Developing psychotherapists’ competence through clinical supervision: protocol for a qualitative study of supervisory dyads.

BACKGROUND: Mental health professionals face unique demands and stressors in their work, resulting in high rates of burnout and distress. Clinical supervision is a widely adopted and valued mechanism of professional support, development, and accountability, despite the very limited evidence of specific impacts on therapist or client outcomes. The current study aims to address this by exploring how psychotherapists develop competence through clinical supervision and what impact this has on the supervisees’ practice and their clients’ outcomes. This paper provides a rationale for the study and describes the protocol for an in-depth qualitative study of supervisory dyads, highlighting how it addresses gaps in the literature. METHODS/DESIGN: The study of 16–20 supervisor-supervisee dyads uses a qualitative mixed method design, with two phases. In phase one, supervisors who are nominated as expert by their peers are interviewed about their supervision practice. In phase two, supervisors record a supervision session with a consenting supervisee; interpersonal process recall interviews are conducted separately with supervisor and supervisee to reflect in depth on the teaching and learning processes occurring. All interviews will be transcribed, coded and analysed to identify the processes that build competence, using a modified form of Consensual Qualitative Research (CQR) strategies. Using a theory-building case study method, data from both phases of the study will be integrated to develop a model describing the processes that build competence and support wellbeing in practising psychotherapists, reflecting the accumulated wisdom of the expert supervisors. DISCUSSION: The study addresses past study limitations by examining expert supervisors and their supervisory interactions, by reflecting on actual supervision sessions, and by using dyadic analysis of the supervisory pairs. The study findings will inform the development of future supervision training and practice and identify fruitful avenues for future research

Attitudes Towards Vaccination Among Medical Students: A Two-Site Study

Introduction: Mandatory immunization for school age children in the 20th Century led to a substantial decline in infectious disease. All US states allow medical exemptions from immunizations with 49 permitting additional religious exemptions and 19 permitting additional philosophical exemptions. Vaccine exemptions have lead to an increase in the incidence of disease outbreaks. Healthcare providers play a critical role in educating parents about the benefits and risks of immunizations. This project compares student attitudes and knowledge regarding vaccination at medical schools in two distinct states: one with no additional exemptions (West Virginia) and one with both additional exemptions (Vermont).https://scholarworks.uvm.edu/comphp_gallery/1218/thumbnail.jp

Clinical Study to Assess the Level of Consciousness/General Anesthesia Following the Administration of High Doses of Xylazine Hydrochloride in Cattle

Achieving anesthesia without DEA controlled drugs prior to administration of IV potassium chloride (KCl) is a limiting factor for humane euthanasia. An overdose of xylazine hydrochloride (XH) is thought by some to induce unconsciousness and is commonly administered prior to IV KCl injection. This study’s purpose was to determine the level of unconsciousness achieved from an overdose of XH in cattle

Family-Centered Early Intervention in North America: Have Home-based Programmes Lived up to their Promise for High-risk Families?

While early intervention programming is not new in North America, such programs have gone through a rapid expansion in recent years. This has been motivated by the recognition of the need for timely intervention, the development of a family rather than a child focused practice philosophy and the desire on the part of funding organizations to save money by promoting less expensive programming. This article reviews the various components of early intervention programmes in North America while also questioning aspects of current practice. There is a clear need for family-centered intervention. This should not be in question. However, the fundamental question should not be whether family centered intervention is necessary but rather how can empirical research inform best practices? It is the conclusion of the authors that this will be the key challenge in the coming years

Exploring students' perceptions on the use of significant event analysis, as part of a portfolio assessment process in general practice, as a tool for learning how to use reflection in learning

BACKGROUND: Portfolio learning enables students to collect evidence of their learning. Component tasks making up a portfolio can be devised that relate directly to intended learning outcomes. Reflective tasks can stimulate students to recognise their own learning needs. Assessment of portfolios using a rating scale relating to intended learning outcomes offers high content validity. This study evaluated a reflective portfolio used during a final-year attachment in general practice (family medicine). Students were asked to evaluate the portfolio (which used significant event analysis as a basis for reflection) as a learning tool. The validity and reliability of the portfolio as an assessment tool were also measured. METHODS: 81 final-year medical students completed reflective significant event analyses as part of a portfolio created during a three-week attachment (clerkship) in general practice (family medicine). As well as two reflective significant event analyses each portfolio contained an audit and a health needs assessment. Portfolios were marked three times; by the student's GP teacher, the course organiser and by another teacher in the university department of general practice. Inter-rater reliability between pairs of markers was calculated. A questionnaire enabled the students' experience of portfolio learning to be determined. RESULTS: Benefits to learning from reflective learning were limited. Students said that they thought more about the patients they wrote up in significant event analyses but information as to the nature and effect of this was not forthcoming. Moderate inter-rater reliability (Spearman's Rho .65) was found between pairs of departmental raters dealing with larger numbers (20 – 60) of portfolios. Inter-rater reliability of marking involving GP tutors who only marked 1 – 3 portfolios was very low. Students rated highly their mentoring relationship with their GP teacher but found the portfolio tasks time-consuming. CONCLUSION: The inter-rater reliability observed in this study should be viewed alongside the high validity afforded by the authenticity of the learning tasks (compared with a sample of a student's learning taken by an exam question). Validity is enhanced by the rating scale which directly connects the grade given with intended learning outcomes. The moderate inter-rater reliability may be increased if a portfolio is completed over a longer period of time and contains more component pieces of work. The questionnaire used in this study only accessed limited information about the effect of reflection on students' learning. Qualitative methods of evaluation would determine the students experience in greater depth. It would be useful to evaluate the effects of reflective learning after students have had more time to get used to this unfamiliar method of learning and to overcome any problems in understanding the task

Understanding Your Soil Test Report

Regular soil testing helps to develop and maintain more productive soils for farming, gardening, and landscaping. The purpose of this guide is to help you understand and interpret the results from a Utah State University soil test report. Additional Utah State University Extension bulletins are available, which address solutions to specific soil problems and offer guidance on fertilizer selection and use. See “Where to obtain additional information” at the end of this guide