teaching pre-doctoral psychology interns to train/supervise first year family practice residents on...
TRANSCRIPT
Teaching Pre-Doctoral Psychology Interns to Train/Supervise First
Year Family Practice Residents on Behavioral Health Theory and Issues Through a Half-Day 12
Week Seminar Format
George Hurley, PhD, R PsychInternship Training Director, University Counselling Centre, Memorial University of Newfoundland, Canadawww.mun.ca/counselling/internship
History of the Interdisciplinary Training Program at the MUN
Counselling Centre• 1981 - First Family Practice Resident at the
Counselling Centre• 1981 - First interdisciplinary practicum at the
Centre• 1983 - Start of Family Practice Residents’
Training Program at the Counselling Centre• 2004 - Doctoral psychology interns begin
teaching/supervising the seminar• 2009 - About 500 family practice residents have
participated in the seminar at the Centre
Assumptions of the Program
• The helping professions are more alike than different in a number of areas.
• Trainees, regardless of discipline, struggle through much the same process of growth and development . (Hurley and Schoenberg, 1983)
• Common training experiences promote an increased understanding of shared as well as differing perspectives. (Hurley, 1986)
Program Structure
• 1st year Requirement of FPU rotation • 12 week Wednesday morning seminar
- baseline standardized patient- review two patient videotapes- participate in seminar discussion- pre-post learning goals review- pre-post interviewing skills self
assesment
Standardized Patient Evaluation
• Standardized Patient Grading• Scale: 1 = Poor; 2 = Adequate; 3 = Good; 4 = Very Good; 5 = Excellent
• Introduced Self and greeted you warmly using your name • Demonstrated courteous and professional behavior • Language: non-jargon; easily understood • Explored your expectations of care• Elicited and responded to the main points of your concerns • Demonstrated active listening by using the techniques of restatement, reflection and
clarification • Perceived a sensitive and caring attitude to your needs and• feelings; acknowledged your emotions • Checked your level of understanding of your illness, treatment etc.• Instilled a sense of confidence in their ability and/or desire to help you and eased
your concern • Rate your satisfaction with this Patient-Doctor encounter • Comments:
Typical SP baseline rating
Seminar ContentSession Topics
New ParticipantsIntroduction to IPR, Session Topics, Participant Record, IPR Inquiry Leads, Four Active Listening Skills, George Hurley’s IPR Heuristics
Week 1Transference/Counter transference
Week 2Stages of ChangeMotivational Interviewing I
Week 3Motivational Interviewing II
Week 4Solution-Focused Counselling I
Week 5Solution-Focused Counselling II
Seminar Content: ContinuedWeek 6
Depression & Cognitive-Behavioural Therapy (CBT) IWeek 7
Depression & Cognitive-Behavioural Therapy (CBT) IIWeek 8
Grief & BereavementWeek 9
Gender & Diversity IssuesWeek 10
Couples CounsellingWeek 11
Personality Disorders/Difficult PatientsWeek 12
Stress Management & Self-Help Resources
IPR SeminarParticipant Record
Participant Name:_________________________________________________Residency, Practicum, or Internship: ____ Family Medicine ____ MEd in Counselling Psychology ____ MN ____ MSW ____ PhD or PsyD in Psychology ____ Psychiatry Self-identified areas of interpersonal interviewing strength:1. ______________________________________________________________2. ______________________________________________________________3. ______________________________________________________________Self-identified growth areas in interpersonal interviewing:1. ______________________________________________________________2. ______________________________________________________________3. ______________________________________________________________Personal education plan for IPR seminars (learning goals for the 12 weeks):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Participant Record: cont.Participant Summary of 12-Week IPR Seminar
• what I feel that I accomplished vis-à-vis my learning goals• what I will continue to address as learning growth edges• how the seminars might be enhanced for future participants
Comments by IPR Facilitator• Final Appraisal: ____ Satisfactory ____ Unsatisfactory• Participant: _______________• IPR Facilitator: _______________• Date: _______________
Typical Interdisciplinary Training Issues
Unfamiliarity with other disciplines– Different languages– Lack of exposure to other trainees– Assumed power differentials– Assumed criticisms– Negative alliances training history
• Us vs. them
Typical Interdisciplinary Training Tasks
Finding mutual ground & developing empathy for one another– Role struggles
• Work hours• Salaries• Trainee status
– Complementary perspectives synergies – Mutual problem solving
Interdisciplinary Training Goals
Forging Positive Alliances– Short term alliances
• Socializing together• Informal consultations
– Medium term alliances • Referrals to one another
– Long term alliances• Setting up multidisciplinary practices
Competencies required by psychology interns to train FP
residents
Supervision experience– Supervise practicum students
UCC experience– Comfort with interdisciplinary environment
• Working with other residents one-on-one
Practical strategies for training interns to supervise residents
Agency Factors:
- Model a positive interdisciplinary environment with faculty/staff hirings.
- Develop interdisciplinary case conferences
- Cross refer and consult regularly with interdisciplinary colleagues
Training Strategies
• Get psychology interns facilitating medical students’ learning
• Let interns see medical students as clients
• Have interns supervise graduate students
• Have interns initially co-facilitate residents’ seminars with faculty/senior staff
• Have interns train/supervise residents towards the end of internship
ReferencesHurley, G., & Garland, J. (Eds.). (1988). Introduction to Medical
Interviewing, St. John's, Newfoundland: University Counselling Centre, Memorial University of Newfoundland.
Hurley, G. (Ed.) (1986). Teaching family practice residents counseling skills in a university counseling centre. Inter national Association of Counselling Services Monograph Series, No. 2. Alexandria, VA: IACS.
Hurley, G. and Schoenberg, B. M. (1983). Interdisciplinary practicum training at a university counselling centre [Summary]. Proceedings of the 1983 Canadian Association of College and University Student Services National Conference, 20.