Making Clinical Hours Personally & Professionally Meaningful

If you are a graduate student in psychology (or related discipline) completing practicum or internship work, you are likely required by your university to keep track of your fieldwork hours and activities. On the surface this may feel like busy work. For example, a school psychology intern I supervised jokingly asked me whether or not the time she spent logging her hours could be counted as hours.

In a series of four blog posts, I have been asked by the developers of Time2Track to reflect on how students can meaningfully incorporate the tracking of hours and activities during field experiences. In each post, I will highlight one of four big ideas integrated in my forthcoming book, Demystifying the School Psychology Internship: A Dynamic Guide for Interns and Supervisors (New York: Routledge).

The big ideas interwoven in my upcoming text were originally designed for school psychology interns, but are adapted here to fit for any practicum student or intern who is using Time2Track as a tool to document their internship work:

• The practicum/internship is a dynamic and formative experience, not a static event;
• The development of a student’s professional skills should be treated as an integrated process, not a series of isolated activities;
• Supervision is a critical component of the practicum/internship, but supervision processes need increased clarity for students, site supervisors, and university supervisors to be maximally effective; and
• Students should be active planners, coordinators, and shapers of their practicum/internship experience.

Bearing in mind the first big idea, in this post I will (a) reflect on challenges in logging clinical hours, and (b) offer some ideas for making the task personally and professionally meaningful, including how to link hours with assessment, goals, and a practicum or internship plan.

Accrual of Hours: A Misleading Number?

Perhaps the most apparent purpose of documenting hours is to fulfill eventual certification and/or licensure requirements. For example, for doctoral students who wish to pursue clinical licensure as psychologists, the Association of State and Provincial Psychology Boards (ASPPB) – an alliance of agencies responsible for licensure of psychologists in the United States and Canada – requires documentation of a specified number of hours of supervised experience (usually at least 3,000, with 1,500 being postdoctoral), in addition to other requirements. Licensing boards use supervisors’ verification of students’ field-based hours and activities as a proxy for the training experience.

However, the process of tracking clinical hours is not an exact science. Reporting practices are not consistent across students or training programs, and many training directors rely on estimates of hours rather than precise records (Bartle & Rodolfa, 1999; Tracy, Bucchianeri, & Rodolfa, 2011).

Also problematic, an implicit assumption in the tracking process is that number of hours is a proxy for professional competence. As noted by McCutcheon (2009), “The passage of time, in and of itself, does not produce professional competence” (p. S51). Instead, competence is the product of structured and goal-directed field experiences, quality supervision, and sufficient passage of time. So too are the achievement of experiential breadth and depth during training, expectations emphasized by organizations such as the American Psychological Association (APA, 2009) and the National Association of School Psychologists (NASP, 2010).

What also may be viewed as problematic is that tracking hours to meet credentialing requirements is externally driven (i.e., it is motivated by outside agencies and universities rather than students’ goals), and may therefore be viewed as meaningless by students in their day-to-day work. Therefore, I pose the question: How can the tracking of clinical hours become a process that is experienced as meaningful in the promotion of students’ ongoing competency development?

Linking Hours to Assessment

The hours and activities completed during fieldwork are devoid of context if not considered with regard to baseline skills and ongoing skill development, goal setting, and a formative plan for fieldwork. Students’ skills should be assessed at the beginning of their fieldwork and throughout the year. Assessors may include supervisors, peers, clients, and the student (i.e., self-assessment).

In the Competency Assessment Toolkit, Kaslow and colleagues (2009) describe numerous assessment tools to support the evaluation of 15 competencies in professional psychology across three benchmark levels (e.g., readiness for practicum, internship, and professional practice). Assessment data gathered at the beginning of the fieldwork experience, as well as throughout the year, can inform the student’s goals and practicum or internship plan.

In other words, how students spend their hours during fieldwork should be determined based on their assessment-informed goals. Logs of fieldwork can also be used as formative assessment data. For example, students may look at a weekly or monthly data summary and reflect on whether the activities and domains in which they spent their time matched with their goals.

Linking Hours to Goals

Students, in conjunction with supervisors, may set practicum or internship goals based on (a) skills that are assessed to be absent or deficient and need to be enhanced, as well as (b) professional strengths they wish to further develop. Goals can also be linked to considerations of competence using documents such as the Competency Benchmarks developed by the APA (Fouad et al., 2009).

Based on goals, students and supervisors can discuss how time in the field may best be spent. Prioritized areas should be covered, and if upon review of clinical hours they are not, interns and supervisors can collaboratively determine next steps.

For example, upon a midyear review of her internship progress including her internship plan, goals, and hours, an intern I supervised realized she wanted additional experience completing play-based assessments at the early childhood level. She and her field supervisor negotiated minor scheduling changes to help the student meet this training goal.

A Formative Plan, not an Autopsy

Assessment data should inform training goals, and goals should link directly to the student’s practicum or internship plan. The plan delineates the activities that the student will engage in during the field experience, and is developed by the student and supervisor(s) with the intention of increasing professional competence in a formative manner.

If the plan is not pragmatic it likely gets filed away in a far off universe, overpowered by the fast-paced and overscheduled realities of practice, only to surface for a year-end autopsy confirming completion of requirements.

However, presuming that students are required to regularly track their hours, these data can be meaningfully tied to an ongoing consideration of progress towards goals. Discussions regarding what are various domains of practice, why they are important, and how to achieve competence go part and parcel with developing and reviewing the practicum or internship plan, and the student’s ongoing work (including documented activities and hours).

Formative planning is preferable to the student and supervisor looking at a printout of hours categorized by domain, drawing summative conclusions about the student’s experience and developmental progress only at year’s end.

Conclusion

Tracking field hours is a requirement in most psychology training programs, and documentation of hours is often a prerequisite for credentialing. However, students may view logging hours as a rote task rather than a meaningful one. Keeping in mind the notion that the practica and internships are dynamic and formative experiences, not static events, I have offered some ways to make tracking hours a more meaningful endeavor throughout the year. As stated by McCutcheon (2009), “Competence is a product of both intentional educational interventions and a sufficient passage of time to allow for development. Both are necessary, each alone is insufficient” (p. S51). Therefore, it seems to be a combination of purposeful planning, formative goal setting, and ongoing assessment – all supported by supervision – that provides the link between hours of fieldwork completed and the ongoing development of professional competence.

References

American Psychology Association (2009). Guidelines and principles for accreditation of programs in professional psychology. Washington, DC: Author.

Bartle, D.D., & Rodolfa, E.R. (1999). Internship hours: Proposing a national standard. Professional Psychology: Research and Practice, 30, 420-422.

Fouad, N. A., Grus, C. L., Hatcher, R. L., Kaslow, N. J., Hutchings, P. S., Madson, M.,…Crossman, R.E. (2009). Competency benchmarks: A model for the understanding and measuring of competence in professional psychology across training levels. Training and Education in Professional Psychology, 3, S5–S26.

Kaslow, N. J., Grus, C. L., Campbell, L., Fouad, N. A., Hatcher, R. L., & Rodolfa, E. R. (2009). Competency assessment toolkit for professional psychology. Training and Education in Professional Psychology, 3, S27 –S45.

McCutcheon, S.R. (2009). Competency benchmarks: Implications for internship training. Training and Education in Professional Psychology, 3, S50-S53.

National Association of School Psychologists. (2010). Standards for the graduate preparation of school psychologists. Bethesda, MD: Author.

Tracy, E.N., Bucchianeri, M.M., & Rodolfa, E.R. (2011). Internship hours revisited: Evidence for a national standard. Training and Education in Professional Psychology, 5, 97-101.