Dell Children’s Medical Center of Central Texas
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TCSC Internship Brochure
Doctoral Internship Policies

Supervision

Interns and supervisors are expected to meet regularly each week for supervision of clinical work, resulting in at least 4 hours of supervision each week. Interns have at least 2 hours of individual supervision per week with licensed psychologists. At least 2 additional hours of group supervision are provided, through the pediatric and outpatient specialty clinic rotations. Supervision is an agreement between supervisor and supervisee to meet regularly. At the beginning of each rotation, interns and supervisors collaboratively develop a supervision agreement. Each individual’s time is important, and mutual respect is crucial. If the intern has to reschedule supervision, s/he should do this as soon as possible. Patient care is a priority, so if a patient issue arises, supervision may have to wait. Otherwise, interns are expected to arrive to supervision on time, and prepared for supervision as outlined in the supervision agreement done with each supervisor. Interns should be able to summarize a formulation of each patient, think about questions regarding each patient, and any other agenda items that are helpful for supervision.

There must be a supervisor on site during intern work at TCSC, in case of an urgent situation, and to lock up the Center at the end of the day.

Intern Evaluation

General Principles
The Texas Child Study Center internship program requires interns to demonstrate minimum levels of competency across all training goals, objectives and competencies. The aim of the evaluation process is to provide interns with feedback and strengthen their emerging professional skills and identity.  Further, the evaluation process is meant to strengthen the program by providing feedback about its effectiveness in training interns and identifying any problem areas.

Intern Evaluations
Informal evaluation: Interns should be given formative and summative feedback by supervisors.  Ongoing informal feedback is expected through regular discussions, observations, and supervision meetings.  Interns are expected to continually assess their strengths and weaknesses and provide feedback about their experience in the training program. Intern progress is discussed in monthly training committee meetings.

Formal evaluations: Interns are formally evaluated twice annually.  They are provided with written evaluations by each rotation supervisor (3 total) at mid-year and end of year. Evaluations are conducted using a standard rating form, which includes comment spaces where supervisors include specific written feedback regarding the interns’ performance and progress. The evaluation form includes information about the interns’ performance regarding all of TCSC’s expected training competencies and the related objectives. Supervisors are expected to review these evaluations with the interns and provide an opportunity for discussion if the intern has questions or concerns about the feedback.

Minimum requirements for achievement

A minimum level of achievement on each evaluation is defined as a rating of “3” for each individual competency item. The rating scale for each evaluation is a 5-point Likert scale, with the following rating values:
5 = Exceeds what is expected of an intern at this point in the program
4 = Consistently meets what is expected of an intern at this point in the program
3 = An area of growth that is developmental in nature and expected to improve with additional training and experience
2 = Minimally satisfactory, some improvement needed to remain in good standing.
1 = Unsatisfactory, needs significant improvement to remain in good standing
NA = Not able to assess / Not Applicable

If an intern receives a score less than 3 on any individual item, or if supervisors have reason to be concerned about the intern’s performance or progress, the program’s Due Process procedures will be initiated. The Due Process guidelines can be found in this handbook.

Additionally, all interns are expected to complete 2000 hours of training during the internship year. Interns must take this into account when planning for vacations. Meeting the hours requirements and obtaining sufficient ratings on all evaluations demonstrates that the intern has progressed satisfactorily through and completed the internship program. Feedback to the interns’ home doctoral program is provided at the culmination of the internship year. Doctoral programs are contacted within one month following the end of the internship year and informed that the intern has successfully completed the program. If successful completion of the program comes into question at any point during the internship year, or if a formal review under the Due Process procedures due to a grievance by a supervisor or an inadequate rating on an evaluation results in an acknowledgment notice, probation, or termination, the home doctoral program will also be contacted. This contact is intended to ensure that the home doctoral program, which also has a vested interest in the interns’ progress, is kept engaged in order to support an intern who may be having difficulties during the internship year. The home doctoral program is notified of any further action that may be taken by TCSC as a result of the Due Process procedures, up to and including termination from the program.

Self Evaluations
Interns will complete self evaluations using the standard evaluation form, at three time points: beginning of the year, mid-year, and end of year.  The beginning of the year self evaluation will assist interns and their supervisors in identifying areas of strength and areas of further growth.

Feedback to Program
Additionally, interns will complete a program evaluation at the mid-point and end of the internship year, in order to provide feedback that will inform any changes or improvements in the training program including opportunities to evaluate and provide feedback for specific rotations and supervisors. This program survey is reviewed directly with supervisors at mid-point and end of year. Interns also have the opportunity to meet with the Training Director to provide anonymous feedback about rotations and supervisors, and the Training Director compiles all feedback to provide to rotations and supervisors at least once yearly.

Resources

Salary
The annual stipend for the 2014-2015 training year will be $26,000.

Benefits
Health benefits are provided to all interns through the University of Texas at Austin. Interns attend a University of Texas orientation at the beginning of the training year to learn about and select benefits packages.  Also see http://www.utexas.edu/hr/current/insurance/

Leave
Annual vacation, professional, and sick leave is provided to all interns:

Vacation: 8 hours accrued monthly
Sick Leave: 8 hours accrued monthly
Emergency Leave/Funeral Leave: up to 3 days for a death in the immediate family
Jury Duty: full pay provided when serving jury duty or if subpoenaed for witness duty
State Compensatory Time: UT employees can earn compensatory time. For information see
http://www.utexas.edu/hr/current/leave/compensatorytime.html

Interns must keep track of their time worked through monthly internship logs as well as UT time sheets. Interns must consult with all supervisors about vacation and leave and fill out a vacation request form, which must be approved by all supervisors. All time off will be monitored by the intern and training program, and leave approvals will take into consideration the likelihood that interns will complete their required training hours . Interns are expected to space their time off appropriately throughout the year and are strongly discouraged from taking significant time off in the last month of the internship. If interns will be out of the office, interns must notify their patients, supervisors, and the front desk, update their schedules, and indicate on their voicemail that they are out of the office. Clinical coverage must also be indicated in case of an urgent situation.

As University of Texas employees, Interns are provided with the following scheduled holidays:
Labor Day
Thanksgiving Day + Friday following
Christmas Eve
New Year’s Eve
Martin Luther King, Jr. Day
Memorial Day
Independence Day

Additional Resources
TCSC interns have access to numerous additional resources.  Training materials including testing materials, rating scales, and video equipment, are provided by each training site. Each intern additionally has access to administrative and IT support through the Texas Child Study Center and Dell Children’s Medical Center.  Interns are provided with a workspace including a computer, phone with voicemail, and lockable file drawers for storage. 

Due Process Procedures

Procedures for Grievances Concerning Interns

PURPOSE
Consistent with its values, the Texas Child Study Center (TCSC) is committed to providing excellence in both training and service. A high standard of performance is essential to achieving this outcome. Intern misconduct can impact TCSC's ability to meet this commitment. TCSC will make every effort to collaborate with the intern on remediating problematic behavior to allow interns to improve performance.  In the case of gross ethical misconduct or behavior that has the potential to cause harm, TCSC may choose to terminate the intern from the program.

DEFINITION OF PROBLEM BEHAVIOR:
Problem behavior is defined broadly as behavior that interferes with the intern’s ability to function professionally within the internship site.  Interference may include unethical behavior or behavior that is inconsistent with the professional standards of psychology, behavior that is noncompliant with the policies and procedures of the training site, an inability to perform duties at the minimum level of expected competency, and/or an inability to manage personal stress or emotional reactions. 
TCSC internship training faculty should act directly and promptly whenever they encounter intern conduct that is in need of correction. This should be done whether or not the intern in question is under their immediate supervision. Professional judgment will be used to determine whether behavior is considered problematic rather than reasonable given the context within which the behavior was exhibited.

DUE PROCESS PROCEDURE
If progressive discipline rather than immediate discharge is used, the actions taken shall comply with the following:
1. There shall be due regard given to the extent to which the misconduct interferes with the safe, efficient and orderly operation of TCSC.
2. A fair, objective and comprehensive investigation, including speaking to appropriate parties, shall be conducted.
3. The disciplinary decision shall be nondiscriminatory.
4. The discipline to be taken shall be reasonable based on the seriousness of the misconduct as well as the intern's record with TCSC.

Step 1: Informal Review
When an internship faculty believes that intern behavior is becoming problematic, the first course of action will be to raise the issue directly with the intern as soon as feasible unless an intern displays gross misconduct or unethical behavior with the potential to cause harm.  This course of action will be communicated to the Training Director but not retained in the intern’s file.

Step 2: Formal Review
If an informal review does not resolve the problem behavior, or if an intern receives a rating of “1” or “2” on any competency item on a supervisory evaluation, the following process will be followed:

  1. The supervisor who has identified the problematic behavior will provide a written notice €“ an email will suffice - to both the intern and Training Director (or TCSC Director of Psychological Services if the supervisor is also the Training Director). This notice is retained in the intern’s file. 
  2. The intern, his/her supervisor, and the Training Director will meet within 5 working days to discuss the problem and determine course of action.  If the Training Director is also the supervisor bringing up the issue, the TCSC Director of Psychological Services will attend the meeting.
  3. The intern will have an opportunity to provide a written statement related to the behavior and his/her response to the problem, to be retained in his/her record.
  4. After this meeting, one of the following courses of action may be taken:
    1. The problem is documented by the Training Director (or Director of Psychological Services if the supervisor is also the Training Director) with no further action taken.
    2. An “Acknowledge Notice” is issued by the Training Director (or Director of Psychological Services if the supervisor is also the Training Director) which acknowledges that the problem was identified by faculty and has been brought to the attention of the intern, that the faculty will work with the intern to specify the steps necessary to rectify the problem or skill deficits addressed by the inadequate evaluation rating, and that the problem is not significant enough to warrant serious action. This notice will be issued within 5 working days of the meeting. An informal training plan may be written up as part of this process to address competency deficits.
    3. The intern is placed on "Probation" which defines a relationship such that the faculty, through the supervisors and Training Director, actively and systematically monitor, for a specific length of time, the degree to which the intern addresses, changes and/or otherwise improves the problematic behavior or skill deficit. The length of the probation period will depend upon the nature of the problem and will be determined by the intern’s supervisors and Training Director. The probation is a written statement to the intern and the Director of Clinical Training at the intern’s graduate institution, to be issued within 7 days of the decision, and includes:
      1. the actual behaviors or skills associated with the problem
      2. the specific recommendations for rectifying the problem,
      3. the time frame for the probation during which the problem is expected to be ameliorated, and
      4. the procedures designed to ascertain whether the problem has been appropriately rectified.

Step 3: Follow Up

  1. If either the Acknowledgment Notice or the Probation action occurs, the Training Director will inform the intern's sponsoring university within 7 days of the decision, indicating the nature of the inadequate rating, the rationale for the action, and the action taken by the faculty. The intern shall receive a copy of the letter to the sponsoring university.
  2. Once the Acknowledgment Notice or Probation is issued by the Training Director, it is expected that the status of the problem or inadequate rating will be reviewed no later than the next formal evaluation period or, in the case of probation, no later than the time limits identified in the probation statement. If the problem has been rectified to the satisfaction of the faculty and the intern, the Director of Clinical Training at the intern’s graduate institution and other appropriate individuals will be informed and no further action will be taken.

Termination
TCSC reserves the right to discharge an intern if the problem is not rectified through the above processes, or if the problem represents gross misconduct or ethical violations that have the potential to cause harm. The decision to terminate an intern’s placement would be made by the entire Training Committee and would represent a discontinuation of participation by the intern within every aspect of the internship program. The Training Committee would make this determination during a meeting convened within 7 days of the original meeting discussed in step 1. The Training Director may decide to temporarily suspend an intern’s clinical activities during this period prior to a final decision being made, if warranted. 

Hearing
If the intern wishes to challenge the decisions made, he or she may request a “Hearing” before the Training Committee. This request must be made in writing- an email will suffice- to the Training Director within 7 days of notification regarding the decision made regarding the behavior. If requested, the Hearing will be conducted by a review panel convened by the Training Director and consisting of him/herself, the Director of Psychological Services, and at least two other members of the Training Committee. The intern may request a specific member of the Training Committee to serve on the review panel. The Hearing will be held within 7 days of the intern’s request. The review panel will review all written materials and have an opportunity to interview the parties involved or any other individuals with relevant information. The review panel may uphold the decisions made previously or may modify them. The review panel has final discretion regarding outcome.  Documentation of the outcome of the Hearing will be retained in the intern’s file and communicated to the Director of Clinical Training at the intern’s graduate institution.

Health-Related Option
a. When reduced attendance or productivity occurs because of legitimate physical or mental disability, the training program should make every effort to see that appropriate referrals are made for treatment and assistance/accommodation. When, despite accommodations, the intern is unable to perform duties and cannot meet minimum expectations for the training program, the intern may be given the option of voluntarily terminating the training year or requesting a leave of absence for the purpose of restoring his/her health.  If the intern chooses not to exercise the option of voluntary termination or leave of absence and the result is consistent with the definition of problematic behavior as stated above, Due Process procedures may be initiated.
b. The intern remains accountable for addressing health-related problems.

Procedures for Grievances by Interns

PURPOSE:
Texas Child Study Center strives to give objective consideration to intern concerns and to assure fair resolution of intern problems through a formal problem resolution procedure.  Interns who pursue grievances in good faith will not experience any adverse professional consequences.

PROCEDURE:
NOTE: At the end of each step in this procedure, within the parameters of the next step, the intern shall decide whether or not to proceed to the next step.
NOTE: If the nature of the grievance is related to harm or harassment towards the intern, at any step in the process outlined below the Training Director may temporarily suspend the relationship between an intern and the person being grieved until the resolution has been determined.

Informal Review:
Unless the grievance is related to harm or harassment, interns should first try to resolve grievances promptly and directly with involved supervisors, staff members, fellow interns, and/or the Training Director.
Formal Review:
If the grievance cannot be informally resolved, or if the grievance is related to harm or harassment:

  1. The intern should submit a written statement outlining the grievance and requested resolution to the Training Director, or the Director of Psychological Services if the object of the grievance is the Training Director.
  2. The Training Director, or Director of Psychological Services, and intern will meet within 3 working days of receipt of the grievance to further discuss the grievance.
  3. The Training Director, or Director of Psychological Services, will notify the individual being grieved following this meeting, who will submit a written response within 3 working days of the meeting outlined in Step 2.
  4. Within 3 working days of receipt of this statement, the Training Director, or Director of Psychological Services, will meet with the intern and the individual being grieved to determine a resolution to the problem. The Training Director, or Director of Psychological Services, will document the process and outcome of the meeting. The intern and the individual being grieved will be asked to report back to the Training Director or Director of Psychological Services in writing within 10 working days regarding whether the issue has been adequately resolved.
  5. If the issue has not been adequately resolved, the Training Director or Director of Psychological Services will convene a review panel consisting of him/herself and at least two other members of the Training Faculty within 5 working days. The intern may request a specific member of the Training Faculty to serve on the review panel. The review panel will review all written materials and have an opportunity to interview the parties involved or any other individuals with relevant information. The review panel has final discretion regarding outcome. If the review panel determines that a grievance against a staff member has merit, then the issue will be turned over to the employer agency (Seton Family of Hospitals or the University of Texas at Austin) in order to initiate the due process procedures outlined by the staff member’s employer.

Records:
Upon conclusion of the formal process, all notes, documents, and materials shall remain the property of Texas Child Study Center and considered confidential. No taping shall be done during the any step of the process. 

1. "Working days" defined as Monday through Friday, exclusive of holidays, even though the intern may not be at work. In addition, calculation of "working days" begins the day after the receipt of the request.

Diversity and Non-Discrimination Policy

The Texas Child Study Center Internship Program strongly values diversity and believes in creating an equitable, hospitable, appreciative, safe, and inclusive learning environment for its interns. Diversity among interns and supervisors enriches the educational experience, promotes personal growth, and strengthens communities and the workplace. Every effort is made by TCSC to create a climate in which all staff and interns feel respected, comfortable, and in which success is equally possible and obtainable. TCSC strives to make every effort to dispel ignorance or anxiety associated with multicultural experiences. TCSC’s training program includes an expected competency in diversity training, and multiple experiences are provided to be sure that interns are both personally supported and well-trained in this area.
TCSC welcomes applicants from diverse backgrounds and believes that a diverse training environment contributes to the overall quality of the program. TCSC provides equal opportunity to all prospective interns and does not discriminate because of a person’s race, color, sexual orientation, religion, sex, national origin, age, disability, or any other factor that is irrelevant to success as a psychology intern. Applicants are individually evaluated in terms of quality of previous training, practicum experiences, and fit with the internship.

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