,
    training, experience, and special assessment
  • In this sense, competencies would appear to be
    elements of competence

6
WHAT DOES COMPETENCY MEAN? (cont.)
  • What individuals know or are able to do in terms
    of knowledge, skills, and attitudes
  • The ability to perform a complex task or function
    effectively
  • Ability to transfer skills and knowledge to new
    situations

7
WHAT IS PROFESSIONAL COMPETENCE?
  • Professional competence is the habitual and
    judicious use of communication, knowledge,
    technical skills, clinical reasoning, emotions,
    values, and reflection in daily practice for the
    benefit of the individual and community being
    served
  • (Epstein Hundert, 2002)

8
META-COMPETENCIES
  • Meta-knowledge is knowledge about knowledge
    knowing what you know
  • Meta-competencies refers to the ability to judge
    the availability, use, and learnability of
    personal competencies

9
DOMAINS OF COMPETENCY
  • What the person brings to the role
  • What the person does in the role
  • What is achieved
  • Thus, knowledge, performance, and outcome are
    essential features

10
COMPONENTS OF COMPETENCE (Stratford, 1994)
  • Observable
  • Measurable
  • Containable
  • Practical
  • Derived by experts
  • Flexible

11
DEVELOPMENTAL PERSPECTIVE ON COMPETENCE
  • Dreyfus 5 Stages of Development
  • Beginner
  • Advanced beginner
  • Competent
  • Proficient
  • Expert

12
DEVELOPMENTAL PERSPECTIVE ON COMPETENCE (cont.)
  • Training implies a sequence of learning, from a
    relative lack of knowledge to increasing degrees
    of sophistication and competence. Training
    therefore should include

13
DEVELOPMENTAL PERSPECTIVE ON COMPETENCE (cont.)
  • Exposure introduction to the topical area in a
    didactic seminar or through observation in an
    applied or research setting
  • Experience the practice of the topical area of
    activity and
  • Expertise course work and extensive experience
    in the topical area at a level of competence at
    which a psychologist can practice independently
  • (Roberts et al., 1998)

14
COMPETENCY BASED EDUCATION AND TRAINING (CBET)
  • CBET has its origins in preparing teacher
    education programs and human resources
  • Competency-based training is relatively new in
    its wide application to psychology
  • Fantuzzo outlined one model for CBET for
    psychologists, which serves as a useful example

15
MASTERY MODEL (Fantuzzo)
  • MASTERY model for competency-based training for
    psychologists involves
  • Knowledge of fundamental psychological principles
  • Mandatory skills
  • Legal and ethical restraints
  • Educators must identify the requisite information
    and skill sets, and students must be assessed and
    to be competent must perform above the minimal
    standard set

16
MASTERY MODEL (cont.)
  • M - Master prerequisite body of knowledge
  • A - Assess skill of competency
  • S - Set minimal competency
  • T Train to competency
  • E Evaluate understanding of relevant legal and
    ethical principles
  • R Review skill level
  • Y- Yield to continued education

17
PROPERTIES OF COMPETENCY CONSTRUCT (Nelson, 2001)
  • Mastery and application of relevant knowledge and
    developmentally-informed and culturally competent
    methods/procedures to
  • Assess/diagnose problems
  • Select appropriate intervention(s)
  • Analyze and interpret intervention outcomes
  • Communicate outcomes to other professionals and
    the public
  • Educate/supervise other professionals

18
PROPERTIES OF COMPETENCY CONSTRUCT (cont.)
  • The above should occur in a manner consistent
    with standards of peer review, including ethical
    principles of the profession and continuing
    professional education

19
WHAT DOES THE ETHICS CODE SAY ABOUT COMPETENCE?
  • APA Ethics Code Revision (2002)
  • Psychologists provide services, teach, and
    conduct research with populations and in areas
    only within the boundaries of their competence,
    based on their education, training, supervised
    experience, consultation, study, or professional
    experience

20
ETHICS CODE (cont.)
  • Where scientific or professional knowledge in the
    discipline of psychology establishes that an
    understanding of factors associated with age,
    gender, gender identity, race, ethnicity,
    culture, national origin, religion, sexual
    orientation, disability, language, or
    socioeconomic status is essential for effective
    implementation of their services or research,
    psychologists have or obtain the training,
    experience, consultation, or supervision
    necessary to ensure the competence of their
    services, or they make appropriate referrals

21
ETHICS CODE (cont.)
  • Psychologists planning to provide services,
    teach, or conduct research involving populations,
    areas, techniques, or technologies new to them
    undertake relevant education, training,
    supervised experience, consultation, or study

22
ETHICS CODE (cont.)
  • When psychologists are asked to provide services
    to individuals for whom appropriate mental health
    services are not available and for which
    psychologists have not obtained the competence
    necessary, psychologists with closely related
    prior training or experience may provide such
    services in order to ensure that services are not
    denied if they make a reasonable effort to obtain
    the competence required by using relevant
    research, training, consultation, or study

23
ETHICS CODE (cont.)
  • In those emerging areas in which generally
    recognized standards for preparatory training do
    not yet exist, psychologists nevertheless take
    reasonable steps to ensure the competence of
    their work and to protect clients/patients,
    students, supervisees, research participants,
    organizational clients, and others from harm

24
  • WHAT IS THE RECENT HISTORY WITHIN PSYCHOLOGY ON
    COMPETENCIES?
  • KEY HIGHLIGHTS

25
UNDERGRADUATE PSYCHOLOGY LEARNING GOALS OUTCOMES
  • 2 major categories of goals
  • Knowledge, skills, and attitudes consistent with
    the science and application of psychology
  • Knowledge, skills, and attitudes consistent with
    liberal arts education that are further developed
    in psychology
  • Each of these categories contain 5 goals

26
UNDERGRADUATE PSYCHOLOGY LEARNING GOALS
OUTCOMES (cont.)
  • Knowledge, skills, and attitudes consistent with
    the science and application of psychology
  • Knowledge base of psychology
  • Research methods in psychology
  • Critical thinking skills in psychology
  • Application of psychology
  • attitudes in psychology

27
UNDERGRADUATE PSYCHOLOGY LEARNING GOALS
OUTCOMES (cont.)
  • Knowledge, skills, and attitudes consistent with
    liberal arts education that are further developed
    in psychology
  • Information and technological literacy
  • Communication skills
  • Sociocultural and international awareness
  • Personal development
  • Career planning and development

28
UTAH CONFERENCE (1987)
  • National Conference on Graduate Education in
    Psychology resolved that the responsibility for
    specifying core content of graduate education for
    all psychologists rests with the departments and
    schools of psychology, a similar conclusion to
    that drawn in Miami 30 years earlier
  • Recognized there was a common core, but reluctant
    to identify it to avoid a uniform prescription

29
NATIONAL COUNCIL OF SCHOOLS AND PROGRAMS IN
PROFESSIONAL PSYCHOLOGY (NCSPP)
  • Contexts in which core competencies model is
    embedded
  • Continuity among doctoral, internship, and
    postdoctoral training
  • Core set of attitudes, aptitudes, and values
  • Sociocultural, situational, and professional
    training contexts of the competencies are key
    considerations

30
NCSPP ATTITUDES, APTITUDES, VALUES
  • Intellectual curiosity and flexibility
  • Scientific skepticism
  • Open-mindedness
  • Psychological health
  • Belief in the capacity for change in human
    attitudes and behavior
  • Appreciation of individual and cultural diversity
  • Interest in providing human services
  • Personal integrity and honesty
  • Capacity of developing interpersonal skills
  • Self-awareness

31
NCSPP GUIDING PRINCIPLES OF CORE COMPETENCY
MODEL (1986, 1987, 1990, 1992, 1997)
  • Each competency is composed of the knowledge,
    skills, and attitudes, which, as a coherent
    group, are necessary for professional practice
    knowledge, skills, and attitudes are inextricably
    related
  • Specific, identifiable knowledge, skills, and
    attitudes are important parts of the training
    experience and conceptually and pragmatically
    joined in the competencies

32
NCSPP GUIDING PRINCIPLES (cont.)
  • Competencies develop together and often remain
    intertwined
  • Competencies must be acquired in the context of
    the diversity of clients, areas of practice,
    problems, and approaches used
  • A systems view should be evident in the
    competency areas, reflecting assessment and
    intervention at the individual, couple, family,
    group, organizational, and community levels

33
NCSPP GUIDING PRINCIPLES (cont.)
  • Competencies can be defined at varied levels that
    vary in terms of generality (focus), complexity,
    and experience
  • Foundation or core level generic to all
    programs, most general, require the least
    experience
  • Focused or special proficiency level draw on
    foundation experience, adds depth
  • Specialty level most focused, including a focus
    on generalist, comes with advanced training and
    experience

34
NCSPP INTEGRATIVE PEDAGOGY
  • Academic-scientific materials
  • Real examples and experiences
  • Incorporate contributions from disciplines other
    than psychology
  • Development of each individual student as a
    professional psychologist, his/her professional
    self, in a reflective process
  • Explicit discussion of the relevant social
    issues, marginalization, power, and authority

35
NCSPP INTEGRATIVE PEDAGOGY (cont.)
  • Local, unique elements relevant to a particular
    client or professional situation local clinical
    scientist
  • Faculty and supervisory role models
  • Appropriate attitudes, including explicit ways of
    thinking like a psychologist

36
SCIENTIST-PRACTIONER CONFERENCE (1990)
  • National Conference on Scientist-Practitioner
    Education and Training for the Professional
    Practice of Psychology (Gainesville)
  • (Belar Perry, 1992)

37
SCIENTIST-PRACTITIONER CONFERENCE
  • Basic Principles of Scientist Practitioner Model
  • Integrative approach to science and practice
  • Contributes to and essential for the ever
    changing discipline of psychology
  • Overall theoretical, empirical, and experiential
    approach to science and professional practice in
    psychology
  • Consistent with APA Code of Ethics
  • Sensitive to issues of diversity and individual
    differences

38
SCIENTIST-PRACTITIONER MODEL (cont.)
  • Model provides for the development of the
    knowledge, skills, and attitudes that encourage
    the scientific approach to practice
  • Model calls for life-long learning
  • Value placed on role models

39
SCIENTIST-PRACTITIONER MODEL (cont.)
  • Didactic Scientific Core
  • Didactic Practice Core
  • Scientific Experiential Core
  • Professional Practice Experiential Core

40
MULTICULTURAL GUIDELINES
  • Psychologists are encouraged to recognize that,
    as cultural beings, they may hold attitudes and
    beliefs that can detrimentally influence their
    perceptions of and interactions with individuals
    who are ethnically and racially different from
    themselves
  • Psychologists are encouraged to recognize the
    importance of multicultural sensitivity/responsive
    ness, knowledge, and understanding about
    ethnically and racially different individuals

41
MULTICULTURAL GUIDELINES (cont.)
  • As educators, psychologists are encouraged to
    employ the constructs of multiculturalism and
    diversity in psychological education
  • Culturally sensitive psychological researchers
    are encouraged to recognize the importance of
    conducting culture-centered and ethical
    psychological research among persons from ethnic,
    linguistic, and racial minority backgrounds

42
MULTICULTURAL GUIDELINES (cont.)
  • Psychologists strive to apply culturally-appropria
    te skills in clinical and other applied
    psychological practices
  • Psychologists are encouraged to use
    organizational change processes to support
    culturally informed organizational (policy)
    development and practices

43
MULTIDIMENSIONAL MODEL OF CULTURAL COMPETENCE
  • D. Sue (2001) proposed a multidimensional model
    of cultural competence that incorporates 3
    primary dimensions
  • Racial and culture-specific attributes of
    competence
  • Components of cultural competence
  • Foci of cultural competence

44
MULTIDIMENSIONAL MODEL OF CULTURAL COMPETENCE
(cont.)
  • Based on a 3 (awareness, knowledge, skills) X4
    (individual, professional, organizational,
    societal) X5 (African American, Asian American,
    Latino/Hispanic American, Native American,
    European American) factorial combination, the
    multidimensional model of cultural competence
    allows for the systematic identification of
    cultural competence in a number of different areas

45
COMMITTEE ON ACCREDITATION (CoA)
  • In the Guidelines and Principles document under
    Domain B pertaining to Program Philosophy,
    Objectives, and Curriculum Plan it states that
    the program specifies education and training
    objectives in terms of the competencies expected
    of its graduates

46
CoA (cont.)
  • The competencies must be
  • Consistent with the programs philosophy and
    training model
  • Substantive areas for which the program prepares
    students at the entry level of practice
  • An understanding of professional issues,
    including ethical, legal, and quality assurance
    principles

47
CoA (cont.)
  • For graduate programs, the program must implement
    a clear and coherent curriculum plan that
    provides the means whereby students can acquire
    and demonstrate a basic level of understanding
    and competence in defined areas

48
CoA (cont.)
  • For internships, there must be an organized and
    programmed sequence of professional supervised
    training experiences that are characterized by
    greater depth, breadth, duration, frequency, and
    intensity than practicum training

49
CoA (cont.)
  • The program must require that all interns
    demonstrate an intermediate to advanced level of
    professional psychological skills, abilities,
    proficiencies, and competencies, and knowledge in
    defined areas

50
CoA (cont.)
  • For postdoctoral residencies, the program must be
    organized and build upon, but be distinct from,
    doctoral and internship training, and must be
    consistent with the programs philosophy and
    model of professional training and education

51
CoA (cont.)
  • The residency must include education and training
    activities that are cumulative, graduated in
    intensity, and structured
  • The primary training method is supervised service
    delivery and direct contact
  • Training includes socialization into the
    profession through mentoring, didactics, role
    modeling, observational learning, and
    supervisory/consultative guidance

52
CoA (cont.)
  • All residents must demonstrate advanced level of
    competence, skills, abilities, proficiencies, and
    knowledge in defined areas

53
CoA (cont.)
  • Issues of cultural and individual diversity are
    considered to be relevant to the development of
    competence on all levels in all defined areas
  • Attitudes essential for life-long learning,
    scholarly inquiry and professional
    problem-solving as psychologists in the context
    of an evolving body of scientific and
    professional knowledge are also underscored

54
CoA (cont.)
  • In many ways, the current accreditation process
    judges the degree to which a program has achieved
    the goals and objectives of its stated training
    model, rather than making collective judgments
    about what constitutes a standard professional
    training program

55
ASPPB PRACTICE ANALYSIS
  • 1993 - ASPPB conducted a practice analysis to
    serve as the basis for the restructuring of the
    EPPP
  • Survey was conducted in the U.S. and Canada
  • Practice Analysis Update is underway

56
ASPPB PRACTICE ANALYSIS (UPDATE)
  • Clinical with emphasis on managed care context
  • Neuropsychology
  • Cross-cultural studies
  • Forensics
  • Geropsychology
  • Neuroscience
  • Psychopharmacology
  • Quantitative methods
  • Health psychology

57
AMERICAN BOARD OF PROFESSIONAL PSYCHOLOGY (ABPP,
1993)
  • A specialty is a defined area in the practice of
    psychology that connotes special competency
    acquired through an organized sequence of formal
    education, training, experience, and professional
    standing

58
ABPP (cont.)
  • Purpose To serve the public and profession by
    certifying that psychologists in various
    specialty areas of psychology
  • have completed the education, training, and
    experience requirements of a specialty, including
    an examination designed to assess the
    competencies required to provide quality services
    in the specialty
  • maintain high ethical standards

59
ASSOCIATION OF POSTDOCTORAL PROGRAMS IN CLINICAL
NEUROPSYCHOLOGY (APPCN)
  • Defines competency in terms of
  • The broad spectrum of specialty assessment and
    intervention (knowledge skills)
  • Defending ones practice on the basis of its
    scientific foundations
  • Communicating with other professionals and the
    public
  • Recognition of the limits of ones competence
  • Threshold level of capability

60
APPCN (cont.)
  • Knowledge Base
  • Generic psychology core
  • Generic clinical core
  • Foundations for the study of brain-behavior
    relationships
  • Foundations for the practice of
    clinical-neuropsychology

61
APPCN (cont.)
  • Skills
  • Assessment
  • Treatment and interventions
  • Consultation
  • Research
  • Teaching and supervision

62
APPCN (cont.)
  • Outline training recommendations regarding
    competencies in clinical neuropsychology at the
    doctoral, internship, residency, and continuing
    education levels
  • Depicts a model of education and training that
    facilitates longitudinal integration and
    continuity in knowledge skill acquisition with
    an emphasis that will vary according to training
    level

63
Practice Directorate Task Force on Professional
Child Adolescent Psychology
  • Multicultural competencies
  • Delivery and evaluation of comprehensive and
    coordinated services of care
  • Collaborative and interprofessional skills
  • Empirically supported assessments and treatments
    for promotion behavioral change in children,
    families, and other systems
  • Entrepreneurial and supervisory skills
  • (La Greca Hughes, 1999)

64
SOCIETY OF PEDIATRIC PSYCHOLOGY (SPP) TASK FORCE
RECOMMENDATIONS
  • Life-span developmental psychology
  • Life-span developmental psychopathology
  • Child, adolescent, and family assessment
  • Intervention strategies
  • Research methods and systems evaluation
  • Professional, ethical, and legal issues
    pertaining to children, adolescents, and families

65
SPP TASK FORCE RECOMMENDATIONS (cont.)
  • Issues of diversity
  • The role of multiple disciplines in
    service-delivering systems
  • Prevention, family support, and health promotion
  • Social issues affecting children, adolescents,
    and families
  • Consultant and liaison roles
  • Disease process and medical management
  • (Spirito et al., 2003)

66
COMMISSION FOR THE RECOGNITION OF SPECIALTIES AND
PROFICIENCIES IN PROFESSIONAL PSYCHOLOGY
(CRSPPP, 1994)
  • CRSPP has incorporated the competencies
    designated by ABPP in the application process as
    key definition elements for emerging or
    traditional specialties in the Petition for the
    Recognition of a Specialty in Professional
    Psychology

67
COMMISSION (2001)
  • The Commission on Education and Training Leading
    to Licensure in Psychology highlighted
    competencies in the recommendations section
  • Define competencies (e.g., research, practice,
    human diversity, etc.) expected of graduates of
    doctoral programs in professional psychology over
    the next decade and design developmentally
    informed education and training guidelines for
    their achievement and assessment

68
EDUCATION LEADERSHIP CONFERENCE (2001)
  • One of the ELC Conference groups addressed what
    psychologists should have in common, despite the
    diversity of bodies of knowledge foundational to
    psychology as a scientific discipline and
    profession, and despite the diversity of pedagogy
    models among doctoral programs in psychology

69
EDUCATION LEADERSHIP CONFERENCE (cont.)
  • It was recommended that all psychologists have
  • A substantive understanding of multiple
    determinants of behavior in individuals, groups,
    organizations, and communities
  • A culture of evidence perspective about
    behavior based on scientific inquiry and
    reasoning, replicable methods of observation and
    measurement, and interpretation of qualitative
    and quantitative evidence

70
EDUCATION LEADERSHIP CONFERENCE (cont.)
  • An understanding of ethical principles applicable
    to practice, research, and teaching, as well as a
    value orientation of respect for human diversity
  • An understanding of what it means to learn as a
    psychologist and a commitment to life-long
    learning

71
INTERNATIONAL EFFORTS
  • CANADA Mutual Recognition Agreement of the
    Regulatory Bodies for Professional Psychologists
    in Canada
  • European Union Leonardo Project (initiative of
    the European Federation of Professional
    Psychologists Association)

72
  • CORE
  • COMPETENCIES

73
CONTRIBUTING GROUPS
  • American Board of Professional Psychology (ABPP)
  • Association of State and Provincial Psychology
    Boards (ASPPB)
  • College of Professional Psychology
  • Commission for the Recognition of Specialties and
    Proficiencies in Professional Psychology (CRSPPP)

74
CONTRIBUTING GROUPS (cont.)
  • Committee on Accreditation (CoA)
  • Council of Counseling Psychology Training
    Programs (CCPTP)
  • Council of Credentialing Organizations in
    Professional Psychology (CCOPP)
  • Joint Council on Professional Education in
    Psychology (JCPEP)

75
CONTRIBUTING GROUPS (cont.)
  • Mutual Recognition Agreement of the Regulatory
    Bodies for Professional Psychologists in Canada
  • National Council of Schools and Programs in
    Professional Psychology (NCSPP)
  • National Register of Health Service Providers in
    Psychology (NRHSPP)
  • Scientist Practitioner Conference

76
ASSESSMENT
  • Assessment
  • Evaluation
  • Diagnosis
  • Appraisal
  • Measurement
  • Psychological Assessment

77
BREADTH OF SCIENTIFIC PSYCHOLOGY
  • Basis of Behavior (affective, biological,
    cognitive, cultural, developmental, social)
  • Normal and Abnormal Behavior
  • History and Systems of Psychology
  • Techniques of Data Analysis and Statistics
  • Application of Research

78
CONSULTATION
  • Consultation
  • Consultation and Teaching
  • Intervention and Consultation
  • Consultation and Program Evaluation
  • Consultation and Education

79
DIVERSITY
  • Diversity
  • Cultural and Individual Differences with Diverse
    Populations
  • Cultural and Individual Diversity
  • Individual Differences and Diversity

80
ETHICS AND LEGAL
  • Ethics and Legal Foundations
  • Professional and Ethical Standards
  • Consistent with APA Code of Ethics
  • Professional Ethics and Standards
  • Ethics, Social, and Legal Responsibility
  • Professional Conduct, Ethics, and the Law
  • Ethics and Standards
  • Legal and Ethical Issues
  • Protection of the Public

81
INTERVENTION
  • Intervention
  • Intervention and Consultation
  • Scientifically Validated Interventions
  • Evaluating the Efficacy of Interventions
  • Empirically Supported Treatments

82
MANAGEMENT AND SUPERVISION
  • Supervision
  • Supervision, Administration/Management
  • Supervision and Training
  • Supervision and/or Teaching Organization
    Management, and Administration
  • Management and Supervision
  • Administration and Supervision

83
PROFESSIONAL IDENTIFICATION
  • Professional Identification
  • Professional Issues
  • Attitudes for Life-Long Learning
  • Professional Socialization
  • Socialization into the Professional Practice of
    Psychology
  • Professional Development
  • Consumer Protection

84
RELATIONSHIP
  • Interpersonal Relationships
  • Relationship
  • Working Relationships
  • Interpersonal Skills
  • Communication Skills
  • Impact of the Personal Characteristics of the
    Psychologist in Professional Interactions

85
RESEARCH
  • Science Base and Application
  • Research Design and Methods
  • Research, Evaluation, and Scientific Thinking
  • Evaluation Research
  • Strategies of Scholarly Inquiry
  • Methods of Evaluation
  • Critical Thinking
  • Scientific Method

86
NEWER COMPETENCIES
  • Social Responsibility
  • Public Policy/Advocacy
  • Managed Care
  • Forensics
  • Geropsychology
  • Neuroscience
  • Psychopharmacology
  • Health Psychology

87
ACCREDITATION COUNCIL FOR GRADUATE MEDICAL
EDUCATION (ACGME)
  • Patient Care
  • Medical Knowledge
  • Practice-based Learning and Improvement
  • Interpersonal and Communication Skills
  • Professionalism
  • Systems-based Practice

88
  • CONTROVERSIES,
  • CHALLENGES,
  • QUESTIONS

89
  • DO WE HAVE THE
  • RESOURCES FOR
  • COMPETENCY BASED EDUCATION AND TRAINING?

90
RESOURCES
  • CBET takes time, money, and other resources for
  • Task analysis
  • Development of assessment tools and training
    modules
  • Repeated assessment
  • Training
  • Feedback

91
  • SHOULD WE IDENTIFY
  • CORE COMPETENCIES?

92
YES
  • Wards off potential litigation
  • Keeps up with current trends
  • Better defines the skills for graduates to
    perform
  • Ensures a relationship between instructional
    methods and goals
  • Competencies can be determined in part by the
    programs philosophy
  • (Sumerall et al., 2000)

93
YES
  • Ensures breadth of training, particularly
    important in the face of trends toward
    specialization
  • Provides psychologists with a needed common
    identity as members of a recognized professional
    discipline
  • (Benjamin, 2001)

94
NO
  • Concerns that determining core competencies will
    lead to required curriculum
  • Concerns that identifying core competencies would
    mean a core curriculum that would place unwanted
    constraints on a program of study, prohibiting
    the diversity needed to keep abreast of changes
    in psychology and related fields implied
    narrowness of focus

95
NO (cont.)
  • Concerns that the definition of core competencies
    reduces the profession to a collection of
    specific skills that might or might not require
    extensive educational/experiential training

96
NO (cont.)
  • Koch Psychology does not and can not represent
    a coherent science
  • Lipsey There is no … intellectual core in
    psychology no set of distinctive concepts that
    both pervade the field and play an integral role
    in the substantive content of the major specialty
    areas

97
NO (cont.)
  • Psychologists value variability, experimentation,
    and educational freedom far more than we value
    conformity and standardization (Ericksen)

98
  • IS COMPETENCE
  • ENOUGH?

99
COMPETENCE VS. CAPABILITY
  • Traditional education and training tends to focus
    on competence
  • As we advance, we must educate not merely for
    competence, but for capability
  • Capability - extent to which individuals can
    adapt to change, generate new knowledge, and
    continue to improve their performance
  • (Fraser Greenhalgh, 2001)

100
TO ERR IS HUMAN (IOM, 2000)
  • Most errors do not occur as a result of the lack
    of one persons competence
  • More commonly errors are caused by faulty
    systems, processes and conditions that lead
    people to make mistakes or that fail to prevent
    errors
  • Thus, mistakes can best be prevented by designing
    safer and more effective systems

101
  • HOW DO WE
  • IDENTIFY COMPETENCIES?

102
ACGME RECOMMENDATIONS
  • Generate lists of skills via brainstorming
  • Cluster into groups via affinity grouping
  • Identify priority criteria via brainstorming
  • Rank items by importance via a priority matrix
  • Assign requirements (number, sequence) via
    consolidation and consensus
  • Important to get buy-in at each step in the
    process

103
  • HOW DO WE TRAIN
  • CORE AND SPECIALIZED
  • COMPETENCIES?

104
CHALLENGES IN TRAINING
  • Assuming a developmental stance
  • Working with differences in learning style
  • Some competencies are more teachable than others
  • Some students are more trainable than others
  • Problem or difficult students
  • Integrating both didactic and experiential
    innovations into the education and training
    process

105
  • WHAT ARE THE KEY CHALLENGES IN ASSESSING
    COMPETENCIES?

106
ASSESSMENT CHALLENGES
  • Need clear and measurable learning objectives and
    associated competencies
  • An effort to make competencies as precise and
    measurable as possible can lead to a reduction of
    significant competencies to trivial, but
    measurable, tasks
  • Questionable validity and reliability of our
    assessment approaches for assessing knowledge,
    performance, and outcomes

107
ASSESSMENT CHALLENGES (cont.)
  • The more specific the target identified, the more
    likely the educational program is to achieve it
  • Conversely, the level of abstraction in a
    training goal is inversely proportional to the
    validity of its measurement

108
ASSESSMENT CHALLENGES (cont.)
  • Subjective, multiple-choice, and standardized
    patient assessments, although reliable and
    internally valid, fail to capture key aspects of
    professional competence integration of
    knowledge, skills, attitudes context of the
    work information management teamwork systems
    and interpersonal relationships

109
ASSESSMENT CHALLENGES (cont.)
  • Most commonly used assessment strategies
  • do not observe the person being evaluated in
    real-life situations
  • do not integrate feedback of peers and
    clients/patients
  • do not use measures that predict clinical outcomes

110
ASSESSMENT CHALLENGES (cont.)
  • Assessment often creates resistance in multiple
    people within the system
  • Comprehensive assessment can be costly and it is
    unclear who will cover the costs
  • Other professions have been more creative and
    innovative than psychology in assessing
    competence What can we learn from them?

111
  • HOW DO YOU ASSESS COMPETENCIES?

112
FORMAT
  • Definition of Competence
  • Articulation of associated knowledge, skills, and
    attitudes
  • Expectations of level of competence/capability at
    various developmental levels
  • Examples of developmentally appropriate
    competence/capability attainment
  • Assessment approaches
  • Outcomes expected

113
ACGME MEASUREMENT TOOLBOX EXAMPLES
  • 360 Degree Evaluation
  • Checklist Evaluation
  • Global Ratings
  • Standardized Oral and Written Examinations
  • Objective Structured Clinical Examination (OSCE)
  • Standardized Client Examinations
  • Client Surveys

114
RESEARCH MEASUREMENT
  • Comprehensive Examinations
  • Thesis and Dissertation
  • Peer-Review Process Local
  • Peer-Review Process Professional Community
  • Grant Submission Review Process (e.g., NRSA)

115
PRINCIPLES TO GUIDE ASSESSMENT
  • Undergraduate Psychology Learning Goals and
    Outcomes Principles
  • A set of outcomes is meaningful and useful in
    improving instruction only if student abilities
    are measured thoughtfully with the specific
    intent of improving teaching and learning
  • Students should receive direct feedback to
    facilitate their learning from completing
    assessment activities

116
PRINCIPLES TO GUIDE ASSESSMENT (cont.)
  • Assessment planning should encourage systematic
    improvement, rather than concentrate on
    deficiencies
  • Multiple assessment strategies are needed
  • Classroom/course data
  • Individual projects/performance assessment
  • Summative performance assessment
  • Self-assessment/reflection
  • Collaboration
  • Interviews and surveys
  • Archival measures

117
SELF-ASSESSMENT (Belar et al., 2001)
  • Self-assessment is important and teachable
  • Ethical practice requires self-assessment
    regarding the boundaries of ones competence
  • Psychologists should ask themselves specific
    questions to identify their own boundaries of
    competence for engaging in a particular
    professional activity

118
SELF-ASSESSMENT (cont.)
  • When deficits in knowledge, skills, attitudes are
    revealed through the self-assessment process,
    self-study and appropriate consultation or
    supervision should be obtained

119
QUESTIONS?
  • What are the goals and objectives of education
    and training in professional psychology?
  • What attributes must our graduates possess in
    order to meet societys expectations of them in
    the practice of professional psychology?
  • Should all graduates possess a common foundation
    of knowledge, skills, and attitudes?
  • If so, what are they?

120
QUESTIONS (cont.)
  • Can we define competencies that can operationally
    be shown to differ from other competencies?
  • Can we create definitions of competencies that
    can be measured?
  • Can we create dynamic descriptions of competence
    and competencies that can modified as change
    occurs?

121
QUESTIONS (cont.)
  • How do we balance between a focus on the core
    competencies and capitalizing on the academic and
    professional strengths of the programs faculty
    and the interests of the students?
  • How do we reconcile contradictory tendencies
    toward developing a detailed wish list of
    desirable competencies versus a restrictive list
    based on concerns that these competencies will be
    used for accreditation certification?

122
QUESTIONS? (cont)
  • To what extent and how is our conceptualization
    of core competencies related to our model of
    training and professional role functioning?
  • How can we conceptualize competencies
    developmentally?
  • When should specialty training occur?

123
QUESTIONS (cont.)
  • What education resources must be designed and
    developed to build the required knowledge,
    skills, and attitudes?
  • Are some competencies more teachable than others?
  • How do competencies evolve/develop in psychology
    and when might competencies no longer be
    considered core and relevant?

124
QUESTIONS (cont.)
  • How can we have better communication among
    trainers at various levels and credentialers of
    individuals and programs in the process of
    determining our approach to competencies?
  • How well can established psychologists learn new
    competencies, and what makes doing so challenging
    for us?

125
  • ALL I REALLY NEED TO KNOW I LEARNED IN
    KINDERGARTEN
  • UNCOMMON THOUGHTS
  • ON COMMON THINGS
  • Robert Fulghum, 1993
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