The Standards of Accreditation (SoA), launched in 2017, introduced a new requirement that evaluations of students and trainees at all levels be based on direct observation of evaluated competencies. Direct observation, as it came to be known, was further explained in a series of implementing regulations (IRs). The table below identifies where requirements for direct observation are located in the SoA and IRs:
| Training level | SoA | IR |
| Doctoral | Standard II.B.3.d | IR C-14 D |
| Internship | Standard II.D.1.a.iv-v | IR C-17 I |
| Postdoctoral | Standard II.D.1.b.ii | IR C-17 P |
Programs regularly consult with the Office of Program Consultation and Accreditation about issues related to direct observation, and this article addresses some of the most frequently encountered questions.
Must direct observation be live and in-person?
Direct observation can be completed live and in-person (e.g., in-room or one-way mirror observation), through synchronous audio-video streaming, or through either audio or video recording.
Who can provide direct observation?
Supervisors conducting direct observation must be appropriately trained, credentialed and prepared in their discipline and in the health service psychology activities being supervised, legally authorized for independent practice in their jurisdiction, and legally responsible for the direct service being provided. While supervision of students and trainees may be provided by trainees at higher levels of education and training (e.g., a practicum student supervised by a doctoral intern or a doctoral intern supervised by a postdoctoral resident), direct observation may only be provided by the appropriately trained and credentialed individual responsible for the supervised services.
Must all nine (9) profession-wide competencies be directly observed by doctoral and internship programs?
Doctoral and internship programs are not required to provide direct observation of all the profession-wide competencies; however, direct observation should cover a sufficient variety of activities and competencies to meaningfully contribute to performance evaluations of trainees.
How should direct observation be documented and verified?
Programs at all levels of training should verify that direct observation has been completed on signed student/trainee evaluation forms.
How frequently should direct observation take place?
At the doctoral level, direct observation must be completed for each evaluated practicum. If several practica are completed and evaluated in a single semester, it is expected that each evaluated experience would include at least one single instance of direct observation. At the internship and postdoctoral levels, performance feedback must be provided on a semiannual basis, and each instance of formal feedback must be based in part on an instance of direct observation. Should an intern or resident complete multiple rotations, each rotation must include an instance of direct observation.
Additional questions about direct observation should be referred to the Office of Program Consultation and Accreditation.
Correction: The version of this article published Friday, Sept. 28 stated that “Direct observation should be completed by the doctoral-level psychologist responsible for the services being delivered.” Direct supervision can be provided by doctoral-level psychologists and also by other supervisors who are appropriately trained, credentialed and prepared in their discipline and in the health service psychology activities being supervised. This correction has been incorporated above.
