The Neuropsychology Fact-Finding Casebook: A Training Resource

The Neuropsychology Fact-Finding Casebook: A Training Resource Although fact-finding exercises are becoming increasingly common as a way to assess competency in neuropsychology (i.e., part of the board certification process), few formal resources are available to assist with developing skill and experience with these exercises. As the prevalence of clinical neuropsychologists attempting to achieve board certification through the American Board of Professional Psychology (ABPP) increases, resources for successful completion of this process are of ever increasing importance. While some previously published texts provide adequate preparation for the written exam, including Board Certification in Clinical Neuropsychology: A Guide to Becoming ABPP/ABCN Certified Without Sacrificing Your Sanity (Armstrong, Beebe, & Hilsabeck, 2008) and Guide to Board Certification in Clinical Neuropsychology (Alberts, Ebbe, & Kazar, 2013), these books do not provide in-depth overviews of the oral examination. Designed as a manual for both supervisors and trainees, The Neuropsychology Fact-Finding Casebook: A Training Resource fills this void. While framed in part as a manual for those preparing to complete the ABPP oral exam, this text is designed as a broader training resource for all levels of advanced trainees. Through a step-by-step tutorial on the format of the oral fact-finding evaluation followed by a series of case studies, this training resource attempts to prepare trainees both at the graduate and postdoctoral level as well as ABPP board certification candidates to excel. The Neuropsychology Fact-Finding Casebook: A Training Resource is organized into four distinct yet complimentary sections that serve as building blocks for the reader to first develop an understanding of the fact-finding process before beginning to study case examples. After a short introductory chapter, the authors provide a detailed template describing a potential approach to fact-finding exercises. Although individuals may choose to utilize a different, equally valid approach, given that fact-finds are inherently unstructured in nature, this template provides a framework to structure the exercise. Examples of specific language that could be used are provided throughout the process of requesting demographic background information and neuropsychological data about a case. Emphasis is placed on asking for this information in a way that demonstrates examinees’ understanding of the case, relevant literature, and perhaps most importantly, their thought process as they request and receive information. Furthermore, the authors emphasize the need to be able to justify why certain information may be clinically relevant, an important clinical skill for differential diagnosis, forensic settings, and during the ABCN oral examination. This provides an important example for trainees at all levels and, should this book be used in a course setting, would provide for meaningful discussion. This training template is then followed by short chapters discussing test interpretation (including a review of common errors) and supervisory considerations for both using this book as well as approaching fact-finding exercises in general. The review of test interpretation, although comprehensive in scope, is relatively short, making it accessible to early stage trainees and serving as a general review for trainees with more clinical experience. This review covers pattern analysis, general psychometric principles, and a review of clinical judgment considerations when reasoning through cases. Further, common biases and errors in hypothesis testing which could lead an examinee to make false inferences and incorrect diagnoses are reviewed with suggestions for developing awareness of and strategies for avoiding these pitfalls. Next, the text provides recommendations for supervisors helping trainees prepare for the fact-finding examinations. The fact-finding exercise is reviewed again, this time from the perspective of the administrator, with highlights focusing on helping the supervisor develop exercises which provide realistic preparation for the exam. Emphasis is placed upon explaining potential changes in supervisory style to trainees (e.g., more neutral, less supportive role) as well as taking time after the exercise to process the experience and provide feedback. Additionally, methods for teaching in individual and groups settings are provided followed by a discussion of the importance of structuring fact-finding exercises based upon trainees’ developmental level, with suggestions given for the intern, resident, and “ready for independent practice” stages. Although brief, this provides an outline of developmental expectations at each training level. Finally, recommendations for developing competency as an oral examiner are reviewed, with references to use of the Socratic Method and current training standards in the field. More detailed discussion of how best to apply various supervision techniques as well as common supervisory errors within the context of the fact-finding exercise would be beneficial, although some predictable difficulties are briefly mentioned throughout this chapter. In the final section of the book, numerous case presentations are provided for trainees and supervisors to review. The following 24 chapters each cover one case, arranged such that more difficult cases are toward the end of the book. After relevant patient history is discussed, readers are provided with a prompt to consider their differential diagnosis before being presented with testing data, after which the authors discuss the case formulation, differential diagnoses, and recommendations. Discussion questions, brief follow-up information about the case (if available), and a very brief summary of important points are then provided. This book was designed with internship and fellowship training settings in mind, so its structure is very useful for training directors looking to regularly incorporate fact-finding exercises into their program. Nevertheless, this book could also be used as the foundation for an advanced graduate seminar course. Both the training template and the numerous case examples make this text an excellent resource for helping trainees develop competencies in case conceptualization and presentation. Given the importance of effectively summarizing and disseminating the results of neuropsychological evaluations to patients, families, and other health care professionals, these exercises could augment clinical courses and practica at the graduate and internship level. The authors’ approach also closely mirrors the ABCN oral examination, so for those specifically choosing to use this book to prepare for that examination, they will find the numerous sample exercises to be of benefit, particularly for those individuals who are not part of a training program or do not have someone with whom they can practice this particular skill. As with any book, The Neuropsychology Fact-Finding Casebook has some limitations, most of which are acknowledged upfront by the authors. First, all cases are adult/geriatric in nature, so those individuals with a pediatric focus will not benefit as fully from the case samples provided. While this book may provide a good foundation of the oral examination structure along with some specifics for how to approach the exam, clinicians seeking to pass the pediatric ABCN exam will need to supplement this text. Readers using this to prepare for the ABCN examination should be prepared to discuss cases in somewhat greater detail than is discussed in the book, including demonstrating a more thorough understanding of a disorder’s underlying anatomy/pathophysiology, providing detailed explanations of their differential diagnosis throughout the history gathering phase, and how their case formulation would change if certain features in the history or test results were modified. Additional supplemental resources for ABCN examination preparation would likely focus on underlying neuroanatomy of disease, disease-specific neuropsychological profiles and their differential diagnosis, interdisciplinary collaborations, and treatment recommendations. Additionally, while a wide variety of cases is presented, atypical presentations or highly unusual diagnoses are missing from this book. This is a meaningful gap as case presentations are focused on relatively simple or common disorders with straightforward presentations. More complex cases with less clearly delineated diagnoses would provide trainees with the opportunity to prepare for more difficult fact-finding exercises. More difficult cases would also provide those using this book the opportunity to more thoroughly practice employing some of the strategies provided in the training template in order to demonstrate their thought process and clinical judgment while working through the case. Readers should also be careful not to simply memorize the template and the example language provided as doing so would limit the development of critical thinking and clinical judgment skills. It will be important for trainees to use the template and example language as starting places for discussion, practice, and development of their own unique style. Finally, this book is not designed to be an all-inclusive review book, so more junior trainees in particular may need to supplement this book with other resources to build foundational knowledge in neuroanatomy and neurologic/psychiatric disorders as well as to reason through the differential diagnoses and discussion questions as detailed explanations and answers to the discussion questions are not provided. Taken together, these limitations are relatively minor, and The Neuropsychology Fact-Finding Casebook provides a much-needed resource for supervisors, trainees at the graduate, intern and postdoctoral level, and individuals preparing for the ABCN oral examination. It could also be used as a core text for a more in-depth graduate course on case conceptualization, case presentation, and oral examination preparation. This book easily maintains the reader’s interest and is not overly saturated with technical details or jargon. Further, this book has many strengths, including the well-developed training template for both examinees and supervisors and the numerous case examples. As a field, board certification is becoming increasingly important and more prevalent. The Neuropsychology Fact-Finding Casebook presents potential ABCN candidates with a meaningful resource for developing case conceptualization competencies to use for successful completion of the ABCN oral examination and was thoroughly enjoyable to read. References Alberts , F. L. Jr , Ebbe , C. E. , & Kazar , D. B. ( 2013 ). Guide to board certification in clinical psychology . New York, NY: Springer Publishing Company . Armstrong , K. , Beebe , D. W. , & Hilsabeck , R. C. ( 2008 ). Board certification in clinical neuropsychology: A guide to becoming ABPP/ABCN certified without sacrificing your sanity . New York, NY: Oxford University Press . © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Clinical Neuropsychology Oxford University Press

The Neuropsychology Fact-Finding Casebook: A Training Resource

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Oxford University Press
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© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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0887-6177
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Abstract

Although fact-finding exercises are becoming increasingly common as a way to assess competency in neuropsychology (i.e., part of the board certification process), few formal resources are available to assist with developing skill and experience with these exercises. As the prevalence of clinical neuropsychologists attempting to achieve board certification through the American Board of Professional Psychology (ABPP) increases, resources for successful completion of this process are of ever increasing importance. While some previously published texts provide adequate preparation for the written exam, including Board Certification in Clinical Neuropsychology: A Guide to Becoming ABPP/ABCN Certified Without Sacrificing Your Sanity (Armstrong, Beebe, & Hilsabeck, 2008) and Guide to Board Certification in Clinical Neuropsychology (Alberts, Ebbe, & Kazar, 2013), these books do not provide in-depth overviews of the oral examination. Designed as a manual for both supervisors and trainees, The Neuropsychology Fact-Finding Casebook: A Training Resource fills this void. While framed in part as a manual for those preparing to complete the ABPP oral exam, this text is designed as a broader training resource for all levels of advanced trainees. Through a step-by-step tutorial on the format of the oral fact-finding evaluation followed by a series of case studies, this training resource attempts to prepare trainees both at the graduate and postdoctoral level as well as ABPP board certification candidates to excel. The Neuropsychology Fact-Finding Casebook: A Training Resource is organized into four distinct yet complimentary sections that serve as building blocks for the reader to first develop an understanding of the fact-finding process before beginning to study case examples. After a short introductory chapter, the authors provide a detailed template describing a potential approach to fact-finding exercises. Although individuals may choose to utilize a different, equally valid approach, given that fact-finds are inherently unstructured in nature, this template provides a framework to structure the exercise. Examples of specific language that could be used are provided throughout the process of requesting demographic background information and neuropsychological data about a case. Emphasis is placed on asking for this information in a way that demonstrates examinees’ understanding of the case, relevant literature, and perhaps most importantly, their thought process as they request and receive information. Furthermore, the authors emphasize the need to be able to justify why certain information may be clinically relevant, an important clinical skill for differential diagnosis, forensic settings, and during the ABCN oral examination. This provides an important example for trainees at all levels and, should this book be used in a course setting, would provide for meaningful discussion. This training template is then followed by short chapters discussing test interpretation (including a review of common errors) and supervisory considerations for both using this book as well as approaching fact-finding exercises in general. The review of test interpretation, although comprehensive in scope, is relatively short, making it accessible to early stage trainees and serving as a general review for trainees with more clinical experience. This review covers pattern analysis, general psychometric principles, and a review of clinical judgment considerations when reasoning through cases. Further, common biases and errors in hypothesis testing which could lead an examinee to make false inferences and incorrect diagnoses are reviewed with suggestions for developing awareness of and strategies for avoiding these pitfalls. Next, the text provides recommendations for supervisors helping trainees prepare for the fact-finding examinations. The fact-finding exercise is reviewed again, this time from the perspective of the administrator, with highlights focusing on helping the supervisor develop exercises which provide realistic preparation for the exam. Emphasis is placed upon explaining potential changes in supervisory style to trainees (e.g., more neutral, less supportive role) as well as taking time after the exercise to process the experience and provide feedback. Additionally, methods for teaching in individual and groups settings are provided followed by a discussion of the importance of structuring fact-finding exercises based upon trainees’ developmental level, with suggestions given for the intern, resident, and “ready for independent practice” stages. Although brief, this provides an outline of developmental expectations at each training level. Finally, recommendations for developing competency as an oral examiner are reviewed, with references to use of the Socratic Method and current training standards in the field. More detailed discussion of how best to apply various supervision techniques as well as common supervisory errors within the context of the fact-finding exercise would be beneficial, although some predictable difficulties are briefly mentioned throughout this chapter. In the final section of the book, numerous case presentations are provided for trainees and supervisors to review. The following 24 chapters each cover one case, arranged such that more difficult cases are toward the end of the book. After relevant patient history is discussed, readers are provided with a prompt to consider their differential diagnosis before being presented with testing data, after which the authors discuss the case formulation, differential diagnoses, and recommendations. Discussion questions, brief follow-up information about the case (if available), and a very brief summary of important points are then provided. This book was designed with internship and fellowship training settings in mind, so its structure is very useful for training directors looking to regularly incorporate fact-finding exercises into their program. Nevertheless, this book could also be used as the foundation for an advanced graduate seminar course. Both the training template and the numerous case examples make this text an excellent resource for helping trainees develop competencies in case conceptualization and presentation. Given the importance of effectively summarizing and disseminating the results of neuropsychological evaluations to patients, families, and other health care professionals, these exercises could augment clinical courses and practica at the graduate and internship level. The authors’ approach also closely mirrors the ABCN oral examination, so for those specifically choosing to use this book to prepare for that examination, they will find the numerous sample exercises to be of benefit, particularly for those individuals who are not part of a training program or do not have someone with whom they can practice this particular skill. As with any book, The Neuropsychology Fact-Finding Casebook has some limitations, most of which are acknowledged upfront by the authors. First, all cases are adult/geriatric in nature, so those individuals with a pediatric focus will not benefit as fully from the case samples provided. While this book may provide a good foundation of the oral examination structure along with some specifics for how to approach the exam, clinicians seeking to pass the pediatric ABCN exam will need to supplement this text. Readers using this to prepare for the ABCN examination should be prepared to discuss cases in somewhat greater detail than is discussed in the book, including demonstrating a more thorough understanding of a disorder’s underlying anatomy/pathophysiology, providing detailed explanations of their differential diagnosis throughout the history gathering phase, and how their case formulation would change if certain features in the history or test results were modified. Additional supplemental resources for ABCN examination preparation would likely focus on underlying neuroanatomy of disease, disease-specific neuropsychological profiles and their differential diagnosis, interdisciplinary collaborations, and treatment recommendations. Additionally, while a wide variety of cases is presented, atypical presentations or highly unusual diagnoses are missing from this book. This is a meaningful gap as case presentations are focused on relatively simple or common disorders with straightforward presentations. More complex cases with less clearly delineated diagnoses would provide trainees with the opportunity to prepare for more difficult fact-finding exercises. More difficult cases would also provide those using this book the opportunity to more thoroughly practice employing some of the strategies provided in the training template in order to demonstrate their thought process and clinical judgment while working through the case. Readers should also be careful not to simply memorize the template and the example language provided as doing so would limit the development of critical thinking and clinical judgment skills. It will be important for trainees to use the template and example language as starting places for discussion, practice, and development of their own unique style. Finally, this book is not designed to be an all-inclusive review book, so more junior trainees in particular may need to supplement this book with other resources to build foundational knowledge in neuroanatomy and neurologic/psychiatric disorders as well as to reason through the differential diagnoses and discussion questions as detailed explanations and answers to the discussion questions are not provided. Taken together, these limitations are relatively minor, and The Neuropsychology Fact-Finding Casebook provides a much-needed resource for supervisors, trainees at the graduate, intern and postdoctoral level, and individuals preparing for the ABCN oral examination. It could also be used as a core text for a more in-depth graduate course on case conceptualization, case presentation, and oral examination preparation. This book easily maintains the reader’s interest and is not overly saturated with technical details or jargon. Further, this book has many strengths, including the well-developed training template for both examinees and supervisors and the numerous case examples. As a field, board certification is becoming increasingly important and more prevalent. The Neuropsychology Fact-Finding Casebook presents potential ABCN candidates with a meaningful resource for developing case conceptualization competencies to use for successful completion of the ABCN oral examination and was thoroughly enjoyable to read. References Alberts , F. L. Jr , Ebbe , C. E. , & Kazar , D. B. ( 2013 ). Guide to board certification in clinical psychology . New York, NY: Springer Publishing Company . Armstrong , K. , Beebe , D. W. , & Hilsabeck , R. C. ( 2008 ). Board certification in clinical neuropsychology: A guide to becoming ABPP/ABCN certified without sacrificing your sanity . New York, NY: Oxford University Press . © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

Archives of Clinical NeuropsychologyOxford University Press

Published: Aug 14, 2017

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