When faculty evaluate psychology trainees, they look at more than just students' performance in coursework and comprehensive examinations: Programs also look for less concrete aspects of professional development and functioning, such as interpersonal abilities, says psychologist Nadine Kaslow, PhD, of Emory University, who formerly chaired the Association of Psychology Postdoctoral and Internship Centers.
But often, students-and even faculty-don't understand all that their training programs evaluate because the requirements are not spelled out in program materials.
So an APA group, chaired by Kaslow and formed to end student confusion, recently formalized recommended language that training programs can use to spell out exactly what competencies they test students on to determine their fitness to work with patients.
The Student Competence Task Force of the Council of Chairs of Training Councils (CCTC) in March finalized a model policy that spells out what it means for professional psychology programs to comprehensively evaluate students' competence. The policy is an important step toward bolstering the evaluation information students receive from programs as they begin their psychology training, says task force member Michael Madson, a doctoral candidate in counseling psychology at Marquette University in Milwaukee.
"The bottom line of this document is it will make it so students will have informed consent," Madson says. "They'll know all that they're going to be evaluated on; they're not going to be shocked by it."
Students who attend programs that use the model will know up front that their programs expect a certain level of competence, avoiding surprises when issues like problematic interpersonal or social skills are brought up by a supervisor, says Carol Williams-Nickelson, PsyD, APAGS associate executive director.
"For students who don't have knowledge that this may happen when they enter the program, it can seem unfair and intrusive to receive this type of personal feedback," she explains.
The document explains that in addition to performance in coursework, seminars, scholarship, comprehensive examinations and related program requirements, programs will also evaluate other aspects of students' professional development and functioning, including cognitive, emotional, psychological, interpersonal, technical and ethical considerations, says Kaslow. Faculty evaluate these aspects, sometimes tacitly, through examining student participation in classes, practicums and other program activities; if there are no problems, the outcomes of those tacit evaluations may never be discussed with students.
The model policy, which task force members hope training programs will consider adopting as their own, alerts students that faculty, training staff, supervisors and administrators have an ethical and potentially legal obligation to:
Establish criteria and methods through which they can assess students' competence in such areas as emotional stability and well-being, interpersonal skills, professional development and personal fitness for practice.
Ensure that trainees who complete their programs are competent to manage future relationships-whether with clients, colleagues, the public, supervisees or students-in an effective and appropriate manner.
AWARENESS ALL AROUND
When a program questions a student's competence in, for example, interpersonal relationships, the student may not be the only one reeling; because competency problems are infrequent and very specific to the student, faculty and administrators can often find themselves scrambling to help a student with a competency problem too, says psychologist Craig Shealy, PhD, training director for James Madison University's professional psychology program and task force member. Having an articulated policy clarifies the process for them too, he says.
It also lays to rest the fears of some students that their peers will be allowed to graduate without developing sufficient competencies, says psychologist Linda Forrest, PhD, who manages students in the counseling psychology department at the University of Oregon and is a task force member.
"Students in training programs want to know that faculty are addressing the competence problems among their peers," she says. "Students are sometimes deeply distressed when they watch fellow students provide inadequate care to vulnerable clients, and this policy provides clarification that faculty are working with their peers who are struggling to be good therapists."
In particular, the CCTC document recommends that programs should give students clear information on the process and purpose of evaluations, conduct evaluations with more than one person to avoid potential personal issues and offer students remediation opportunities, such as individual therapy and additional coursework, as long as training staff believe that such steps could have a satisfactory outcome, says Madson.
The task force's document also recommends that programs make clear that trainees must demonstrate sufficiency in four general areas:
- Interpersonal and professional competence. Trainees should adequately relate to clients, peers, faculty, allied professionals, the public and individuals from diverse backgrounds and histories.
- Self-awareness, self-reflection and self-evaluation. Students should know their own beliefs and values and how those can affect others.
- Openness to addressing problems. Trainees should be able and willing to explore issues such as depression or prejudice that either interfere with their provision of care or impede their professional development or functioning.
- Resolution of issues or problems that interfere with professional development or functioning. Trainees should respond constructively to feedback from supervisors or program faculty, successfully complete remediation plans or participate in personal therapy to resolve issues or problems.
The process by which students are screened and accepted for professional psychology programs is set up to prevent people with competency problems from enrolling, Shealy says. But it's not a perfect process.
"Maybe you miss an emotional problem in that process, or something comes up but the admittance group thinks it will be okay, or a student has a life event that prevents them from reaching competency-any of this can come up," he explains.
Neither faculty nor students are always able to anticipate competency problems, Shealy adds, which can lead to the rare case in which a student is halted in their studies after making significant progress toward their degree.
To illustrate his point, Shealy uses this vignette: A student comes into a program academically gifted, but then exhibits chronic problems responding to constructive supervisory feedback about her approach to clients. Because she's too demanding and critical of her clients and unable to develop empathy for their needs, her instructors discuss the problem with her in multiple supervisory sessions. When the situation doesn't improve, her supervisors and the program develop a plan for the student that includes attending therapy and other remedial steps. The student agrees to the plan, but fails to follow through. At this point, Shealy says, the program would likely have the right and responsibility to stop the student from continuing in the program.
"As the document points out, one purpose of evaluation is to help students like this, to give them the chance to remedy their weaknesses, to help them grow to be more reflective and to be able to perform their profession well," Shealy says. "That's all part of the intensive and rigorous process of becoming a competent psychologist, and hopefully this document will lead to a better understanding of these issues up front."
For more information on CCTC, visit their Web site.