journals

Desired Clinical Skills for Students to Achieve

Confident (Can complete independently)

Mostly confident (Can complete with supervision)

Beginning (Have performed with supervision or needs supervision to feel confident)

New (Have never performed or does not apply)

Comprehensive psychiatric evaluation skills in: 

Recognizing clinical signs and symptoms of psychiatric illness across the lifespan

X

Differentiating between pathophysiological and psychopathological conditions 

X

Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) 

X

Performing and interpreting a mental status examination 

X

Performing and interpreting a psychosocial assessment and family psychiatric history 

X

Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).

X

Diagnostic reasoning skill in:

Developing and prioritizing a differential diagnoses list

X

Formulating diagnoses according to DSM 5-TR based on assessment data 

X

Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes

X

Pharmacotherapeutic skills in:

Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management) 

X

Evaluating patient response and modify plan as necessary 

X

Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)

X

Psychotherapeutic Treatment Planning:

Recognizes concepts of therapeutic modalities across the lifespan

X

Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation) 

X

Applies age-appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers

X

Develop an age-appropriate individualized plan of care

X

Provide psychoeducation to individuals and/or any caregivers

X

Promote health and disease prevention techniques

X

Self-assessment skill:

Develop SMART goals for practicum experiences 

X

Evaluating outcomes of practicum goals and modify plan as necessary 

X

Documenting and reflecting on learning experiences

X

Professional skills:

Maintains professional boundaries and therapeutic relationship with clients and staff

X

Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings 

X

Identifies ethical and legal dilemmas with possible resolutions

X

Demonstrates non-judgmental practice approach and empathy

X

Practices within scope of practice

X

Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:

Demonstrates selecting the correct screening instrument appropriate for the clinical situation 

X

Implements the screening instrument efficiently and effectively with the clients

X

Interprets results for screening instruments accurately

X

Develops an appropriate plan of care based upon screening instruments response

X

Identifies the need to refer to another specialty provider when applicable

X

Accurately documents recommendations for psychiatric consultations when applicable

X

Currently, my biggest strength is the ability to understand, select, and customize psychotherapeutic techniques to patients of all ages. I have also perfected self-assessment skills during the practicums. I create excellent SMART goals for practicum, evaluate my achievements, and document them properly. I have also demonstrated diagnostic reasoning, pharmacotherapeutic, and professional skills.

Despite the above strengths, I still need to improve on my skills of selecting and administering screening instruments to patients. I still require supervision to implement screen tools successfully. However, with supervision, I have some confidence in choosing proper screening tools and correct interpretation of the results. My competency in conducting comprehensive physical and patient history is also low.

1. Goal: Mastery of Comprehensive Psychiatric Evaluations

· a. Objective: By the end of this practicum, perform 3 or more comprehensive psychiatric evaluations weekly without supervision, documenting the relationship between the patient’s history and their laboratory results.

· b. Objective: By the end of the practicum, correctly interpret laboratory findings for 100% of patients to rule out medical illnesses for psychiatric symptoms.

· c. Objective: Present an accurate summary of the patient evaluations including three differential diagnoses, to the preceptor for every patient, by the end of the practicum.

2. Goal: Proficiency in Mental Status Examination (MSE)

· a. Objective: By practicum mid-term, recognize and apply correct clinical terminology in 100% of patient notes.

· b. Objective: By the end of the practicum, develop high competency in customizing the MSE for patients of different age groups and with varying mental health disorders during at least 10 clinical encounters.

· c. Objective: By practicum mid-term, sit with my preceptor for post-clinical reflections to evaluate the relationship between the MSE findings and the final diagnoses of at least 10 patients.

3. Goal: Selection and Application of Screening Instruments

Goal: Throughout the practicum, I will demonstrate the ability to select the most appropriate evidence-based screening tools for various clinical presentations.

· a. Objective: By the 5th week, create a a screening tool table that shows a minimum of 10 instruments and their correct application and and clinical validity.

· b. Objective: Throughout the practicum, accurately select the appropriate screening tools for 100% of new patients according to their symptoms.

· c. Objective: Throughout the practicum, make oral presentations to the preceptor to justify the selection of a specific screening instrument for at least 4 patients weekly, noting the appropriateness of the tool based on the patient's age group and symptoms.

4. Goal: Integration of Results for Referrals and Recommendations

Goal: By the conclusion of the practicum, I will efficiently interpret screening results and formulate appropriate treatment recommendations or referrals.

· a. Objective: By the practicum conclusion, confirm the results of at least 10 administrations with the preceptor to achieve 100% accuracy when scoring complex multi-dimensional screening tools.

· b. By the practicum conclusion, write a structured letter that includes applicable data from screening tools for a minimum of 5 patients needing higher levels of care.

· c. By the practicum conclusion, document a clinical note connecting the numerical score to the final DSM-5-TR diagnosis for all patients with positive scores on the screening instruments.