The AU/MCG-CNVAMC Internship organizes practicum activities and supervision around
three four-month rotations, each designed to expose Interns to a wide variety of patients
with all types of diagnoses at varying levels of acuity and complexity, and to provide
emphasis training in an area of interest to the Intern.
In addition, throughout the year one day of the week is set aside for emphasis track
training, enabling a continuity of training experiences in the area of the Intern’s
emphasis interest. There are two rotations required of all Interns: (1) The General
Practice Rotation – located at Uptown VA, AU/MCG, and/or East Central Georgia Regional
Hospital sites, and (2) the General Health Psychology Rotation – located at the Uptown
VA, Downtown VA and/or MCG sites. The third rotation - Emphasis Track Rotations -
is selected prior to entry into the internship program and entails one of the six
emphasis track experiences available. The weekly supervision hours vary by rotation/track
but for the most part each intern will have 3-4 supervisors during each of the three
rotations resulting in significant access to individual and group supervision throughout
the practicum training experiences. Individual and group supervision is primarily
provided on a weekly scheduled basis, although there may be as-needed-case consultation/supervision
that represents a smaller portion of the supervision hours reported above. With the
exception of limited supervision by Postdoctoral Fellows, the supervision is provided
by doctoral-level licensed psychologists that have been credentialed by their respective
service organizations (i.e., Augusta University/Medical College of Georgia, Augusta
University-Summerville Campus, East Central Regional Hospital, and the Charlie Norwood
VA Medical Center). Consistent with the policies of the Medical College of Georgia/Augusta
University and the Charlie Norwood VA Medical Center, supervisors must be on-site
when interns are performing direct patient care activities. Moreover, access to supervisors
is facilitated by paging systems and/or phone in all the internship partner sites
that insure that supervisors can be promptly contacted by interns to address their
supervision needs. Descriptions of the key supervisory roles are provided below:
- 1. Overall Supervisor - Due to the complexity of internship training and the diverse interests and educational
needs of interns entering internship training, the AU/MCG-Charlie Norwood VAMC Internship
provides an Overall Supervisor (OS) for each intern prior to the beginning of the
internship. The OS is charged with the duty to develop an understanding of the unique
educational needs and interests of the Intern and to develop and monitor a yearlong
strategy to maximize the training experience available. Thus, for example, an intern
might desire or require a special emphasis on psychological assessment. The OS would
be responsible for helping the intern devise a sequence of trainings to meet this
need that might begin with basic training in test administration and then move forward
to more interpretive and integration training experiences. These special needs and
sequence of training would be communicated with rotation supervisors to ensure that
the necessary training experiences are provided in each rotation. To facilitate a
developmental process, at the beginning of the training year the Intern completes
the Intern Self-Study and the Self-Assessment of Cultural Competency forms and discusses
the results with the OS to determine specific areas of need for competency development.
The OS is responsible for insuring that each intern has adequate access to patient
care activities that represent the key training requirements for the internship.
In particular, the OS is to facilitate efforts to provide each intern access to at
least 1-2 patients throughout the year that needs “long-term” therapy in order to meet the requirements
of the Psychotherapy Process Seminar. The OS plays a vital role throughout the year
in addressing rotational schedules and within rotational experiences to insure that
target areas of need and interest are adequately addressed. Rotational/track supervisors
are to insure that 2 hours each day will be provided for documentation of clinical
encounters and/or additional training and administrative/institutional responsibilities.
To insure that the Intern is provided sufficient time for documentation/administrative/
institutional responsibilities, the rotation/track supervisors and the Intern collaboratively
create a weekly schedule at the start of each rotation to be submitted to the respective
Overall Supervisor for review. The OS is responsible for providing the following assessments
of the Intern during the training year:
- The OS is responsible for completing the Intern Performance Milestones Tracking form
at the midyear and end of year evaluations – providing a cumulative record of the
completion of requirements and obtainment of required competencies.
- At the completion of each rotation, the intern completes the Intern Performance Milestones
Self-Evaluation form in order to assist in monitoring progress and self - identifying
competency development needs. This completed self-evaluation form is reviewed and
discussed with the OS.
- Interns are required to complete one research-scholarly project in which there is
a written product authored or co-authored by the interns. The Overall Supervisor is
responsible for helping the intern develop with his/her/their research mentor a research-scholarly
project and review the project plan and timetable. Progress and successful completion
of the research-scholarly product will be judged by the responsible project supervisor,
the Overall Supervisor, and the Internship Training Director.
When training issues/deficiencies are identified, the Internship Director of Internship
Training will address these with the OS and the Core Committee so that effective educational
interventions can be planned. In this regard, the Internship policies under the heading
of “Due Process: The identification and management of Intern problems/impairment” stipulate that the OS plays an important role in dealing with problems that may arise
with the Intern’s behavior or performance. Similarly, the OS plays an important role
in responding to any Intern Grievance. The OS is required to serve as a member of
the Core Committee and to participate in the midyear and end of year evaluations of
all of the interns. Finally, the OS insures that guidance is being provided in regard
to career planning including strategies for identifying and applying for postdoctoral
fellowships or professional positions in a timely fashion.
- Co-Directors of Internship Training and Core Committee. To insure that interns are progressing in areas of program competencies and individualized
educational interests/needs, the Co-Directors of Internship Training review all rotational
and seminar evaluations, intern self-evaluations, and the Intern Performance Milestones
Tracking form of all the interns in a timely manner. When training issues/deficiencies
are identified, the Co-Directors of Internship Training will address these with the
OS and the Core Committee so that effective educational interventions can be planned.
At mid-year, each intern’s progress is reviewed with the Co-Directors of Internship
Training and the Core Committee and specific educational goals for the remainder of
the training year are devised. At the end of the year, each intern’s performance is
reviewed with the Co-Directors of Internship Training and the Core Committee to insure
that all required training experiences have been completed and all required competencies
have been obtained. The Co-Directors of Internship Training provide a summary letter
of the intern’s progress to the respective Graduate School Training Director at the
mid-year and end-of-year evaluations.
- Practicum Experiences and Supervision. The Rotational/Track supervisors are responsible for establishing and communicating
clear educational goals for the rotational/track experience, identifying and delegating
appropriate clinical assessment/treatment cases for the Intern, supervising all clinical/professional
activities on the rotation/track, maintaining on-site presence during all Intern clinical
encounters, verifying the accuracy and timeliness of all clinical documentation, and
providing routine verbal and written feedback regarding the Intern’s rotation/track
performance. Interns are required to document all patient encounters in the appropriate
electronic records that must be reviewed and signed by the appropriate supervisor.
Typically, interns will have 2-4 rotational/track supervisors for all rotations and
tracks. At a minimum, as a component of the rotational/track training interns must
receive 4 hours of supervision per week with a minimum of 2 hours of individual supervision
(one-on-one) per week and 1.5 hours of group supervision per week (supervision with
multiple interns and a supervisor). It should be noted that additional group supervision
is provided in the Psychotherapy Process Seminar.
In regard to rotation/case supervision, the AU/MCG-Charlie Norwood VAMC Internship
emphasizes the following supervisory activities that facilitate a sequential and cumulative
training experience that is graded in complexity:
- Initial assessment of the Intern’s skills/competencies and training needs is essential
and the data obtained should guide the supervisor in regard to the training experiences
- For new areas of skill development, didactic instruction and reading materials need
to be provided prior to patient-care training activities. There should be provision
of a bibliography with continually updated research-oriented articles and articles
specific to the cultural issues relevant for the clinical populations served. Instruction
should include not only the teaching of specific techniques but also the general principles
that underlie them.
- In early stages of skill development, conjoint clinical/professional activities in
which the Intern can observe the Supervisor in action should be emphasized. These
observational experiences can then be followed by the Supervisor observing live or
via video recording the Intern engaging in the targeted skill/competence. Effective
skill/competence development in professional psychology is dependent upon practice
in patient care activities.
- A feedback model of supervision should be provided as the Intern progresses in the
early phases of skill/competence development. This model emphasizes: 1) A clear understanding
of what constitutes a “correct” and “incorrect” conceptualization or treatment intervention,
and 2) Immediate, unambiguous and consistent supervisory feedback regarding the specific
relevant behaviors observed. As the Intern progresses in the skill development this
feedback model of supervision should also progress in regard to the level of supervisor-intern
collaboration pertaining to what was observed and the relevant evaluations associated
with the observed behaviors.
- As much as possible, assignment of patient care experiences should begin with the
less complex and less high acuity cases and move according to demonstrated competencies
toward the more complex and higher acuity cases. Some services, however, may not have
the patient care complexity/acuity range to enable such a progression. Therefore,
in such circumstances a weaning process is encouraged in which the Supervisor initially
is highly visible and engaged in the clinical care and then gradually allows the Intern
to take more significant roles in the patient care activity.
- To enhance transfer and maintenance of skills/competencies, the Supervisor should
increase the variability or range of training experiences to which the Intern responds.
- A reflection-driven model of supervision should increasingly be incorporated in the
middle to latter phases of skill development. This model emphasizes: 1) The Supervisor
encourages the Intern to engage in a reflective process in which the Intern pays deliberate
attention to his/her/their experience, critically analyzes feelings and observations,
and engages in more of a self-evaluative process, 2) The Supervisor actively teaches
the Intern how to learning from his/her/their own experience, 3) Supervisory input
and teaching is guided more and more by the Intern’s own inquiry and conceptualization
of case material, and 4) Supervisory discussions should increasingly become more about
collaborative reflections on skills and strategies, personhood issues, and conceptualizations.
- Within the legal limitations of practice of psychology, the Intern should increasingly
become more and more independent in the clinical care training opportunities afforded
as skills/competencies are successfully obtained.
It is required that the Rotational supervisor(s) and Intern have a relatively formal
discussion of the Intern's progress six weeks after beginning the rotation. Each supervisor makes a report not less than every four months to the Internship
Core Committee after discussion between the supervisor and supervisee concerning the
evaluation of the Intern’s performance. These evaluations are used to assess educational
progress and further develop educational plans for the Intern.
If special expertise is needed on a case, or if the Intern has a special interest
in working with a specif faculty member, a Case Supervisor can be added at any time.
This includes supervision of a research project. The Case/Research Supervisor, though
not responsible for most of the Rotational or Track experiences, would be responsible
for the appropriate supervision of the case or research project and must provide feedback
in verbal and written form to the Intern and to the Training Director and Core Committee
each 4-month block.
After the Intern gets to know the faculty, we encourage, but do not require, the Intern
to seek a personal mentor relationship with a faculty person. In the past, the faculty
mentor has acted as a friend, informal counselor, ombudsperson, role model, and case
supervisor. Please recognize that our internship is in the process of changing the
way more formal mentorship is determined and provided. New details will be communicated
via this site as they become available.