| Literature DB >> 30122787 |
Josephine Terry1, Craig Gonsalvez1, Frank Patrick Deane2.
Abstract
OBJECTIVE: Supervisor assessments of trainee competence are integral to ensuring that clinical psychology trainees reach competency benchmarks. The commonly used Clinical Psychology Practicum Competencies Rating Scale (CΨPRS) has been shown to elicit inflated ratings of competency. Hence, the aim of this study is to examine whether brief supervisor training reduces ratings by providing objective criteria with which supervisors can assess trainee competency.Entities:
Keywords: competency assessment; field placement evaluations; online training; psychology practicum assessment; rater biases; supervisor evaluations
Year: 2016 PMID: 30122787 PMCID: PMC6084334 DOI: 10.1111/ap.12250
Source DB: PubMed Journal: Aust Psychol ISSN: 0005-0067
CΨPRS Rating Means (M), Standard Deviations (SD), Confidence Intervals (95% CI) for the Total Sample and the Trained and Untrained Groups
| Domains | Total sample ( | Trained ( | Untrained ( | ||||||
|---|---|---|---|---|---|---|---|---|---|
|
|
| 95% CI |
|
| 95% CI |
|
| 95% CI | |
| Counselling | 4.28a | 0.65 | 4.09, 4.34 | 4.10 | 0.60 | 3.88, 4.33 | 4.33 | 0.66 | 4.22, 4.45 |
| Clinical assessment | 4.20b | 0.66 | 3.99, 4.25 | 4.00 | 0.60 | 3.75, 4.21 | 4.26 | 0.66 | 4.14, 4.38 |
| Case conceptualisation | 4.16b | 0.66 | 3.95, 4.20 | 3.93 | 0.60 | 3.70, 4.16 | 4.22 | 0.67 | 4.10, 4.34 |
| Intervention | 4.17b | 0.66 | 3.96, 4.22 | 3.94 | 0.60 | 3.72, 4.17 | 4.23 | 0.67 | 4.12, 4.35 |
| Ethical attitude/behaviour | 4.37c | 0.60 | 4.17, 4.41 | 4.15 | 0.56 | 3.95, 4.36 | 4.42 | 0.60 | 4.32, 4.53 |
| Scientist‐practitioner | 4.21ab | 0.66 | 4.00, 4.26 | 4.00 | 0.60 | 3.77, 4.23 | 4.26 | 0.67 | 4.14, 4.39 |
| Professionalism | 4.38c | 0.61 | 4.21, 4.45 | 4.24 | 0.56 | 4.03, 4.45 | 4.42 | 0.62 | 4.31, 4.53 |
| Reflective practice | 4.28a | 0.62 | 4.09, 4.33 | 4.10 | 0.55 | 3.88, 4.31 | 4.33 | 0.63 | 4.22, 4.44 |
| Response to supervision | 4.38c | 0.62 | 4.19, 4.43 | 4.20 | 0.59 | 4.00, 4.40 | 4.43 | 0.61 | 4.32, 4.54 |
| Total mean | 4.20 | 0.61 | 4.08, 4.32 | 4.07 | 0.61 | 3.86, 4.28 | 4.32 | 0.61 | 4.21, 4.44 |
Notes. Rating scale ranges from 1 = Beginner through to 4.9 = Competent. abcDomains that share a superscript are not significantly different from each other (p > .0014). For example, the counselling, scientist‐practitioner, and reflective practice domains share the superscript “a,” indicating that their mean ratings are not significantly different from one another. Alternatively, counselling and clinical assessment do not share a common superscript, indicating that their mean ratings are significantly different. CΨPRS = Clinical Psychology Practicum Competencies Rating Scale.
Figure 1Calibration Vignette: Mean Difference Between the Supervisor Ratings and the Expert Calibrators as a Function of Training (Untrained vs Trained). Note. Error bars represent standard error of the mean (SEM).
| Stages | Description of stages |
|---|---|
| Stage 1. Beginner | Knowledge, skills, attitude value and relationship competencies are yet to be developed or at an early stage of development, and are on par with trainees commencing training without any practicum experience. Frequent minor or major inadequacies may be apparent, including difficulty applying knowledge to practice, difficulty managing sessions or conducting specific tasks, or little awareness of process issues. In later placements, a Stage 1 rating indicates failure to demonstrate adequate competency, with more frequent or intensive supervision required than would be expected. |
| Stage 2. | Knowledge, skills, attitude value, and relationship competencies are developing, and while more basic competencies are demonstrated under some circumstances, they may be inconsistent or not generalised. More complex competencies may be absent. Minor inadequacies occur frequently, and major problems may occur occasionally, although insufficient to cause serious harm. In later placements, a Stage 2 rating may indicate a failure to demonstrate adequate competency in the domain or a requirement for additional supervision to ensure adequate performance. |
| Stage 3. | The trainee demonstrates a moderate repertoire of basic knowledge, skills, attitude value, and relationship competencies, which are generalised to a wide range of common contexts, with more complex competencies emerging. There is a growing independence and responsibility for their own practice, with only minor inadequacies occurring. |
| Stage 4. Competent | The trainee demonstrates a wide repertoire of basic to advanced knowledge, skills, attitude value, and relationship competencies applied across a wide range of contexts. Performance is consistent with competencies of a graduate who has just completed all requirements of their professional Master's degree. There is an appropriate level of independence and development of adequate professional identity. |
| Domain | Vignette | Calibration score (Max 5) |
|---|---|---|
| Counselling competencies | Trainee TA relates effectively with clients in commonly encountered situations, and this capability is developing in more complex cases. She/he maintains a comfortable, warm, and respectful demeanour with most client situations. She/he frequently demonstrates good reflective listening skills and makes appropriate emotional and meaningful responses that help validate client experiences and clarify client issues. She/he appropriately directs and guides client focus in most client situations but tends to become less effective when dealing with complex presentations, including client resistance. | 3.71 (0.38) |
| Clinical assessment competencies | Trainee TB collects sensitive information and uses session time effectively in most cases. She/he integrates collected information into hypothesis, diagnosis, and case formulations for commonly encountered cases and is developing this skill with more unusual or difficult cases. She/he displays an awareness of incorporating socio‐cultural factors into clinical assessments but is sometimes inconsistent in integrating this information. She/he is capable of conducting risk assessments and/or formulating risk management plans for standard cases but needs some assistance for complex cases (e.g., multiple diagnoses). | 3.40 (0.54) |
| Intervention competencies | Trainee TC demonstrates the ability to conduct a few structured behavioural and cognitive techniques relatively well but has a limited repertoire of CBT skills. The trainee appears unable to move fluently from one technique to the other, making the session feel disjointed and significantly reducing the effectiveness of the strategies employed. She/he is often able to identify negative cognitions and makes attempts to pose Socratic questions, but these attempts are typically restricted to a variant of “what's the evidence for that?” Slow but modest progress is made during typical sessions with cooperative clients presenting with low levels of severity. With more difficult cases, progress is less obvious and may stall. | 2.30 (0.39) |
| Ethical attitude and behaviour | Trainee TD generally follows most aspects of the relevant legal, professional, and cultural ethical guidelines. She/he recognises the relevant ethical issues in simple cases but occasionally has difficulties with more complex cases. She/he displays a developing awareness of one's own values and biases, including cultural biases. She/he displays the capacity to apply an appropriate problem‐solving approach to ethical issues encountered, but these may be simplistic. She/he does not always recognise when it might be helpful to seek appropriate consultation and supervision in order to guide her/his ethical practice. | 2.82 (0.62) |
| Professionalism | Trainee TE requires close supervision in order to ensure that workload responsibilities are being adequately met in a timely manner. She/he is able to communicate with other team members and respond to direct instructions. Some difficulties present in prioritising competing demands and being appropriately assertive within the team when needed. Minor instances of poor record keeping, poor case preparation, or unprofessional demeanour have occurred. Self‐reflection and self‐awareness are limited, leading to overly negative or positive self‐evaluations. There are also some concerns about punctuality and the occasional insensitive comment when interacting with peers and professionals. | 1.90 (0.42) |
| Domain | Vignette | Calibration score (Max 5) |
|---|---|---|
| Case formulation | Trainee YA's attempts at case formulation are fairly simplistic and mostly derive from a menu‐driven approach linking intervention strategies to symptoms/problems rather than from an approach based on an understanding of underlying principles and/or key processes. Consequently, K assesses and formulates appropriate simple interventions but demonstrates difficulty applying formulated interventions to the client's individual context or circumstances. She/he requires assistance to modify intervention plans as new information emerges. She/he requires assistance in the translation of formulations into a language the client will understand and is tentative in their client communication. | 2.14 (0.33) |
| Intervention | Trainee YB has a modest repertoire of interactional/intervention skills that allow fair progress with clients presenting with low‐to‐moderate levels of severity/complexity. The trainee's performance during a typical session is patchy, being interspersed with competent performance of simple interventions and other segments evidencing limited or laboured progress. The therapist evidences difficulty to move efficiently from one therapy episode/technique to the other, reducing to some extent the effectiveness of the interventions. She/he displays awareness of process issues, including client resistance, and makes initial attempts to address underlying dynamics. However, the interventions are only of limited value as these efforts lack the incisiveness, sophistication, and fluency characteristic of more advanced trainees. | 2.68 (0.49) |
| Psychological testing | Trainee YC is able to generate some hypotheses leading to appropriate test selection for straightforward cases, but needs direction for more complex presentations. She/he generally balances the need to follow standardised test administration procedures while maintaining rapport and managing the client. The trainee shows adequate knowledge of psychometrics and test theory and is able to interpret test scores and discrepancies with some assistance. Her/his ability to derive appropriate recommendations from test data are slightly limited, leading to the occasional neglect of some central issues. With some supervisory input, the trainee is capable of producing written reports that show sufficient structure, accuracy, and clarity. | 2.92 (0.40) |
| Scientist‐practitioner approach | Trainee YD demonstrates a commitment to bringing the scientific method to their work. The trainee generally consults the scientific literature and other relevant materials, such as tests or school reports, to assess and treat their clients. She/he regularly uses new information from clients to formulate and test hypotheses. The trainee usually makes attempts to systematically assess client progress and consider alternate hypotheses when treatment is not progressing. When the literature or research evidence is less clear, they have difficulty formulating a theory‐informed strategy to devise an appropriate way forward, instead seeking direction from their supervisor. | 3.22 (0.48) |
| Professionalism | Trainee D has minor problems with consistently discharging workload responsibilities in an effective and timely manner. Inexperience or limited skills in prioritising demands within or across different professional roles contribute to variable outcomes and/or work‐related stress. Excessive time may be devoted to less important aspects of the job. Lack of confidence often leads to an alternating pattern of self‐directed learning and requests for guidance and support. She/he works fairly well within a team, but demeanour and communication styles lack the authority and autonomy of a mature professional. | 2.44 (0.61) |