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VA Tennessee Valley Healthcare System
Rotations in Neuropsychology Important Note: There are two Neuropsychology training rotations offered, one at the Nashville Campus supervised by Dr. Marshman, and one at the York Campus supervised by Dr. Denning. As two different neuropsychologists run and supervise the different rotations, there will be some differences in the training experiences. The one intern in the Neuropsychology Track will participate in both of these rotations during the first two rotations of the internship. Other interns will have the opportunity to take one, but not both of the neuropsychology rotations. Location: Murfreesboro Campus and Nashville Campus Supervisors: Dr. John Denning (Murfreesboro) and Dr. Kim Marshman (Nashville) Setting: The neuropsychological assessment rotation provides an opportunity to learn about brain-behavior relationships, the field of neuropsychology, various methods of assessment, and the functioning of a neuropsychology service within a medical center setting. Neuropsychology is a consultative service that receives referrals from various sources including neurology, neurosurgery, psychiatry (inpatient/outpatient), primary care, vocational rehabilitation, general inpatient medical wards, and other specialty clinics/services. The service primarily provides differential diagnostic assessment and recommendations for treatment, with most patients being seen on an outpatient basis. Typical cases involve the assessment of cortical and subcortical dysfunction associated with various medical conditions, illnesses, and injuries, including degenerative dementias (e.g., Lewy-body, Alzheimer’s, frontotemporal), multiple sclerosis, cerebrovascular diseases/CVAs, epilepsy, traumatic brain injury, “normal aging” memory complaints, and pseudodementia. Due to the nature of the VA population, many evaluations also include evaluation of psychiatric disorders such as Major Depression, Bipolar Disorder, Post-Traumatic Stress Disorder, and others. Because changes in mood and personality may occur in certain neurological conditions, personality assessment (e.g., PAI, MMPI-2) may also play an important role in a neuropsychological assessment. Since the majority of our patients have comorbid medical conditions (e.g., diabetes, hypertension, sleep apnea, COPD), interns have the opportunity to learn about the impact of non-neurological conditions and medications on cognitive functioning. What Interns Will Do: The neuropsychological assessment format is the "flexible battery" approach. Typical tests include the WASI, CVLT-II, RBANS, FTT, COWAT, WCST and portions of the WMS-III and WAIS-III, among others. Interns are expected to conduct one to two supervised assessments per week, depending upon their level of experience and training needs. Interns will learn how to conduct a neuropsychological clinical interview, administer and score commonly used neuropsychological tests, interpret the results, develop useful recommendations, write a comprehensive but brief neuropsychological report, and provide feedback to patients, families, and other medical staff. Through the clinical cases and outside readings, interns will have the opportunity to learn functional neuroanatomy to integrate into the report and recommendations. Supervision includes 1-2 hours of scheduled individual time, as well as ad hoc supervision. Supervision is also provided via written feedback on each of the intern’s neuropsychological reports. Because the services provided by neuropsychology are often communicated to the referral source solely in writing, interns will be expected to have, or be willing to develop, effective written communication skills during the rotation. The overall goal of this rotation is to help the intern gain a broad understanding of brain-behavior relationships that will enhance his or her general clinical skills and, for those who are interested in pursuing post-doctoral neuropsychological training, to provide a firm foundation for the post-doctoral residency. One intern per year will be enrolled in the Neuropsychology Track, in which the first 6 months of training will be in Neuropsychology (one 3-month rotation with Dr. Marshman and one 3-month rotation with Dr. Denning). The Neuropsychology Track Intern will also choose one rotation from the Mental Health emphasis area and one rotation from the Behavioral Medicine emphasis area. All other interns who have an interest in Neuropsychology may be able to choose one Neuropsychology Rotation, depending upon availability.
9-22-2009 |