Back to our future? The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology

Is it possible and advisable for the profession of psychology to articulate and endorse a common, generalist, and integrative framework for the education and training of its students? At the Consensus Conference on Combined and Integrated Doctoral Training in Psychology, held at James Madison University in Harrisonburg, VA (USA), May 2 to 4, 2003, participants from across the spectrum of education and training in professional psychology ultimately answered "yes." This article, the first in this special series on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology, essentially provides an overview of the conference rationale, participants, goals, proceedings, and results. Because the other 12 articles in this series all reference the Consensus Conference and C-I model, this overview provides a good starting point for understanding what occurred at the conference, what it means to educate and train from a C-I perspective, and what the potential implications of such a model might be for the profession of psychology.     

Interprofessional collaboration: implications for Combined-Integrated doctoral training in professional psychology

Interprofessional collaboration (IPC) is becoming "best practice" in the field of professional psychology and other health care professions. It was named as a core competency at Competencies 2002 and the Consensus Conference and has been endorsed by the American Psychological Association on several occasions. The authors provide a definition of IPC, present conceptual, scholarly, and pragmatic support for IPC, and offer guidance on how Combined-Integrated (C-I) doctoral programs in professional psychology can include IPC to ensure students are well equipped to respond to a client's complex needs. Furthermore, although C-I programs might be particularly well prepared to incorporate IPC into their training, it is argued that programs in the single practice areas of clinical, counseling, and school psychology also may benefit from the inclusion of IPC.     

Recommendations for incorporating palliative care education into the acute care hospital setting.

This article presents recommendations for improving the education of physicians about end-of-life care in the acute care hospital setting. The authors, who have a variety of backgrounds and represent several types of institutions, formulated and reached consensus on these recommendations as members of the Acute Care Hospital Working Group, one of eight working groups convened at the National Consensus Conference on Medical Education for Care Near the End of Life in May 1997. A recently published literature review on the status of palliative care education, a summary of recent research on education about end-of-life care, and expert opinion were helpful in developing the recommendations. The authors emphasize that the acute care setting offers many opportunities for education about care at the end of life. Faculty should support learners' appreciation of the importance of end-of-life care, and convey the meaning and privilege of attending to patients and families at this difficult time. Faculty should teach students and residents to provide care that embodies attention to the control of distressing physical, physiologic, and spiritual symptoms, appropriate awareness of patients' differing cultural backgrounds and their impact upon the experience of dying, excellent communication skills, the application of bioethical principles, timely referral and smooth transition to other care settings that meet patient and family goals, and the role of the interdisciplinary team in meeting the diverse needs of dying patients and their families.     

The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology--overview of part 1: nature and scope of the Combined-Integrated model

This special series of articles on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology consists of 13 articles in two successive volumes of the Journal of Clinical Psychology. Six articles are presented in Part 1 (Vol. 60, Issue 9), which collectively describe the "nature and scope" of the C-I model (e.g., historic and definitional issues; the potential advantages of this model; implications for the profession). In Part 2 of this special series (Vol. 60, Issue 10), articles 7 through 12 address the broader implications and potential applications of the C-I model within a range of professional and societal contexts (e.g., for interprofessional collaboration; the health care field; development of a global curriculum; the unified psychology movement; issues of assessment and professional identity; and higher education); article 13 provides a summary of the series as well as a discussion of future directions. As an overview, this paper provides the abstract for each of the articles in Part 1, and describes the various topics of the articles in Part 2. Taken together, the articles in this special series are designed to provide a coherent account of how and why the C-I model is timely and relevant, and therefore warrants serious consideration by the larger education and training community in professional psychology.     

Beyond consensus: a summary of the special series and future of the Combined-Integrated model

The articles that comprise this Special Series offer a comprehensive examination of the results and implications of the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology (see Shealy, Cobb, Crowley, Nelson, & Peterson, 2004). Given the scope of this effort, it may be helpful to provide a summary of the 12 preceding articles. Such a presentation should illustrate the complementarity of the diverse perspectives presented in this series, the essential coherence of this innovative and compelling model of education and training, and its timely relevance for the future of professional psychology. Following a summary of these articles, eight "future topics for discussion" also are presented.     

The clinician's view: role of human papillomavirus testing in the American Society for Colposcopy and Cervical Pathology Guidelines for the management of abnormal cervical cytology and cervical cancer precursors

The American Society for Colposcopy and Cervical Pathology (ASCCP) National Consensus Conference for the Management of Women With Cervical Cytological Abnormalities and Cervical Cancer Precursors was held on the National Institutes of Health campus in Bethesda, Md, September 6-8, 2001. The conference was attended by 121 representatives from 29 national organizations interested in cervical cancer screening issues. For the first time, guidelines for the management of women with abnormal cervical cytology, developed from evidence-based literature, were presented to delegates from the majority of organizations with interest in cervical cancer screening, voted on, and revised when necessary to achieve a majority two-thirds approval. This development of consensus-approved guidelines is likely to be considered one of the most important milestones to date in the management of women with abnormal cervical cytology. The timing of this Consensus Conference resulted from the convergence of many different factors, including new cytologic terminology developed at the Bethesda 2001 workshop and publication of the enrollment data from the National Cancer Institute's Atypical Squamous Cells of Undetermined Significance (ASC-US)/Low-Grade Squamous Intraepithelial Lesions (LSIL) Triage Study, otherwise known as ALTS. Additionally, new preliminary longitudinal ALTS data provided much of the information on the natural history of abnormal Papanicolaou tests and cervical intraepithelial neoplasia (CIN), as well as data on the performance of both new liquid-based cytology and human papillomavirus (HPV) DNA testing in the management of women following colposcopy. The result was a large database of new information that provided the foundation for the ASCCP Consensus Conference. This article covers only the recommendations of the ASCCP Guidelines that were based in large part on the results of the ALTS trial. Therefore, the focus is on the management of women with equivocal (ASC-US) and low-grade (LSIL) cytologic abnormalities. Management of women with these cytologic abnormalities has been particularly problematic, because individually these women are at least risk for CIN 3 and cancer, yet their sheer numerical dominance ensures that they account for the majority of high-grade CIN detected in the United States in the follow-up of abnormal cervical cytology. Data from ALTS confirmed that women with ASC-US could be safely managed by any of the conventional approaches (repeat Papanicolaou test, immediate colposcopy, or HPV testing), but that the preferred management approach for women having an ASC-US report from liquid-based cytology was to assess the patient's risk by testing for HPV. Additionally, longitudinal ALTS data determined that repeat liquid-based cytology at 6 and 12 months and an HPV test at 12 months were nearly equivalent options in the follow-up of women referred for HPV-positive ASC or LSIL, yet not found to have CIN 2+ at initial colposcopy. Therefore, all follow-up recommendations for women with CIN 1 or lower postcolposcopy findings include these 2 options. The data and the recommendations for the management of ASC-US, ASC cannot exclude high-grade squamous intraepithelial lesion, and LSIL are discussed.     

Sepsis and the theory of systemic inflammatory reaction is an attempt of clinicomorphological consensus

The authors propose to put the 1991 US Consensus Conference criteria for sepsis into practice and research methodology. This will be helpful in reaching the consensus in definitions.     

A model and method for "making" a Combined-Integrated psychologist: equilintegration (EI) theory and the beliefs, events, and values inventory (BEVI)

Although the Consensus Conference on Combined and Integrated Doctoral Training in Psychology (e.g., Bailey, 2003) generated much content of relevance to the structure and commitments of Combined-Integrated (C-I) programs, faculty, and students-and Competencies 2002: Future Directions in Education and Credentialing in Professional Psychology (www.appic.org) developed language and guidelines regarding the knowledge areas, skills, and values that students in professional psychology programs should acquire and demonstrate-specific models and methods are necessary to translate these professional guidelines and aspirations into reality. This article offers one such model, Equilintegration (EI) Theory, and method, the Beliefs, Events, and Values Inventory (BEVI), that can be used by faculty, training staff, supervisors, and students in C-I programs to operationalize, assess, and cultivate basic values of education and training from a C-I perspective (e.g., self-awareness, self-assessment, and self-reflection). In addition to this model and method, relevant background information, theory, and research are presented along with attendant implications, hypotheses, and principles.     

Health status of adolescents and modern approaches to holding medical professional consultations

Due to unfavorable trends in the health state of contemporary children and teenagers, the total number of young males and females, who have health-related limitations in educational and occupational spheres, went up to 80%. A medical professional consultation belongs to a system of measures, whose purpose is to assist the young males and females with impaired health to choose professions or occupations, which would maintain their health intact and promote successfully their adaptation to professional training conditions and subsequently to actual occupational conditions. A timely and high-skilled implementation of medical professional consultations with a subsequent rational employment of teenagers and youth with impaired health should be regarded as a secondary prevention of pathologies. The holding of such medical professional consultations for teenagers is reasonable both at the stage, when a teenager makes his or her choice of a job (i.e. at school), and at the stage of receiving a professional education, so that the schoolchildren and students could get a job in line with their health status and that they could be employed with respect to doctor's recommendations. The Research Institute for Children's Health elaborated a number of methodological and regulating documents to promote the efficiency of the medical professional consultations; an automated assessment system is in the process of construction at the above institution.     

New strategies for higher professional education.

Since the original recommendation in 1968 for a period of higher professional education, the development of this form of education has been slow. However, in 1990 a working party was established by the education division of the Royal College of General Practitioners to report on higher professional education. This paper describes some of the early work of the working party and its recommendations with particular emphasis on educational strategies, assessment and accreditation. A flexible, learner centred approach needs to be developed to encourage autonomy. Educational strategies are described which value previous experience and allow for a shift of responsibility for learning from the teacher to the learner.     

Design and Patient Characteristics of the Chronic Graft-versus-Host Disease Response Measures Validation Study

In 2014, the National Institutes of Health sponsored the second Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease (GVHD). The purpose was to update recommendations about key elements of chronic GVHD research, including definitions for diagnosis, severity scoring, and response measures, based on empirical data published since the first 2005 Consensus Conference. The most significant modifications were to the response assessments, based on studies demonstrating difficulty with the first consensus definitions. The Response Measures Validation Study is a multicenter, prospective cohort study of patients who are starting initial or subsequent treatments for chronic GVHD. The aim of the study is to evaluate the performance of the 2014 response measures and determine whether any other combination of assessments is superior. Clinical data, clinician assessments, patient-reported outcomes, and research samples are collected at enrollment and 3, 6, and 18 months later, and whenever another chronic GVHD systemic treatment is added. The target enrollment of 368 evaluable patients from 12 transplantation centers has been reached. This report describes the rationale, design, and methods of the Chronic GVHD Response Measures Validation Study, and invites other investigators to collaborate with the Consortium to analyze data or specimens.     

4e Conférence internationale sur les envenimations par morsures de serpent et piq?res de scorpion en Afrique : Dakar, 25–29 avril 2011

The authors present a summary of the proceedings and the recommendations of the Fourth International Conference on Envenomations by Snakebites and Scorpion Stings in Africa, held from 25 to 29 April 2011 in Dakar. After a two-day workshop for Senegalese health personnel on the most relevant aspects of the management of envenomations, about 270 participants met to share their experiences in the field. Nearly a hundred oral and poster presentations were made on the epidemiology of snakebites and scorpion stings in Africa, the composition and action of venoms and the manufacture and use of antivenoms. The last day was devoted to an institutional debate involving experts, representatives of national health authorities and concerned professionals (physicians, pharmacists, nurses and traditional healers) as well as members of the pharmaceutical industry to discuss and elaborate a set of recommendations. It was agreed that it is necessary to improve knowledge of the epidemiological situation by case reporting. Quality control of antivenoms and procedures for their registration at the level of national health authorities should aim at improving the distribution of safe and effective antivenoms in peripheral health centers for the better assessment of victims. It was also recommended that adequate training should be provided for health personnel in all aspects of medical management of envenomations. Equitable distribution of funding and the establishment of a network of African experts were also discussed in the conference.     

A Decade of Research on the Use of Three-Dimensional Virtual Worlds in Health Care: A Systematic Literature Review

Background

A three-dimensional virtual world (3DVW) is a computer-simulated electronic 3D virtual environment that users can explore, inhabit, communicate, and interact with via avatars, which are graphical representations of the users. Since the early 2000s, 3DVWs have emerged as a technology that has much to offer the health care sector.

Objective

The purpose of this study was to characterize different application areas of various 3DVWs in health and medical context and categorize them into meaningful categories.

Methods

This study employs a systematic literature review on the application areas of 3DVWs in health care. Our search resulted in 62 papers from five top-ranking scientific databases published from 1990 to 2013 that describe the use of 3DVWs for health care specific purposes. We noted a growth in the number of academic studies on the topic since 2006.

Results

We found a wide range of application areas for 3DVWs in health care and classified them into the following six categories: academic education, professional education, treatment, evaluation, lifestyle, and modeling. The education category, including professional and academic education, contains the largest number of papers (n=34), of which 23 are related to the academic education category and 11 to the professional education category. Nine papers are allocated to treatment category, and 8 papers have contents related to evaluation. In 4 of the papers, the authors used 3DVWs for modeling, and 3 papers targeted lifestyle purposes. The results indicate that most of the research to date has focused on education in health care. We also found that most studies were undertaken in just two countries, the United States and the United Kingdom.

Conclusions

3D virtual worlds present several innovative ways to carry out a wide variety of health-related activities. The big picture of application areas of 3DVWs presented in this review could be of value and offer insights to both the health care community and researchers.     

Communication teaching and assessment in medical education: an international consensus statement. Netherlands Institute of Primary Health Care

The importance of communication between doctors and patients has been well established, and there is growing acceptance of the need to teach and assess communication skills in medical schools. Faculty meeting at a consensus workshop during the International Conference on Teaching Communication in Medicine (Oxford, July 1996) generated a series of recommendations for developing and implementing teaching and assessment programmes. The points were refined in subsequent discussions with other interested groups, and endorsed in their current form by a workshop of teachers attending the Communication in Health Care Conference organized by NIVEL, the Netherlands Institute of Primary Health Care (Amsterdam, June 1998). While focused on medical schools, the eight recommendations highlighted in this consensus statement are also relevant to both graduate and continuing medical education programmes: (1) teaching and assessment should be based on a broad view of communication in medicine; (2) communication skills teaching and clinical teaching should be consistent and complementary; (3) teaching should define, and help students achieve, patient-centred communication tasks; (4) communication teaching and assessment should foster personal and professional growth; (5) there should be a planned and coherent framework for communication skills teaching; (6) students' ability to achieve communication tasks should be assessed directly; (7) communication skills teaching and assessment programmes should be evaluated; (8) faculty development should be supported and adequately resourced.     

Secure e-Health: managing risks to patient health data

e-Health, as an inter-jurisdictional enterprise, presents risks to patient health data that involve not only technology and professional protocols but also laws, regulations and professional security cultures. The USA Patriot Act is one example of how national laws can shape these concerns. Secure e-Health therefore requires not only national standardization of professional education and protocols but also global interoperability of regulations and laws. Some progress in this regard has been made in the European context; however, even here developments are incomplete, and nothing similar has been accomplished on a global scale. Professional health information organizations must take the lead in developing appropriate high-level principles for professional certification and security protocols and in harmonizing these on a global basis, so that they can provide a firm and consistent foundation for international treaties. Such developments should occur in concert with other health professions, so that coordinated requirements are integrated into revisions of the relevant codes of ethics. This presentation identifies and addresses some of the ethical and legal issues and proposes a series of recommendations.     

Prognostic factors in prostate cancer. Key elements in structured histopathology reporting of radical prostatectomy specimens

Prostate cancer is the most common visceral cancer and the second most common cause of cancer death in males. The number of radical prostatectomies performed each year is increasing and accurate data from the histopathological examination of these specimens aid clinicians in stratifying patients for surveillance and adjuvant therapies. This review focuses on the histopathological prognostic factors which should be routinely recorded in pathology reports and complements the Royal College of Pathologists of Australasia Structured Reporting Protocol for Prostate Cancer (Radical Prostatectomy). Such structured pathology reports have been shown to significantly enhance the completeness and quality of data provided to clinicians. The review also discusses the International Society for Urological Pathology Consensus Conference recommendations which were published recently.     

Recommendation: National Conference on Training Clinical Child Psychologists

The final recommendations adopted by the National Conference on Training Clinical Child Psychologists hem at Hilton Head Island, South Carolina, on May 15-18, 1985, are presented. Recommendations are for three levels of training: academic, internship, and postdoctoral/continuing education.