Rotation/Track Performance Evaluation. It is required that the supervisor and Intern have a relatively formal discussion of the Intern's progress six weeks after beginning each of the three required rotations. Each rotation/track supervisor makes a report regarding internship performance not less than every four months using the electronic evaluation system of One45 (SEE “ Intern Performance Milestones Evaluation” in Appendix A). ) Goals/Objectives/ Competencies milestones are all rated by the supervisors as the intern makes progress toward the milestones targeted for the completion of internship – Level 3 or higher, which generally represents that the Intern is “competent to function effectively in interdisciplinary teams independently with supervision/review”. The general standard for progress through the program is for the intern to demonstrate steady movement from Level 1 competencies toward Level 3 or higher. Failure to make progress beyond Level 1 milestones are indicative of the possible need for some form of remediation. The degree of administrative formality of the remediation plan is dictated by the severity of deficit observed. The Training Director reviews all One45 evaluations of interns and releases those to the interns upon review. The Internship Core Committee conducts end of rotation review of all evaluations for each Intern. If significant problems are noted, the committee decides if any changes are to be instituted. The committee can institute a four-month probationary period if indicated, and this period can be extended. All reports and actions taken by the committee are incorporated into the file kept on each Intern. The Intern Performance Milestones Tracking Form provides a mechanism to verify at mid-year and end-of-year evaluations that the cumulative intern evaluations are indicating that interns are developmentally on course in regard to completion of the program goals/objective/sub-objectives and their associated competencies.
Clinical Skills Verification Exam. At the end of the first rotation Interns are required to complete a Clinical Skills Verification Examination. Individual each Intern presents a 45-50 minute video of a new patient assessment to the directors of the Diagnostic and Treatment Seminar and the Psychotherapy Process Seminar. The Overall Supervisor would be invited to attend as well. Following the viewing of the video, the Intern is expected to provide:
The AADPRT Clinical Skills Verification Examination Form CSV.3 is used to rate the assessment performance along with the Intern Clinical Skill Verification Evaluation Supplement – evaluates in greater detail evidence of conceptualization skills. Results are immediately discussed with the intern and findings are submitted on the One45 evaluation system. The Training Director reviews all One45 evaluations of interns and releases those to the interns upon review.
As part of the Diagnostic/Treatment Seminar all interns must successfully conduct a Cognitive-Behavioral Therapy (CBT) Session judged by the seminar directors/CBT instructor as “good” on the question, “How would you rate the clinician overall in this session, as a cognitive therapist?” (See Cognitive Therapy Scale -Young and Beck, 1980). Results of the session evaluation are immediately reviewed with the intern and the evaluation form is completed and placed in the Intern’s cumulative record.
By the end of the first month of the third rotation, Interns are required to present a case in which a treatment case formulation and treatment plan demonstrates an empirically based and interdisciplinary approach to treatment as well as cultural competence. The case presentation must include key biopsychosocial data that include psychological testing data and an integration of the “data” that reflects a process of theory building at the individual patient level. This integration process must also demonstrate clear linkages of science to the case formulation and treatment plan and thus references to scholarly work are required. The required Case Presentation must also include an integration of psychological testing data. The Case Presentation must include a treatment plan that fits the “theory of the patient” and constructs an intervention approach that integrates the idiographic aspects of the patient’s needs along with knowledge of empirically supported treatments. The Case Presentation must directly address the pertinent cultural data obtained that guided the conceptualization of the case and the development of the treatment plan. The Case Presentation must reflect an integrative assessment/ treatment model of health care problems in which there is appreciation for the contributions that can be made by various health care disciplines in the care of the patient. Finally, the Case Presentation must reflect an appreciation of the unique life goals and strengths of the patients as they guide the development of an effective treatment plan. Thus this Case Presentation provides an assessment and learning experience that is intended to occur in the later stages of the Interns development and focuses on a high level of conceptualization competence. Proficiency of the Case Presentation is judged by the responsible clinical supervisor(s) and the Overall Supervisor.
Midyear Evaluations. At the end of six months, the Internship Core Committee meets with the Intern to review his/her ratings, discuss his or her progress, and make specific recommendations. Evaluations of the Intern’s performance are provided by the Rotational/Track Supervisors, the Overall Supervisor, and the Faculty Directors of the Diagnostic/Treatment Seminar, the Psychotherapy Process Seminar, and the Professional Issues Seminar (SEE “Intern Performance Milestones Evaluation – Seminar Form” in Appendix A). Ratings for the performance in the Diagnostic-Treatment Seminar, Psychotherapy Process Seminar, and the Professional Issues Seminar are completed by the seminar directors and recorded in the One45 evaluation system. In addition, the Interns are required to complete a self-evaluation rating of their performance in order to assist in evaluating the progress in the Internship Training and to develop specific educational goals for the remainder of the year (SEE “Intern Performance Milestones Self-Evaluation Form” in Appendix A). Finally, at the Midyear Evaluation, the Overall Supervisor for each respective intern completes and reviews the Intern Performance Milestones Tracking Form with the intern and submits to the Internship Training Director via the One45 system. This tracking form maintains a formal account of the progress of each intern in meeting the internship training goals established generally by the training model and specifically according to the individualized intern training goals. The Internship Training Director summarizes the findings of this Midyear Evaluation in a letter sent to the Graduate School Training Director of the respective intern. The Intern is given the opportunity of reviewing and requesting revisions of the Midyear Evaluation letter prior to its being sent to the respective Graduate School Training Director.
Research Paper Evaluation. Interns must complete one research-scholarly project in which there is a written product authored or co-authored by the intern by the end of the 11 month of the training year. Proficiency of the research-scholarly product is judged by two faculty not directly involved in the research project and the Training Director using the Evaluation of Intern Research Paper form. The research paper and faculty ratings are placed in the intern’s cumulative record.
End of the Year Evaluation. At the conclusion of the year, the Internship Core Committee meets with the Intern to review his/her ratings, discuss his or her performance, and make specific recommendations regarding post-internship professional development. Evaluations of the Intern’s performance are provided by the Rotational Supervisors, the Overall Supervisor, and the Faculty Directors of the Diagnostic/ Treatment Seminar, the Psychotherapy Process Seminar, and the Professional Issues Seminar. Ratings for the performance in the Diagnostic-Treatment Seminar, Psychotherapy Process Seminar, and the Professional Issues Seminar are completed by the seminar directors and recorded in the One45 evaluation system. In addition, the Interns are required to complete a self-evaluation rating of their performance in order to assist in evaluating their success in completing their educational goals during the Internship Training and to assist them in developing future personal career educational goals. Furthermore, the final Intern Performance Milestones Tracking Form is completed by the Overall Supervisor and submitted to the Internship Training Director via the One45 system. By the end of the training year the intern must be rated by the supervisors as having demonstrated the majority of milestones targeted for the completion of internship – Level 3 or higher, which generally represents that the Intern is “competent to implement clinical skills independently with supervision/review”. Internship Training Director summarizes the findings of this End of the Year Evaluation in a letter sent to the Graduate School Training Director of the respective intern. The Intern is given the opportunity of reviewing and requesting revisions of the End of the Year Evaluation letter prior to its being sent to the respective Graduate School Training Director.
Evaluation of the Internship and Faculty by Interns. The Internship continually seeks to improve the training program curriculum and faculty performance. Every four months interns are required to complete the Rotation/Track Evaluation Form. This formal evaluation procedure provides feedback to the rotation and track supervisors regarding the overall quality of the training experience for the rotation or track as well as Intern recommendations regarding how the training experience might be further enhanced. At the midyear point and at the end of the training year, Interns are required to submit written and oral feedback reports concerning the quality of their training. The written and oral feedback reports are submitted in a full faculty meeting and copies of their written feedback are provided to all Faculty present and not present. The content and format of the Interns’ written and verbal feedback is at the discretion of the Intern class. At the end of each 4-month rotation, the Interns complete evaluations of their supervising faculty using the Trainee Evaluation of Core Faculty form on One45. This faculty performance information provides proximal data pertinent to faculty performance but also data relevant to the overall effectiveness of the training program. At the midyear point, the Internship Training Director and the VAMC Training Director meet with the intern class to obtain their narrative evaluations of individual faculty performance. These individual faculty narrative performance data are analyzed annually for program review as well as faculty performance feedback. Evaluation data is used to evaluate faculty performance, for annual job reviews and for departmental excellence in education awards. Faculty receive this information and are expected to use it as a basis for improvement if needed. The results of the individual faculty performance are also provided to the Faculty’s respective Administrative Service Chief.