Assessing the Clinical Competence of Psychology Students Through Objective Structured Clinical Examinations (OSCEs): Student and Staff Views

Objective Structured Clinical Examinations (OSCEs) are a well‐known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open‐ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector.     

关于内科临床技能培训教学课程设置的探讨

通过对参加内科临床技能培训的大连医科大学2007级、2009级五年制及七年制临床医学专业学生进行问卷调查及客观结构化临床考试（OSCE）,探讨内科临床技能培训课程的学时及课程内容等设置.100%的学生认为有开设临床技能培训课的必要,50%以上的学生认为在大学4年级开设本课程较合适,50%以上的学生认为12学时的设置较合理,80%以上的学生认为应每4人共用一名模拟人.OSCE证实毕业前12学时培训组成绩优于实习前8学时组.     

A Pilot Study of a Method for Teaching Clinical Psychology Trainees to Conceptualise and Manage Countertransference

There is evidence that therapists' countertransference responses can affect the therapeutic relationship. There is also evidence that trainee therapists can experience difficulty understanding and managing countertransference. This evidence suggests the need for greater focus on countertransference in the training of professionals, such as psychologists, for whom therapy is a core activity. However, little is currently known about the best way of providing such training or the impact of such training on recipients. This pilot study examined clinical psychology trainees' responses to a teaching and learning method for conceptualising and managing countertransference. The method was designed to be accessible to a range of psychology trainees including those in cognitive behavioural therapy programmes. This article outlines the method and its pilot evaluation. An anonymous online questionnaire was completed by 55 trainees pre‐intervention and 40 post‐intervention. Qualitative methods were used to examine changes in trainees' analyses of countertransference pre‐ and post‐intervention, and their reports of understanding and managing countertransference. Trainees also rated the intervention. The majority of participants who completed the post‐intervention questionnaire reported that training increased awareness of or the ability to conceptualise countertransference. They reported strategies for managing countertransference, although they were less confident in this area.     

Psychological assessment on internship: a survey of training directors and their expectations for students

We used a survey of internship training directors to examine the nature of assessment use and assessment skills training at 382 internship settings in professional psychology across the United States and Canada. For the purposes of this study, we created a questionnaire that inquired about the types of assessment instruments used at each internship setting, the amount and type of training offered at internship sites, and the type of assessment experience desired of interns before beginning their rotations. The results revealed several differences across type of internship facility surveyed as well as several trends in the current use of assessment in applied settings. The findings further demonstrate the important role of projective assessment in the training of graduate students and lead to the conclusion that major discrepancies may exist between what is being taught in graduate school and what students are expected to know on entering their internship positions.     

University psychology clinics in Australia: Their place in professional training

Abstract: There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real‐world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and high‐quality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low‐cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.     

The Emphasis on Cognitive‐Behavioural Therapy within Clinical Psychology Training at Australian and New Zealand Universities: A Survey of Program Directors

Surveys of clinical psychologists' self‐reports of professional practice exist in Australia and New Zealand, but comparatively little data exist on the training available in universities. The present study was designed to gather data on the training and assessment of cognitive–behavioural therapy (CBT). A semi‐structured phone interview was designed for use with clinical psychology training directors, or equivalent, in Australia and New Zealand. Out of a total of 48 universities in the region, 40 clinical directors were successfully contacted: One declined involvement, and 39 agreed to participate, yielding a response rate of 81% (six in New Zealand and 33 in Australia). The data showed that it is common for clinical training programmes in our region to provide clinical trainees with foundational knowledge in CBT (i.e., 29 of the 39 surveyed). However, CBT is mainly incorporated into the auspices of clinical training programmes, there is a wide range of assessment methods to evaluate competence in providing therapy, and relatively few academic units exist that focus exclusively on CBT.     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

Experiences of Countertransference: Reports of Clinical Psychology Students

While historically linked with psychoanalysis, countertransference is recognised as an important component of the experience of therapists, regardless of the therapeutic modality. This study considers the implications of this for the training of psychologists. Fifty‐five clinical psychology trainees from four university training programmes completed an anonymous questionnaire that collected written reports of countertransference experiences, ratings of confidence in managing these responses, and supervision in this regard. The reports were analysed using a process of thematic analysis. Several themes emerged including a desire to protect or rescue clients, feeling criticised or controlled by clients, feeling helpless, and feeling disengaged. Trainees varied in their reports of awareness of countertransference and the regularity of supervision in this regard. The majority reported a lack of confidence in managing their responses, and all reported interest in learning about countertransference. The implications for reflective practice in postgraduate psychology training are discussed.     

Clinical training and the duty to protect.

Given that the duty to protect is now a well established clinical and legal expectation, training in professional psychology should assist students in developing conceptual models for violence risk assessment and management. This report presents a training model incorporating recent advancements in risk assessment (such as the assessment of psychopathy), the need for basic legal understanding, and knowledge of specific risk management strategies. Additionally, academic and internship training programs in Michigan were surveyed by telephone about current training patterns. Preliminary results indicated program strengths in general awareness and training in risk factors. However, the data also suggested a need to formalize a faculty role in risk education, improve the training of students in relevant legal information, and establish coherent conceptual models of dealing with potential patient violence. It is argued that improving training of future professionals in this way will improve clinical practice, reduce legal liability, and improve public safety.     

Inside it was orange squash concentrate: trainees’ experiences of reflective practice groups within clinical psychology training

Despite many clinical psychology training programmes utilising reflective practice groups (RPGs) to develop reflective practice (RP) skills, there remains little research examining how trainees experience these groups. This study uses interpretative phenomenological analysis (IPA) to explore the experiences of eight qualified clinical psychologists who attended RPGs on one United Kingdom (UK) clinical psychology training programme. A purposive sample was recruited for single, semi-structured interviews. Five superordinate themes were identified: ‘The process: there were so many layers’; ‘The impact: an ongoing process’; ‘Commitment: I hated it, but I still went’; ‘The facilitator: a presence who was not always present’; and ‘Getting through it: finding ways to cope’. The findings illustrate the varied and complex experiences of the participants. Whilst the experience was often difficult, the participants were committed to attending and sought out ways to navigate it. The results are conceptualised in terms of existing psychological theory and literature. A critique of the research and suggestions for future studies are offered, including exploring the views of group facilitators and comparing how groups are utilised within different training programmes. Recommendations are made on the development of future RPGs, which include consideration of the facilitation style and the groups’ frequency and size.     

Practicing what we know: Multicultural counseling competence among clinical psychology trainees and experienced multicultural psychologists

Multicultural (MC) competence is considered a necessary skill for clinical and counseling psychologists; however, there is little to no research on the assessment of demonstrated multicultural counseling competence (DMCCC) of clinical psychology graduate students. In this study, we developed a MC assessment instrument to assess DMCCC of clinical psychology graduate students compared with MC-experienced psychologists. In addition, we assessed for differences between the endorsement of MC-appropriate strategies and actual use of these strategies in clinical practice, both by MC-experienced psychologists and clinical psychology students. Results revealed significant differences between the DMCCC of clinical psychology graduate students and MC-experienced psychologists. Significant differences also emerged between endorsement of strategies as multiculturally appropriate and likelihood of actual use of these strategies. Findings suggest that future training and competence models should incorporate participants' ability to not only identify multiculturally appropriate strategies but also use these strategies in therapy.     

Psychological Assessment Training in Clinical Psychology Doctoral Programs

We surveyed American Psychological Association–accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment—specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method—self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.     

Postgraduate Clinical Psychology Placements in Victoria: The Experience of Students and Supervisors

In a recent study conducted at Swinburne University of Technology, researchers examined the challenges involved in coordinating, undertaking, and supervising clinical psychology placements within Victoria. The aim of the investigation was to develop and improve strategies ensuring the sustainable provision of university‐based postgraduate psychology programmes. Results provide detailed information about the components involved in this multifaceted problem. Findings indicate that those involved in clinical placements within university training programmes in Victoria are experiencing major difficulties and that these difficulties raise serious concerns regarding the future provision of clinical placements within the postgraduate system. This article focuses on student and supervisor experiences and perspectives. Implications are discussed.     

Working memory limitation as a source of confusion in the abstract THOG task

Limitations of working memory are proposed as a major determinant of problem difficulty in the THOG task. This task is a logical reasoning task which uses an exclusive disjunction and requires hypothetico-deductive reasoning. Four experiments with students of mathematics or psychology were used to test the hypotheses that, first, guiding participants' attention facilitates the task and, second, the use of paper and pencil as external problem representation reliefs working memory load. Focusing participants' attention upon a critical aspect of the task does not improve solution rates. Students of mathematics were better than students of psychology, but only if they were allowed to use paper and pencil or to work on the task repeatedly. These results partially support the working memory hypothesis. They point toward the importance of training and practice in relatively simple meta-cognitive skills in logical reasoning. Received: 20 March 2000 / Accepted: 22 January 2001     

Evidence-Based Practice in Psychology: An Ethical Framework for Graduate Education,Clinical Training,and Maintaining Professional Competence

Evidence-based practice is often acknowledged as the future state of psychology, yet those graduate students who will soon be applying such practices tend to hold several misconceptions about the major components within this framework. This review highlights implications for graduate education, clinical training, and professional competence in light of the movement toward evidence-based practice in psychology. These implications are discussed in relation to the close parallel between the major components of the evidence-based framework and the current Ethical Principles of Psychologists and Code of Conduct. The evidence-based framework is discussed as an ideology that promotes lifelong learning and best prepares graduate students for ethical clinical practice throughout their careers as psychologists.     

The MMPI: Does It Have a Place in Counseling Psychology Training?

Although a number of surveys have examined psychological assessment training in clinical psychology programs, studies about assessment training in counseling psychology programs have been all too few. This survey gathered information about the place of the Minnesota Multiphasic Personality Inventory (MMPI) in the training of counseling psychology students. A 3-page questionnaire was mailed to alt directors of APA-approved counseling psychology programs for completion by the individual primarily responsible for teaching the MMPI. Forty (85%) of the 47 questionnaires were returned, it was found that the MMPI (a) was taught in one or more courses in virtually all programs; (b) was viewed as useful by most respondents: and (c) was included, with same variability, in practicum training and on doctoral qualifying examinations. As in clinical psychology programs, the MMPI appeared to occupy a place of importance in the assessment training of counseling psychologists.     

The future of Canadian counselling psychology: Doctoral students

Little is known about the overall characteristics and beliefs of Canadian counselling psychology doctoral students. An online survey was administered to 43 doctoral students across all Canadian counselling psychology programmes, representing an approximate 26% response rate. Results indicated that the average age of doctoral students in the sample was about 32 years and that the majority were women (about 77% in the sample). Additionally, findings can be taken to suggest that participants were satisfied with their choice of counselling psychology as a career. The doctoral students sampled primarily practised from an integrationist theoretical standpoint and spent very little of their practice time providing formal psychological assessment services or career counselling. Participants generally intervened through individual counselling or psychotherapy and were focused on disorder treatment rather than preventative or developmental services. Curriculum changes that should be considered from the results of this study pertain to the topics of assessment, career counselling, advocacy/media skills, professional identity development and prevention/developmental interventions. The results of this study can also be taken to predict characteristics of the next generation of Canadian counselling psychologists and the future practice of counselling psychology in Canada.     

EVALUATION OF A TRAINING MANUAL FOR THE ACQUISITION OF BEHAVIORAL ASSESSMENT INTERVIEWING SKILLS

Two procedures were used to teach behavioral assessment interviewing skills: a training manual and one-to-one instruction that included modeling, rehearsal, and feedback. Two graduate students and two advanced undergraduates were trained with each procedure. Interviewing skills were recorded in simulated assessment interviews conducted by each student across baseline and treatment conditions. Each training procedure was evaluated in a multiple baseline across students design. The results showed that both procedures were effective for training behavioral interviewing skills, with all students reaching a level of 90%-100% correct responding. Finally, a group of experts in behavior analysis rated each interviewing skill as relevant to the conduct of an assessment interview and a group of behavioral clinicians socially validated the outcomes of the two procedures.