ABSTRACT

Objectives: The objective of this multisite study was to examine failure rates across placements during clinical psychology training.

Method: Placement supervisors from nine clinical psychology programmes used the Clinical Psychology Practicum Competencies Rating Scale (CΨPRS) to rate trainees’ competencies at the end of one of four placements (P1, P2, P3, P4).

Results: Out of a total of 1449 placements, seventeen (1.17%) placements were failed, with fail-rates reducing as trainees progressed from P1 (2.45%) to P2 (0.77%), P3 (0.33%) and P4 (0.37%). CΨPRS norms used to identify competence as Much Below Standards generated similar fail-rates: 1.04% for all placements; 0.61% for P1; 1.28% for P2; 1.33% for P3; and 1.12% for P4. A larger subgroup (6.97% for all placements; 9.41% for P1; 4.34% for P2; 5.65% for P3 and 7.87% for P4) were also categorised as falling Somewhat Below Standards. The majority (88%) of these “Below Standards” placements received a pass grade from their supervisor.

Conclusions: Supervisors tend to pass trainees who fail to meet competence thresholds on the CΨPRS. Placement supervisor assessments are essential but insufficient to ensure trainee competence, and supplemental assessments such as objective structured clinical examinations or competency assessment portfolios are important to complement supervisor assessments.

KEY POINTS

(1) The study reports end of placement failure rates for clinical psychology trainees across nine training institutions.

(2) A number of trainees who received scores below competency thresholds were passed by their placement supervisors.

(3) The study raises serious concerns about the sole reliance on placement supervisors’ assessments, and recommends additional independent assessments such as the use of standardised objective structured clinical examinations (OSCE) to ensure safe and competent practice among clinical psychology trainees.

摘要

目的：这项多地点研究的目的是检查临床心理学培训期间跨实习的失败率。

方法：来自九个临床心理学项目的实习主管使用临床心理学实习能力评定量表 (CΨPRS) 在四个实习（P1、P2、P3、P4）之一结束时对学员的能力进行评分。

结果：在总共 1449 个实习中，有 17 个 (1.17%) 实习失败，失败率随着学员从 P1 (2.45%) 到 P2 (0.77%)、P3 (0.33%) 和 P4 (0.37%) 的进展而降低）。用于将能力识别为远低于标准的 CΨPRS 规范产生了类似的失败率：所有展示位置为 1.04%；P1 为 0.61%；P2 为 1.28%；P3 为 1.33%；P4 为 1.12%。更大的子组（所有展示位置为 6.97%；P1 为 9.41%；P2 为 4.34%；P3 为 5.65%，P4 为 7.87%）也被归类为低于标准。这些“低于标准”的职位中的大多数（88%）从他们的主管那里获得了及格分数。

结论：主管倾向于通过未能达到 CΨPRS 能力门槛的学员。安置主管评估是必不可少的，但不足以确保受训人员的能力，并且诸如客观结构化临床考试或能力评估组合之类的补充评估对于补充主管评估很重要。

关键点

(1) 该研究报告了九个培训机构的临床心理学学员的最终安置失败率。

(2) 一些分数低于能力门槛的学员被其安置主管通过。

(3) 该研究对仅依赖实习导师的评估提出了严重关切，并建议进行额外的独立评估，例如使用标准化的客观结构化临床考试 (OSCE)，以确保临床心理学学员的安全和称职的实践。