Return to Fellowship Page

Expected Outcomes | Structure, Format and Core Content | Mentorship | Products & Expectations | Didactic Component

Overall Goals of the VA Special Fellowship in Advanced Psychiatry and Psychology

The primary goal of the VA Special Fellowship Program in Advanced Psychiatry and Psychology is to develop outstanding academic and/or healthcare system leaders who will lead mental health research in the 21st century and effectively translate their research findings into clinical practice and educational activities. This goal will be achieved by providing Fellows with state-of-the-art training in mental health research, cutting-edge educational experiences, and advanced clinical training. Although many Fellows will pursue careers focused predominantly upon academic research and education in mental health, successful graduates of the program also will include those who pursue leadership careers that emphasize education and clinical contributions in the field of mental health. In particular, the Fellowship program aims to train Fellows for academic careers in mental health within the VA system. Additionally, Fellows who pursue careers outside of VA will be encouraged to make their trainees, interns, and residents aware of the career opportunities within the VA healthcare system.

Expected Long-term Outcomes

By the end of the Fellowship Program, Fellows pursuing academic clinical research careers should be ready to submit applications for career development awards. In particular, Fellows should be ready to apply for a VA career development award, a NIH K-Award, or other appropriate clinical research grants. Additionally, Fellows ought to be ready to pursue entry-level leadership roles, which integrate state-of-the-art research, education, and clinical approaches to mental health in the VA healthcare system and other academic institutions.

Structure, Format and Core Content

There are three main components of the Fellowship program: research, educational, and clinical activities. Research and educational activities comprise 75% of the Fellowship training, while advanced clinical training comprises 25% of the Fellowship. These activities are outlined in detail below. The Fellowship Program contains a didactic component which provides key core content on the three main components of the Fellowship program. Fellows are linked to other sites by means of a monthly Video Teleconference (V-Tel) seminar hosted by the Hub Site. This seminar provides an in-depth overview of key topics in mental health research and clinical practice by experts in the field.

Mentorship

1. The Fellowship program emphasizes a committee mentorship model composed of a primary mentor and other experts to assist the Fellow throughout their fellowship. At the start of the fellowship program, each Fellow in collaboration with the Fellowship Program Director at the local site will establish a committee of mentors who will oversee and advise on the research, educational and clinical components of the Fellowship. These mentors will be renowned researchers in their particular area of training. Some sites may elect to provide a separate mentor for the research, clinical, and education components of the program (although the sites will still designate a primary mentor), while others may provide mentors who will oversee more than one of these components.
2. At the beginning of the Fellowship, Fellows should meet with their primary mentor to determine the Fellow's background and training and to identify key areas the Fellow would like to strengthen. The primary mentor may oversee and advise on the development and conduct of the Fellow's research project, or a research mentor may do that. Fellows should establish individual research, educational and clinical plans in collaboration with their mentors at the beginning of the Fellowship program.
3. Local advisory committee, in collaboration with Fellows' mentors will help Fellows with career development and opportunities, particularly within the VA healthcare system.

Fellowship Products and Expected Learning Experiences

Although Fellows establish individual goals and timelines in collaboration with their mentors at the beginning of the Fellowship program, there is a core set of research, education, and clinical goals that should be achieved within the timeframe of the Fellowship Program. These expectations will be attained through the specific training experiences provided by the Fellowship program. Successful completion of these goals indicates that Fellows demonstrate competency in the research, educational, and clinical activities listed below. Mentors assess the progress of each Fellow at regular intervals. The specific training experiences and associated goals are as follows:

1. Research:
   1. Review literature and define a specific research question within the MIRECC's specialty area.
   2. Design research project.
   3. Obtain IRB approval.
   4. Collect data.
   5. Analyze data.
   6. Write-up and present the findings of the research project.
   7. Submit a minimum of two publications and be first-author on one of these.
   8. Understand how project relates to obtaining subsequent funding.
   9. Complete a draft grant application.

   In designing and conducting a research project, Fellows gain knowledge and experience in advanced methodological and statistical approaches to mental health research; in-depth literature review; knowledge about effectively designing a research investigation; increased understanding of IRB roles and responsibilities; and increased understanding of the legal and ethical issues involved in human subject research. Fellows also gain knowledge about accessing and using VA and other mental health electronic databases for research purposes, increased skills in collecting empirical data, knowledge and experience in advanced statistical analyses of data, and experience in preparing and submitting a publication about research findings. Finally, Fellows will gain increased understanding about the relationship of research investigation to obtaining subsequent funding, increased knowledge of funding mechanisms and career development research awards, and experience in preparing grant applications.

2. Education:
   1. Observe experts who provide effective mental health education to colleagues, trainees, staff, patients, and families using state-of-the-art educational techniques.
   2. Teach/present to colleagues, staff, trainees, patients, families and members of the community about their research and other specific mental health topics.
   3. Receive supportive, constructive feedback on teaching strengths and areas for improvement.
   4. Identify and describe the most recent developments in translational research.
   5. Participate and receive feedback during the second year in mentoring first year Fellows in research, educational, and clinical activities.
   6. Assist with one of the video teleconference (V-Tel) seminars and associated module.
   7. Present research findings at a national meeting.
   8. Obtain an introduction to Telemedicine procedures in Mental Health (V-Tel seminar).
   9. Obtain an introduction to videostreaming technology procedures (V-Tel seminar).

   These educational training activities provide opportunities for Fellows to gain knowledge and experience related to all aspects of effective teaching and translational research. They acquire knowledge and skills in the most recent advances in education and teaching through observing and participating in mentored teaching activities using current technology at their respective MIRECC sites. Fellows are provided with opportunities to expand their experience in using the latest educational tools such as on-line lectures, video-presentations, and chat rooms. Fellows are introduced to and obtain experience in the procedures involved in telemedicine, the use of video streaming technology, and video conferencing. Additionally, Fellows increase their experience in the supervising and advising others in research, educational, and clinical activities. Through skills obtained in translational research and use of state-of-the-art educational tools, Fellows also enhance their abilities to disseminate research findings in a public forum and to a wide range of audiences effectively.

3. Clinical:
   1. Receive training in advanced clinical practice within the MIRECC's specialty area. Such training should include involvement in direct provision of care to patients. In most settings, it is expected that this care will be provided in an interprofessional team context, and that Fellows will receive training in concepts of interprofessional care, its applicability in mental health settings, and skills for becoming an effective interprofessional team member.
   2. Receive training in providing clinical supervision supervision to more junior trainees in the Fellow's discipline; this training will include learning supervisory concepts, providing direct clinical supervision, and receiving supervision of that supervision.
   3. Use current clinical research findings to enhance patient care by incorporating evidence-based approaches into assessment, treatment planning, treatment implementation, and evaluation of treatment outcomes.
   4. Apply statistical methodologies to enhance clinical decision-making and receive supervision on use of such methodologies as applied to clinical decision-making with specific patients receiving care from the Fellow.
   5. Obtain training in complex ethical and legal issues regarding service provision within the MIRECC's specialty area and receive supervision on applying this knowledge to clinical decision-making with specific patients receiving care from the Fellow.
   6. Develop the ability to identify areas in their own clinical practice as part of the MIRECC Fellowship where the evidence-base is insufficient to guide clinical decision-making and develop the ability to generate research questions and methodologies that, if conducted, would have the potential to expand the relevant evidence base in the area of clinical service delivery.
   7. Obtain training in using advanced clinical technologies in mental health practice, such as teleconsultation.

   Through the clinical component of their Fellowship Program, Fellows gain tools crucial to skilled mental health clinical care. Through specialized seminars and mentorship, Fellows increase their understanding of the legal and ethical issues involved in clinical practice in mental health. They also enhance their knowledge of advanced clinical approaches in mental health, such as telepsychiatric consultation, the use of cutting-edge neurochemical, neuroimaging, and chronobiological assessements and the identification, evaluation, and selection of best clinical assessment measures. Additionally, they receive training in statistical methods and procedures that enhance clinical decision-making. Fellows also gain: experience in providing clinical supervision and advice to trainees and increase their understanding of the principles of co-morbidity and how they affect clinical practice. Fellows also increase their ability to apply principles of evidence-based medicine to day-to-day clinical practice and to direct mental health research through their clinical experiences. The Fellowship program encourages clinical experiences that inform the Fellows' Research.

Didactic Component and Seminar Series

The didactic component takes place over the 10 months of the academic year, from October, 1st through the end of June of the following year and starts up again in October. The didactic component provides key core information on the research, educational and clinical components of the Fellowship program. Fellows are encouraged to attend relevant seminars, presentations and courses at each Fellowship site that will facilitate their research, clinical and educational goals. This core content insures that all Fellows have a fundamental knowledge of key content areas essential for the pursuit of leadership roles in mental health. Additionally, key information is presented through monthly V-tel seminars. Additional information on these and other important topics also are provided on-line on the Fellowship website as videos or Powerpoint presentations. Thus, each key topic presented in the seminar series is accompanied by a module with more specific details available on-line. Each site contributes to one or more of the V-Tel seminars, and the associated modules, in which they have significant expertise. The following Key Content areas and topics are included in the didactic on-line component and the 2002-2003 seminar series of the Fellowship program.

Didactic Component for Academic Year 2003-2004

Research/Administration:

1. Introduction to the VA healthcare system and Careers in Mental Health.
2. Legal and Ethical Issues in Mental Health.
3. IRB Roles and Responsibilities.
4. Developing, Leading and Financing Mental Health Systems.
5. Grantsmanship, Funding and Resources.

Research Methods:

1. Signal Detection Methods Use in Prediction of Treatment Response.
2. Kappa Coefficients and Measuring Inter-Rater Reliability.
3. Effect Size: Clinical versus Statistical Significance.
4. Pitfalls of Randomized Clinical Trials: The Value of Large, Simple Studies.
5. Implementation of the Moderator/Mediator Analyses in the Risk Research Framework.
6. Meta Analysis.
7. Placebo Controlled Trials.
8. Principles in Conducting Quality Research.
9. Exploratory vs. Confirmatory Research.

Health informatics:

1. Mental Health Databases.
2. Managing and Using Electronic Databases.
3. Accessing VA Databases for Research and Educational Purposes.

Clinical:

1. Mental Health Epidemiology.
2. Health Service Research.
3. Principles of Co-morbidity.
4. Choosing the Right Scale: Evaluating the Validity and Reliability of Mental Health Measures.
5. Intervention Research.
6. Diversity Issues.

Educational:

1. Translational Research.
2. Interprofessional Collaboration.

Science:

1. Genetics.
2. Neuroscience Receptors/Imaging.