Clinical Neuropsychologist最新文献

Objective: During the past several decades, work has been ongoing to establish specialty-specific competencies for clinical neuropsychology. However, there is a lack of corresponding evaluation tools that link broad competency areas to directly observable behaviors that are required for advancement or completion at different points in training. The objectives of this manuscript are to: (1) briefly review the development of clinical neuropsychology competencies, (2) describe essential components of competency-based evaluation in clinical neuropsychology, focusing on the postdoctoral fellowship level because that is the typically the last formal opportunity to evaluate trainee knowledge and skills prior to independent practice, (3) describe how to implement evaluation policies and procedures to support fellow competency development and program quality improvement, and (4) provide revised example evaluation forms that can be widely used or adapted for postdoctoral fellow assessment and program evaluation. Method: The APPCN workgroup that was initially tasked with developing competency-based assessment tools that could be adapted for widespread use among programs sought feedback from program directors on an initial evaluation tool and conducted a survey regarding current evaluation policies and procedures in clinical neuropsychology fellowship programs. Subsequently, the tool was revised, and the updated recommended evaluation policies and procedures are outlined in this manuscript. Conclusions: The proposed evaluation tools and sequence of assessment during the fellowship period can be widely used and/or adapted among clinical neuropsychology postdoctoral fellowship training programs. Such assessment tools are essential to demonstrate readiness for independent clinical neuropsychology practice.

Objectives: Theoretical models of cross-cultural neuropsychology and practice have seen a rapid increase over the last several years. Yet while much progress has been made from a theoretical perspective, little has been said about the practicality of implementing such programs. Neuropsychology with vulnerable populations often demands more time for less reimbursement. Method: We propose to blend the need for robust and nuanced multicultural neuropsychology with innovative practical training. Community-oriented training programs led by trainees reduce the burden of billing and productivity, while increasing access and teaching complex concepts such as building partnerships, developing programs, and honing cross-cultural clinical skills. Results: The authors discuss two programs built on this model. First the graduate-level HopeWorks program to provides neuropsychology care to unhoused adults in New Mexico and second the Salud Para Niños neuropsychology program to provide care to Spanish-speaking children in Pennsylvania. They also discuss the need for supervision of bilingual trainees by monolingual supervisors and the use of tele-supervision. Conclusions: The authors propose that the success of these programs will encourage supervisors to establish new training rotations to serve their communities' most vulnerable members while providing valuable training experiences and robust supervision.

Introduction: In February 2023, a work group began to develop a new North American organization in neuropsychology to represent and support practicum-training sites. While other training-focused organizations such as the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) and the Association of Internship Training in Clinical Neuropsychology (AITCN) have existed for many years, no organization exists to promote and support practicum level training outside of doctoral degree programs. The work group developed such an organization, subsequently named the North American Association of Practicum Sites in Neuropsychology (NAPSN), beginning with a mission statement and general purpose of the organization. Methods: The work group divided members into five task forces focused on various tasks needed to start the organization, including Mission/Vision, Administrative Structure, Membership, Financials, and Bylaws. The entire work group met monthly with additional meetings and work via email for the various task forces, which resulted in the development of a mission statement and bylaws, as well as a framework for program administration, membership requirements and financial needs. Conclusions: The group developed NAPSN primarily as a resource to support diverse practicum programs in urban, suburban, and rural areas in the US and Canada to provide optimal graduate level clinical training in neuropsychology. Didactics aimed specifically at practicum students was one need identified early in the process. NAPSN is developing a website-based resource in collaboration with other training organizations to increase the didactic offerings to practicum students. Other initiatives and collaborative efforts will be undertaken over time as circumstances warrant.

Objective: The Houston Conference Guidelines (Hannay et al., 1998) provided an initial framework for North American neuropsychology training that served the specialty well for several decades. Subsequent advances in technology, increased diversity of the U.S. and Canadian populations, and the adoption of competency-based training models within Health Service Psychology have created a need to update neuropsychology training guidelines. Therefore, in 2022, the Minnesota Conference to Update Education and Training Guidelines in Clinical Neuropsychology began a two-year drafting process leading to the currently proposed update.

Method: A Steering Committee worked with content experts, consultants, and delegates representing North American neuropsychological organizations and specialists. The final version of the guidelines was developed after reviewing neuropsychological training literature, gathering feedback from specialists, and making iterative revisions of earlier drafts to reach consensus.

Conclusion: The resulting "Minnesota Guidelines" include five foundational (Neuroscience and Brain Behavior Relationships; Integration of Science and Practice; Ethics, Standards, Laws, and Policies; Diversity; and Professional Relationships) and eight functional (Assessment; Intervention; Interdisciplinary Systems and Consultation; Research and Scholarship; Technology and Innovation; Teaching, Supervision, and Mentoring; Health and Professional Advocacy; and Administration, Management, and Business) areas of competency required for entry level specialty practice. While consensus was not achieved, a majority of voting delegates recommended the Guidelines for adoption and the Guidelines have been endorsed by six neuropsychology education and board certification organizations. The American Academy of Clinical Neuropsychology has not endorsed the Minnesota Guidelines and will not make an endorsement decision until three months after online publication.

Objective: To provide guidance for implementation of the Minnesota Conference Guidelines (MNC Guidelines) within doctoral, internship, post-doctoral fellowship, and continuing education programs. The development and maintenance of competencies in clinical neuropsychology is the goal of combined training at these four levels. In this paper, implementation guidance uses terminology consistent with the current Clinical Neuropsychology Taxonomy and current competency development concepts in the specialty.

Method: Delegates to the Minnesota 2022 Update Conference on Education and Training in Clinical Neuropsychology (MNC) were invited to participate in the drafting of this document. The MNC Steering Committee organized this process. Delegates were formed into four drafting teams (Doctoral, Internship, Fellowship, and Continuing Education), each with a Team Lead. Teams provided initial drafts that identified training opportunities at each level and provided example training activities to address the 13 MNC Guidelines competencies. The manuscript's lead authors (SC, AYS, RB) then edited and integrated these drafts and worked iteratively with Team Leads to produce the current document.

Results: The paper provides a conceptual framework for the MNC Guidelines, addresses supervision across training levels, discusses training activities that can be implemented to address the MNC Guidelines competencies, and discusses potential challenges to that implementation. The learning activities contained in these guidelines draw heavily upon existing training methods that are already in wide use across the specialty of clinical neuropsychology.

Conclusion: These Implementation Guidelines are intended to provide training programs and individuals with non-prescriptive guidance on training activities designed to develop and maintain competency across all 13 of the MNC competencies.

Objective: While previous survey research has focused on various training constituencies such as trainees, and postdoctoral/internship supervisors, no previous survey research has examined the needs and perspectives of practicum level supervisors and training programs. This study was designed to address this limitation. These results were used in forming the North American Association of Practicum Sites in Neuropsychology (NAPSN). Method: A 41-item survey was developed and distributed to practicum supervisors across the United States and Canada via listserv. A total of 142 supervisors completed the survey; the majority were employed at academic medical centers (62%) and located in the U.S. (93%). Most participants evaluated adults (61%), while a minority evaluated children (27%), or patients across the lifespan (12%). Results: Most respondents supervise one (44%) or two (26%) students per year and prefer advanced trainees (>90%). The majority (78%) indicated students see one case per week. The number of clinical contact hours and reports varied based on location (U.S. vs. Canada) and population (adult vs. pediatric). Supervisors found professional papers and publicly available didactics to be the most helpful resources. Commonly endorsed needs included help with policies and procedures (53%), supervising trainees from underrepresented groups (49%) and nontraditional backgrounds (44%), and access to didactics (49%). Conclusions: The survey provided insights into current practices and the needs of practicum supervisors. These findings will inform NAPSN's development of materials and policies to support trainees and supervisors and can guide other professionals in supporting their practicum trainees as they navigate training in neuropsychology.

Objective: Effective feedback is necessary for professional growth. However, guidelines and strategies for the delivery of competency-based feedback are not well-established in the field of neuropsychology. Even more complex is managing situations in which trainees require extra support; namely, developing and implementing remediation plans to help trainees to meet their benchmark competencies. Method: A critical review of the existing literature on feedback and remediation for medical and psychology trainees. Conclusion: We draw on the existing medical and psychology literature to help training directors, programs, and supervisors in clinical neuropsychology establish best practices in feedback and remediation.

Objective: The Houston Conference Policy Statement established an integrated model of training for clinical neuropsychologists and has been widely implemented. However, developments and needs related to professional competencies, cultural/linguistic diversity, and technology prompted the need to update training guidelines. In 2021, an interorganizational Planning Commission (PC), with Commissioners from 17 organizations within clinical neuropsychology, was formed to develop a process by which training guidelines would be comprehensively updated via the Minnesota 2022 Conference to Update Educational and Training Guidelines in Clinical Neuropsychology, held 12-16 September 2022.

Method: The PC met virtually from June 2021 through August 2022, and responsibilities included conference site selection, fundraising, Delegate selection, and conference goals, schedule, and policies. The PC also defined the roles and responsibilities for the conference and subsequent activities among the Delegates, Steering Committee, and Content Panels.

Conclusion: The PC set the stage for the participants of the Minnesota Conference to undertake a generational updating of training guidelines. The 25 years since the Houston Conference and the long process of completing the Minnesota guidelines underscore the need to update training guidelines with greater frequency.

Objective: The Minnesota Conference (MNC) Guidelines for Education and Training in Clinical Neuropsychology reflect the specialty's effort to create competency-based training standards aligned with current and future needs. This article summarizes delegate perspectives on the MNC guideline revision process to inform future updates. Method: A feedback survey was distributed to all 55 delegates from June 12-22, 2025. Delegates rated their satisfaction with four aspects of the process: the in-person conference, post-conference writing process, Steering Committee communication, and the delegate role in the writing process. Open-ended feedback was collected and analyzed thematically. The authors (who are delegates) have also integrated reflections throughout the article. Results: The survey received 34 responses (62%). Satisfaction varied across the four domains queried, with the in-person conference receiving the highest satisfaction ratings (59% of respondents reported feeling "satisfied" or "very satisfied") and communication from the Steering Committee receiving the highest dissatisfaction ratings (50% of respondents reported feeling "dissatisfied" or "very dissatisfied"). In addition to several strengths, a recurring recommendation was a desire for increased transparency during the post-conference writing phase and improved communication throughout the entire process. Conclusions: The MNC revision process included years of planning and organization led by the Planning Commission and Steering Committee and was a herculean task that deserves tremendous praise. The present article highlights several strengths of the revision process, challenges regarding procedure and communication, and provides constructive feedback for future revisions. The authors believe these guidelines will advance the field and are optimistic that the recommendations provided can support future guidelines revision efforts.

Objective: This systematic review aimed to assess the neuropsychological, cognitive, and behavioral outcomes in children and adolescents with drug-resistant epilepsy undergoing resective surgery. While epilepsy surgery is often effective in achieving seizure control, post-operative outcomes across neuropsychological, cognitive and behavioral domains remain variable and require further investigation.

Method: Using advanced search terms, a systematic review of electronic databases was conducted, comprising PubMed, PsycINFO, and Scopus. Studies published from January 2010 to March 2025 were included if they involved pediatric patients (≤18 years) undergoing resective epilepsy surgery and reported pre- and/or postoperative neuropsychological, cognitive, or behavioral outcomes. Data were synthesized qualitatively due to study heterogeneity.

Results: Twenty-six studies met the inclusion criteria. Global cognition was generally stable or improved. Verbal memory declined after left temporal resections, while visuospatial and attention deficits were reported after posterior resections, although laterality of resection was not consistently specified. Executive and behavioral improvements were more common in seizure-free patients. Outcomes varied by age at surgery, epilepsy duration, seizure control, and resection extent.

Conclusions: While epilepsy surgery in pediatric populations can lead to neuropsychological, cognitive and behavioral improvements, outcomes remain heterogeneous, reflecting both variability in clinical presentation and the current state of evidence. The available evidence highlights the need to improve methodological quality and reporting standards. Well-designed prospective multicenter trials with adequate follow-up for long-term outcomes are essential to accurately assess outcomes. Establishing standardized core outcome measures across centers would facilitate higher quality evidence and support more informed decision-making for clinicians, patients, and families regarding surgical intervention and expected post-operative trajectories.