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Meier Clinics Neuropsychology Internship and Advanced Practicum Placement Program

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MEIER CLINICS NEUROPSYCHOLOGY INTERNSHIP AND ADVANCED PRACTICUM PROGRAM

February 2014

Kymberly F. Larson, Psy.D., Clinical Neuropsychologist

Meier Clinics

1. PURPOSE: The Meier Clinics Neuropsychology Internship and Advanced Practicum Program

document establishes the description, policies and procedures for the Clinical Neuropsychology Track

Training within the Meier Clinics Internship and Advanced Practicum Program in Clinical Psychology.

2. MISSION: Neuropsychology is the study of brain-behavior relationships. The Meier Clinics

Neuropsychology Internship and Advanced Practicum Program is designed to provide a comprehensive

and intensive one-year training program in the specialty area of clinical neuropsychology, focusing on

learning to conduct comprehensive integrated evaluations of clients across the age range from

childhood through elderly adult, with recommendations for ongoing treatment, rehabilitation, work and

educational accommodations and placements. Emphasis is placed on a scientist-practitioner model

which is competency-based, within the Meier Clinics mission to provide Christian counseling services.

3. RESPONSIBILITIES:

A. Dr. Brad Kahle is the Director of Clinical Training for Meier Clinics, and has overall

responsibility for the Internship and Practicum Training Program in Clinical Psychology. Dr. Kahle

establishes and supervises the training of interns and practicum students that develops their

competence as clinical psychology trainees based on sound scientific and professional practice

foundations. Training includes core seminars, lectures and case conferences which will be attended by

all graduate students. The core education includes the following content areas: psychological

assessment and consultation; organization, management and administration issues pertinent to

psychological service delivery and practice, training and research; professional conduct, ethics and law;

integration of Christian ethical principles in psychological services; and issues of cultural and individual

diversity.

B. Dr. Kymberly Larson is the Director of Training for the Clinical Neuropsychology Specialty

Track, and is responsible for developing the content of the program, day-to-day administration and

activities of the program, and the documentation of training. This includes coordinating with the other

Meier Clinic staff, and staff of other institutions to establish training opportunities for Clinical

Neuropsychology interns and practicum students. The content of the Clinical Neuropsychology Specialty

Track is detailed under Objectives and Content, in this document. The Director of Training for the

Clinical Neuropsychology Specialty Track reports directly to Dr. Brad Kahle, Director of Clinical Training

for Meier Clinics.


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C. Neuropsychology interns and advanced practicum students have as their primary

responsibility the acquisition of a knowledge base and clinical skills to developed advanced competence

in the practice of Clinical Psychology and the practice of Clinical Neuropsychology. Specific objectives

and processes are detailed in Appendix 2: Objectives and Processes for the Clinical Neuropsychology

Specialty Track.

4. GOALS: The Clinical Neuropsychology Specialty Track is structured to ensure the development of advanced professional and technical expertise in the practice of Clinical Neuropsychology of each graduate student based upon sound scientific and professional practice foundations. The primary goal of the Clinical Neuropsychology Specialty Track is to use the scientist-practitioner approach to train clinical psychology graduate students to be prepared to work in a variety of neuropsychology-related clinical, research, and academic settings. The long-term goal of the internship and advanced practicum program is to train psychologists who are interested in pursuing careers in clinical neuropsychology and make significant contributions in clinical, research, or teaching activities. The specific goals and objections of

the specialty area are listed in Appendix 2. The following are integral to the achievement of this goal:

A. The primary training method is supervised service delivery with direct patient care. Each graduate student receives 3 to 4 hours of supervision per week, with a minimum of at least 1 hour involving individual, face-to-face supervision with Dr. Kymberly Larson; one hour clinical group supervision with Dr. Brad Kahle; and one hour clinical neuropsychological group supervision with Dr. Kymberly Larson. Advanced Practicum students will have additional supervision by the Neuropsychology Interns. In addition, graduate students always have access to supervisor consultation and intervention in emergencies.

B. Educational and training activities also comprise a large portion of the graduate students’ training and are designed to be cumulative, graduated in complexity and structured (See Appendix 4 for listing of educational and training activities during the internship and practicum, and Appendix 5 for list of recommended readings).

5. COMPETENCY REQUIREMENTS: During the first week of the program the Director of Training for the

Clinical Neuropsychology Specialty Track, Dr. Kymberly Larson, meets with each graduate student and

reviews the list of required competencies for the specialty training experience (See list of competencies

at Appendix 3). The competency list specifies training requirements in terms of assessment

competencies, treatment competencies, knowledge required, and research activities. Each graduate

student works with Dr. Larson to develop an initial training plan based on the graduate student’s

previous training and experience related to the competencies as well as the graduate student’s areas of

interest. Training activities are listed in Appendix 4.

6. FACILITATING TRAINING AND EDUCATIONAL EXPERIENCE OF INTERNS AND PRACTICUM STUDENTS:

A. The model of integrated education and training in Clinical Neuropsychology is acknowledged.

Each graduate student presents with different degrees of specialty knowledge and skills acquired at

various levels of their training throughout their doctoral studies. At the conclusion of each quarter, each

graduate student is provided feedback on his/her strengths and weaknesses. To the degree possible,

supervision and training for each graduate student is tailored to their individual needs and interests. In


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order to facilitate this, goals and objectives for each quarter are developed collaboratively between the

supervisor and graduate student.

B. In order to maximize the quality and effectiveness of the graduate students' learning

experiences, graduate student-supervisor relations are collegial and conducted in a manner consistent

with ethical principles and professional conduct standards.

C. The Director of Clinical Training will meet with all graduate students weekly during group

supervision, in order to obtain feedback about the program, any concerns the graduate student may

have, and information on specific changes that would facilitate further development and learning.

7. EVALUATIONS AND FEEDBACK:

A. At the conclusion of each quarter, the Director of Training for the Clinical Neuropsychology

Specialty Track evaluates the graduate student's attainment of standards for that quarter, as well as the

graduate student's strengths and weaknesses. These evaluations are recorded and signed by both the

Director of Training for the Clinical Neuropsychology Specialty Track and the graduate student. The

results are utilized to develop individual goals for the graduate student in subsequent quarters.

B. At the conclusion of the internship or advanced practicum, a formal evaluation of the

graduate student’s competency in all of the exit criteria will be conducted. If there is any question that

the graduate student may not meet the exit criteria at the end of his/her internship/practicum, this will

be specifically addressed at the end of quarterly evaluations and the graduate student will be provided timely written notification of all shortcomings, the opportunity to discuss them and guidance regarding

steps to remedy them (if remediable). Additionally, written feedback on the extent to which corrective

actions are or are not successful will be provided.

C. The Director of Training for the Clinical Neuropsychology Specialty Track will keep evaluations

which will not be released to any agency outside Meier Clinics without written permission of the

graduate student. Upon satisfactory completion of the internship/practicum, an appropriate certificate

will be issued to each graduate student attesting to his/her completion of an Internship or Advanced

Practicum in Clinical Psychology, with a specialization in Clinical Neuropsychology.

Dr. Kymberly Larson, Psy.D.

Clinical Neuropsychologist

Director, Clinical Neuropsychology Specialty Track


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APPENDIX 1: Exit Criteria

The following exit criteria will be included in a formal evaluation of the graduate student's competency

in the Clinical Neuropsychology specialty area:

1. Develop interviewing and assessment skills to be able to provide a comprehensive

neuropsychological evaluation, sufficient to practice on an independent basis for interns;

sufficient to qualify for a neuropsychology internship for advanced practicum students.

2. Develop comprehensive knowledge of neurobehavioral syndromes, neuroanatomy,

neuropathology and demonstrate the ability to use that knowledge in neuropsychological

settings.

3. Develop the ability to provide consultation to patients and professionals sufficient to

practice on an independent basis for interns; sufficient to qualify for a neuropsychology

internship for advanced practicum students.

4. Develop an advanced understanding of brain-behavior relationships;

5. For interns, complete a scholarly activity that demonstrates individual competence of

independent and systematic psychological research of publishable quality. This scholarly

activity may be dissertation research. While publication/presentation of the research

project is not required, it is highly encouraged.


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APPENDIX 2: Objectives and Processes for the Clinical Neuropsychology Specialty Track

Objective #1. Obtain substantial experience and develop a high level of expertise in broad state-

of-the art Clinical Neuropsychological assessment techniques and be familiar with psychometric

properties of each of the tests and assessment techniques.

Processes

1. (A). Each graduate student will become highly skilled in selecting, implementing, scoring,

interpreting, and communicating findings from a broad array of psychological assessment

instruments, including experience in each of the following assessment domains:

Mental Status Screening Tests:

MMSE, Cognistat, NAB Screener, Mattis Dementia Rating Scale, CNS Vital Signs, etc.

Cognitive/Intellectual and Achievement/Academic Assessment:

Wechsler Adult Intelligence Scale -IV, Wechsler Intelligence Scale for Children-IV, WRAT- 4,

Wechsler Individual Achievement Test II, Wechsler Memory Scale-IV, Children’s Memory

Scale, WASI, KBIT-2, PPVT-4, NART, etc.

Standard Neuropsychological Assessment Instruments:

Repeatable Battery for the Assessment of Neuropsychological Symptoms, ANAM, Wechsler

Memory Scale-IV, Halstead-Reitan Battery tests, Houston Battery tests, California Verbal

Learning Test-II, Boston Diagnostic Aphasia Examination 3rd edition, Booklet Categories Test,

Beery Tests, Judgment of Line Orientation, etc.

Computerized Neuropsychological Assessment Instruments

Wisconsin Card Sorting Test, Connors’ Continuous Performance Test-II, Test of Variable

Attention(TOVA)-8, CNS Vital Signs, etc.

Assessment of Effort and Motivation

Victoria Symptom Validity Test, Rey Fifteen-Item Test, Portland Digit Recognition Test


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Personality Assessment

Minnesota Multiphasic Personality Inventory-2, Millon Clinical Multiaxial Inventory-III,

MMPI-A, M-PACI, Thematic Apperception Test, Children’s Apperception Test, Personality

Assessment Inventory, Geriatric Depression Scale, Beck Inventories, Beck Youth Inventory,

Conners’ Inventories, Brown Inventories, Clinician Administered PTSD Scale (CAPS), Gilliam

Asperger’s Disorder Scale (GADS), Gilliam Autism Spectrum Disorder Scale, etc.

(B). Each graduate student will receive individual supervision on psychological assessment

with a licensed clinical psychologist. This supervision will occur before the evaluation report is

finalized and feedback is given to the patient and family, if appropriate.

(C). Each graduate student will be familiar with test construction, psychometric properties

and other characteristics of common neuropsychological tests.

(D). Each graduate student will be familiar with non-standardized procedures, computerized

measures and special assessment techniques such as qualitative screening measures.

Objective #2. Ensure acquisition of the knowledge required for advanced training in Clinical

Neuropsychology. These knowledge based prerequisites are as follows: (a) general neuropsychological

principles, (b) developmental principles, (c) clinical syndromes, (d) treatment and rehabilitation (e),

neuroanatomy/neurophysiology, (f) neuropathology (g) clinical neurology/ neuroimaging (h) and

military application of neuropsychology.

Processes

2. (A). Basic knowledge will be acquired through didactic events, to include training in

assessment of ADHD; learning disabilities; traumatic brain injury; dementias; epilepsy;

cerebrovascular disorders, etc. Weekly reading seminars will be reviewed in group

neuropsychology supervision, in relevant topics such as attention/concentration disorders;

language problems and assessment; memory and learning; deficits in

visuospatial/visuoconstructional skills; frontal lobe/executive functioning; affect, emotions

and mood; aphasia syndromes; cerebrovascular disease and stroke; military

neuropsychology and other clinical syndromes. A list of readings appears in Appendix 5.


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(B). In areas where greater experience or knowledge is believed to be necessary prior to

more advanced and autonomous training experiences, opportunities will be provided for the

graduate student to (1) read key references in designated areas, (2) attend relevant

seminars or courses.

Objective #3. Obtain experience and develop a high level of professional expertise in the

conduct of Clinical Neuropsychological evaluations, in differential diagnosis, clinical interviewing and in

case formulation based on contemporary clinical practice. Develop a philosophy of neuropsychological

assessment, brain organization and professional ethics. Develop professional consultation skills and the

ability to provide lectures and information on neuropsychological issues.

Processes

3. (A). Each graduate student will be scheduled for Clinical Neuropsychological evaluations

with a broad age range of patients, from children to elderly adults, with a broad range of

neuropsychological disorders.

(B). Each intern will be scheduled for a minimum of 2 weekly evaluations in the

Neuropsychology Specialty Track. Expectation is that the intern will typically do 2 weekly

evaluations. Each advanced practicum student will be scheduled for a minimum of one

weekly evaluation, and the expectation is that the advanced practicum student will typically

do one weekly evaluation.

(C). Each graduate student will receive cases for evaluation that include a variety of

diagnostic possibilities, including attention deficit disorder, learning disabilities, Asperger’s

disorder, head injury, stroke, dementia, epilepsy and other medical conditions. Fellows will

participate in assessing patients and discussing cases with supervision attending faculty.

(D). Graduate students will discuss interviews and initial case formulations with a clinical

supervisor prior to completing the case formulation, written report, and feedback to the

patient and family if appropriate. This discussion will initially occur immediately following

the interview, allowing for follow-up questions, clarifications, or direct supervisor

involvement with the patient. Test selection will also be discussed with the supervisor prior

to testing the patient. As interns and practicum students demonstrate increased clinical

sophistication, initial case formulation and report writing may occur before formal case

supervision.


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(E). Graduate students will write reports of their evaluations in a timely manner, obtaining

written or verbal feedback on the evaluation reports from the supervising psychologist.

(F). Graduate students will attend weekly case conferences and present evaluation data and

case formulations in this setting several times during each training year. This will enable

consultation, case discussion, or recommendations for patient care as appropriate.

(G). Each intern will provide at least one lecture to fellow interns and advanced practicum

students, as well as other interested Meier Clinics staff.

Objective #4. Obtain skills in supervision of junior trainees and provide input in the

development of training curriculum for those trainees

Processes

4. (A). Each intern will provide supervision to a psychology practicum student on at least 5

clinical cases, with the intent of developing the supervisee’s clinical skills to provide

assessment and evaluation.

(B). Each intern will provide input into the development of training activities for the trainees.

(C). Each intern will receive didactic training in supervision.

Objective #5. Become highly competent and capable of independent and systematic

neuropsychological research and/or a scholarly activity within this specialization.


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Processes

5. (A). Each graduate student may participate in ongoing research projects within their

research specialization track, including accepting of responsibility for managing research

databases and collecting data. Interns are expected to complete a scholarly activity that

demonstrates individual competence of independent and systematic psychological

research of publishable quality, which in most cases will be their dissertation. While

publication/presentation of the research project is not required, it is highly encouraged.


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APPENDIX 3: Clinical Neuropsychology Specialty Area Competence/Knowledge Checklist

Intern/Advanced Practicum Student______________________ Training Year_______________

(N/A = experience not available)

Objective 1: Assessment techniques Completed

1. Cognitive/ Intellectual assessment (WAIS-IV, WRAT-4, WIAT-II, etc) ______________________

2. Personality Assessment (MMPI, PAI, GADS, etc) ______________________

3. Standard Assessment Batteries (RBANS, BDAE,CVLT-II, etc) _____________________

4. Computerized Assessment Instruments (CPT-II, WCST, etc) _____________________

5. Psychometric construction and properties of tests assessed _____________________

6. Supervised Instruction on test administration and scoring _____________________

Objective 2: Foundational Knowledge of Neuropsychological Principles Completed

1. Readings in Neuropsychological Principles ______________________

2. Readings in Clinical Syndromes ______________________

3. Readings in Military Neuropsychology COD Class (12 weeks) ______________________

4. Readings in Ethical Principles ______________________


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Objective 3: Clinical Neuropsychological Evaluations Completed

1. 1-2 Neuropsychological evaluations weekly _______________

2. Clinical Neuropsychological Interviews _______________

3. 5 Learning disability evaluations _______________

4. 10+ ADHD Evaluations _______________

5. TBI Evaluations _______________

6. Stroke, CVA evaluations _______________

7. 5+ Geriatric/ Dementia evaluations _______________

8. Independent case conceptualization and formulation _______________

9. Consultation to patients and family _______________

10. Consultation to medical providers _______________

11. Case conference presentations _______________

12. Integrated Neuropsychological Reports _______________

13. Lectures/Presentations _______________

Objective 4: Supervision Completed

1. Number of Case Supervisions of intern or practicum students _______________

2. Provide input to curriculum for practicum student _______________


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Objective 5: Research or Project/Review Paper /Dissertation Completed

1. Project Title _______________

2. Proposal Presentation/Dissertation _______________

3. Faculty Update/ Approval (if applicable) _______________

4. Faculty Update _______________

5. Faculty Update _______________

6. Project Completion _______________

Core Training Activities Completed

1. Clinical Psychology Case Conferences (Dr. Paul Sather)

a. Attended 90% _______________

b. Presented 3 cases to trainees and staff _______________

APPENDIX 4: EDUCATIONAL AND TRAINING ACTIVITIES

The following training activities specific to the Neuropsychology Specialty Track

1. Neuropsychology Didactic Seminar (1 hour weekly) ________________

a. Attended 90%

b. Presented 3 cases to trainees and staff

2. Neuropsychology case presentations ________________

3. Teaching Assistant for Veterans Counseling Certificate Program, College of DuPage

________________________________________________________________________


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APPENDIX 5: List of Required Readings

I. The Little Black Book of Neuropsychology: A Syndrome-Based Approach (2011), Schoenberg &

Scott , Springer Publishing

1. The Neuropsychology Referral and Answering the Referral Question – 1

2. Deconstructing the Medical Chart – 39

3. Neuroanatomy Primer: Structure and Function of the Human Nervous System – 59

4. Components of the Neuropsychological Evaluation – 127

5. Arousal: The Disoriented, Stuporous, Agitated or Somnolent Patient – 139

6. Attention/Concentration: The Distractible Patient – 149

7. Language Problems and Assessment: The Aphasic Patient – 149

8. Memory and Learning: The Forgetful Patient – 179

9. Deficits in Visuospatial/Visuoconstructional Skills and Motor Praxis – 201

10. Frontal Lobe/Executive Functioning – 219

11. Affect, Emotions and Mood – 249

12. Aphasia Syndromes – 267

13. Cerebrovascular Disease and Stroke – 293

14. Dementias and Mild Cognitive Impairment in Adults – 357

15. Episodic Neurologic Symptoms – 405

16. Epilepsy and Seizures – 423

17. Neuropsychology of Psychogenic Nonepileptic Seizures - 521

18. SomatoformDisorders, Factitious Disorder, and Malingering – 551

19. Parkinson’s Disease and Other Movement Disorders – 567

20. Multiple Sclerosis and Other Demyelinating Disorders – 647

21. Moderate and Severe Traumatic Brain Injury – 663

22. Mild Traumatic Brain Injury – 697

23. Sport-Related Concussion – 721

24. Post-Concussion Syndrome – 745

25. Pediatric Traumatic Brain Injury (TBI): Overview – 765

26. Brain Tumors – 787

27. Neurotoxicity in Neuropsychology – 813

28. Cognitive Decline in Childhood or Young Adulthood – 839

29. Application of Motivational Interviewing to Neuropsychology Practice – 863

30. Reliability and Validity in Neuropsychology – 873

31. Psychometric Foundations for the Interpretation of Neuropsychological Test Results – 893

32. Improving Accuracy for Identifying Cognitive Impairment – 923


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II. PsychEssentials: A Pocket Resource for Mental Health Practitioners (2012), Sonne, American

Psychological Association

1. Initial Clinical Assessment Interview – 11

2. Standardized Screening Measures – 25

3. Structured and Semistructured Interviews – 43

4. Mental Status Examination – 47

5. Psychological Assessment Measures – 57

6. Clinical Assessment of Self-Harm and Interpersonally Violent Thoughts and Behaviors – 81

7. Risk Evaluation and Management of Self-Harm and Interpersonal Violence – 99

8. Child Abuse Reporting - 121

9. Reporting Abuse of Elderly and Dependent, Vulnerable, or Disabled Adults – 135

10. Duty to Protect: Reporting Client threat of Harm to Another – 151

11. Diagnosis – 163

12. Evidence-Based Interventions – 189

13. Psychopharmacotherapies – 197

14. Termination - 245

15. Records and Record Keeping – 251

16. Resources for Clinicians I: Professional Standards – 259

17. Resources for Clinicians II: Strategies for Self-Care and Managing Adverse Events – 287

18. Resources for Clients and Their Significant Others - 291

In addition to the above required books, the following are recommended books:

1. Neuropsychological Assessment, 4th edition Lezak, Howieson, & Loring

2. Principles of Behavioral and Cognitive Neurology (2000), Mesulam

3. A Compendium of Neuropsychological Tests, 3rd edition, Strauss, Sherman, & Spreen

4. The Mental Status Examination in Neurology, 3rd ed., Strub & Black 5. Neuroanatomy Through Clinical Cases (2002), Blumenfeld

6. Neuropsychiatry and Behavioral Neuroscience (2003) Cummings & Mega

7. Clinical Neuropsychology, 4th edition Heilman & Valenstein

8. Clinical Neuropsychology, 2nd edition, Snyder, Nussbaum, & Robins

9. Essentials of Neuropsychological Assessment (2002), Hebben & Milberg

10. Behavioral Neurology & Neuropsychology, 2nd edition, Feinberg & Farah

11. Manter and Gatz’s Essentials of Clinical Neuroanatomy and Neurophysiology, 10th edition,

Gilman & Newman 12. Clinicians Guide to Neuropsychological Assessment, 2nd edition, Vanderploeg

13. Handbook Of Normative Data for Neuropsychological Assessment, 2nd edition, Mitrushina,

Boone, Razani, & D’Elia

14. Forensic Neuropsychology, Fundamentals and Practice (1999), Sweet

15. Forensic Neuropsychology: a Scientific Approach (2005), Larrabee

16. The American Psychiatric Publishing Textbook of Traumatic Brain Injury, 2nd edition, Silver et al.


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17. Dementia: A Clinical Approach, 3rd edition, Mendez & Cummings

18. Neuropathology: A Reference Text of CNS Pathology, Ellison et al. (2003 edition)

19. A Textbook of Neuropathology, 3rd edition, Davis & Robertson 20. Adams and Victor’s Principles of Neurology, 8th edition. Ropper and Brown

21. Neuropsychological Assessment of Neuropsychiatric Disorders, 2nd ed (Sep 96) Grant and

Adams

22. Detection of Malingering During Head Injury Litigation (Critical Issues in Neuropsychology)

(1998) Reynolds

23. Aphasia (I 996) Benson and Ardila 24. Clinical Neurology for Psychiatrists, 6th edition (2006) Kaufman

25. Injured Brains of Medical Minds (1997) Kapur

Finally, graduate students may be assigned reading of selected journal articles.


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APPENDIX 6: Evaluation

Intern/Practicum Student Competency Evaluation

Internship/Advanced Practicum in Clinical Neuropsychology

Meier Clinics

Wheaton, Illinois

Neuropsychology Specialty Track

Student’s Name ____________________________ Date:__________________________

Supervisor: _______________________________ Quarter (1,2,3,4): ________________

Self evaluation Supervisor evaluation

Satisfactory rating indicates that student is currently making appropriate, expected progress toward

competency. Please provide comments on any item rated 1, 2, or 5. A rating of 1 or “fail” on any item

will require a remediation. Ratings of 2 or “Needs Improvement” may result in a remediation plan,

depending on the judgment of the supervisor.

(DK = Don’t Know, NA = Not Applicable)

A. Objective 1 – Advanced Practice Skills and Knowledge

Ethical Behavior: Behavior is consistently ethical and reflects a mature understanding of ethical

principles.

Fail Needs Improvement Satisfactory Above Average Exceptional DK/NA

1 2 3 4 5


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Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Ethical/Legal Knowledge: Aware of ethical and legal issues and can articulate ethical dilemmas.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Cultural Competency: Demonstrates sensitivity to issues of diversity and takes into account cultural

issues in the delivery of services.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________


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Professional Responsibility: Maintains schedule as agreed; follows Meier Clinics procedures; relates well

with staff, support staff, fellow students, and other professionals; maintains professional behavior with

others; handles clinic details.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Written Material: Maintains records as required by site, in a timely manner. Please note what records

are required; e.g., progress notes, assessment reports, case and termination summaries.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Professional Writing: Well organized, clearly written, with meaningful content, and appropriate to

referral question/presenting problem.


1 2 3 4 5


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Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Professional Consultation: Communicates information effectively with other professionals in a concise

and understandable manner.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_

B. Objective 2 – Specialty Competencies: Neuropsychology

Knowledge: Demonstrates acquisition of the knowledge required for advanced training in Clinical

Neuropsychology to include (a) general neuropsychological principles, (b) developmental principles, (c)

clinical syndromes, (d) treatment and rehabilitation, (e) neuroanatomy/neurophysiology, (f)

neuropathology, (g) clinical neurology/neuroimaging, (h) and military application of neuropsychology.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________


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Testing and Measurement: Demonstrates a high level of expertise in broad state-of-art Clinical

Neuropsychological assessment techniques and be familiar with psychometric properties of each of the

tests and assessment techniques.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Evaluations: Demonstrates a high level of professional expertise in the conduct of Clinical

Neuropsychological evaluations, in differential diagnosis, clinical interviewing and in case formulation

based on contemporary clinical practice.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Teaching and Consultation: Develop professional consultation skills and the ability to provide lectures

and information on neuropsychological issues.



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1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Supervision: Obtained skills in supervision of junior trainees and provides input in the development of

training curriculum for those trainees.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

C. Objective 3 - Research & Scholarly Inquiry

Research: Developing the capabilities need to initiate and carry out scholarly inquiry and independent

programmatic research.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________


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_____________________________________________________________________________________

D. Objective 4 – Knowledge of Evidenced Based Practice

Fund of Knowledge: Demonstrates an appropriate use of current literature and an advanced knowledge

of the scientific basis for clinical psychological assessment and intervention.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

E. Objective 5 – Professional Development

Supervision and Teaching: Developing teaching or supervisory skills when experience is available.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________


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Professional Development: Takes advantage of opportunities for additional training events/conferences

outside of required fellowship activities.


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Professional Activities: Participates in professional or community activities to facilitate advancement of

professional identity (teaching assistant for College of DuPage class in Assessment of PTSD, TBI & Co-

Morbid Disorders; community volunteer activities).


1 2 3 4 5

Comments____________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Additional

Comments:___________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________


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_____________________________________________________________________________________

_____________________________________________________________________________________

Signatures:

_______________________ _______________________

Intern/Advanced Practicum Student Date

_______________________ _______________________

Supervisor Date

_______________________ _______________________

Director of Training Date

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