An Empirical Examination of Doctoral Training Models in Clinical Psychology in the United States

Since as early as 1908, psychology as a discipline has grappled with how to integrate research and practice into the field’s professional identity. To further define the area of expertise of a psychologist, three main models of clinical training have been proposed: the scientist-practitioner model, the practitioner-scholar model, and the clinical scientist model. Despite clinical psychology’s universal claim for empirical moorings, the debate about the foundation of training in clinical psychology has remained primarily theoretical. The purpose of this study is to expand upon the limited research exploring the differences between training models to empirically determine which factors significantly predicted training models. To answer this question, a series of logistic regressions were run to determine if training models could be predicted by program admission criteria, faculty modeling, structural factors, differences in epistemological stance, and student factors. Results indicated admission criteria, faculty modeling, and structural factors significantly predicted training models. Results and implications for future research and clinical practice are discussed

A review of research into the development of radiologic expertise: Implications for computer-based training

Rationale and Objectives. Studies of radiologic error reveal high levels of variation between radiologists. Although it is known that experts outperform novices, we have only limited knowledge about radiologic expertise and how it is acquired.Materials and Methods. This review identifies three areas of research: studies of the impact of experience and related factors on the accuracy of decision-making; studies of the organization of expert knowledge; and studies of radiologists' perceptual processes.Results and Conclusion. Interpreting evidence from these three paradigms in the light of recent research into perceptual learning and studies of the visual pathway has a number of conclusions for the training of radiologists, particularly for the design of computer-based learning programs that are able to illustrate the similarities and differences between diagnoses, to give access to large numbers of cases and to help identify weaknesses in the way trainees build up a global representation from fixated regions

Should desperate volunteers be included in randomised controlled trials?

Randomised controlled trials (RCTs) sometimes recruit participants who are desperate to receive the experimental treatment. Some claim this practice is unethical for at least three reasons. The first is that the notion of equipoise, which is often used as a justification for running a RCT, is subjective and value-based. Desperate volunteers are clearly not in equipoise and it is their values that should take precedence. The second is that clinicians who enter patients onto trials are disavowing their therapeutic obligation to deliver the best treatment to patients; they are following trial protocols rather than delivering individualised care. Research is not treatment; its ethical justification is different. Consent is crucial. This leads to the third reason: desperate volunteers do not give a proper consent; they are, in effect, coerced. We begin our reply by advocating a notion of equipoise based on, first, expert knowledge and, second, widely shared values. Where such collective, expert equipoise exists there is a prima facie case for a RCT. Next we argue that trial entry does not involve clinicians’ disavowing their therapeutic obligation; individualised care based on whims and fancies is not in patients’ best interest. Finally, we argue that where equipoise exists it is acceptable to limit access to experimental agents. In the cases desperate volunteers are not coerced because their desperation does not translate into a right to receive what they desire. </p

A Metaphysical and Epistemological Critique of Psychiatry

Current health care standards, in many countries, Australia included, are regrettably poor. Surprisingly, practitioners and treating teams alike in mental health and disability sectors, in particular, make far too many basic care-related mistakes, in addition to the already abundant diagnostic mistakes that cause and amplify great harm. In part, too many practitioners also fail to distinguish adverse effects for what they are and all too often treat adverse effects, instead, as comorbidities. Diagnostic failures are dangerous, the result of which generates and perpetuates harms that are extremely costly in terms of patient welfare, in addition to the financial burden placed on everyone. In this essay, I contend that the authority bestowed upon psychiatry is misplaced. Subsequently, this misplaced authority affects the governing and investigatory institutions reliant and informed by psychiatry. The examination process undertaken in this investigation traces the metaphysics of psychiatric disorders relative to the Diagnostic-Statistical-Manual (DSM) in all its iterations and to the epistemological construction process that serves to underpin the fundamentals of psychiatric practice. There exists a crisis of confidence in psychiatric practice and I urge drastic reform be undertaken to arrest the damage

Complexity and integration. A philosophical analysis of how cancer complexity can be faced in the era of precision medicine

Complexity and integration are longstanding widely debated issues in philosophy of science and recent contributions have largely focused on biology and biomedicine. This paper specifically considers some methodological novelties in cancer research, motivated by various features of tumours as complex diseases, and shows how they encourage some rethinking of philosophical discourses on those topics. In particular, we discuss the integrative cluster approach, and analyse its potential in the epistemology of cancer. We suggest that, far from being the solution to tame cancer complexity, this approach offers a philosophically interesting new manner of considering integration, and show how it can help addressing the apparent contrast between a pluralistic and a unitary account

Situating Interprofessional Education Curriculum within a Theoretical Framework for Productive Engaged Learning: Integrating Epistemology, Theory, and Competencies

Interprofessional education (IPE) has a longstanding presence in the health and social care (HASC) professions, by which its sustainable implementation in HASC professional education has the potential to effectively prepare HASC professional students for interprofessional collaborative practice (IPCP). Implementation of IPE has increased over the last two decades with the emergence of a curriculum guided by constructivist epistemology and learning theories that emphasize demonstrating competence in practice. Nonetheless, since IPE first emerged in the early 1960s, most IPE initiatives have been sporadic and lacked guidance through theoretical underpinnings. This conceptual article first discusses why it is important to have theory drive HASC professional education. Next, it explores what is meant by curriculum, followed by a discussion on the importance of curriculum theory to HASC professional education processes. This article then illustrates the learning theories arising from behaviourist and constructivist epistemologies that inform curriculum theory in the HASC professions, with particular emphasis on how constructivist learning theories inform IPE. Lastly, the article proposes a theoretical framework for productive engaged learning through which IPE opportunities may be grounded, leading to student proficiency in interprofessional professional competencies (knowledge, skills, and dispositions), establishment of professional communities of practice, and eventual improvement of patient/client-oriented outcomes

A Reinterpretation of Historical Gender Bias and Women\u27s Mental Health

This epistemological review suggests that gender stereotypes and oppression have occurred throughout history and reflects past and present portrayals of women, particularly, the reflection of stereotypes and oppression cause women to suffer mental health consequences in two ways. First, societal oppression reduces and enforces women to an inferior status, which promotes mental health suffering and consequences. Second, women suffer from biased assessments, diagnoses, and treatment via hierarchical relationships and gender stereotypes from professionals. Presently, women are maintained at this subordinate position due to a lack of people and policies enforcing health standards specifically for women

Philosophical Ends to Scientific Means: Diagnosis and the Epistemology of Psychology

Modern scientific psychology continues to advance toward newer and greater discoveries of the inner workings of the human mind, posited in the belief that a universal objectivity exists if only to be found. Despite the professional emphasis on conducting psychological enterprises in this manner, the field has spent much of its formalized existence struggling to answer some of its most basic questions. This paper thoroughly explores the nature of a scientific psychology, while suggesting that psychology may find wisdom in its philosophical origins. It further suggests that psychology continue toward a postmodern epistemology, in which a unitary psychological reality is abandoned for the realties that exist within the minds of unique individuals. Social constructionism provides the foundation for the postmodern theory throughout the paper. To highlight the character of this discussion, the concept of diagnosis is carefully examined, with the diagnosis of depression serving as the chief example. In the context of this conversation, research was conducted that attempts to explore the contemporary epistemological and diagnostic beliefs of both beginning and advanced clinicians. This research included the use of an online survey that asked current clinical and counseling psychologists about their views regarding the diagnosis of depression, and the practice of diagnosis more generally. Current doctoral students in clinical and counseling psychology programs were also surveyed, to observe chronological changes in perspective