Neuropsychological Assessment Rotation - Providence VA Medical Center
Faculty Supervisor (s): Megan Spencer, PhD, Donald Labbe, PhD, & Ryan VanPatten, PhD
The Providence VA Medical Center (PVAMC) serves as one of the major teaching hospitals for Psychiatry and Clinical Psychology at Brown. The PVAMC is dedicated to providing high quality comprehensive outpatient and inpatient healthcare to veterans residing in Rhode Island and southeastern Massachusetts. Patients are male and female veterans of the U.S. Armed Forces of varied ethnic and socioeconomic backgrounds. The PVAMC has one of the highest ratios of ambulatory to inpatient services of all VAs nationally. The MHBSS has a 20-bed inpatient unit with 700 admissions per year. MHBSS outpatient services have over 40,000 visits annually. The PVAMC serves as a primary site for Brown residents in Psychiatry, Surgery, and Primary Care Medicine.
This rotation is housed within PVAMC’s Mental Health and Behavioral Sciences Service (MHBSS). Experiences are provided in adult neuropsychology in outpatient and inpatient hospital settings. Referrals arise from various services in the medical center, particularly MHBSS and the Neurology and Primary Care services. The neuropsychology training experience emphasizes the impact of psychiatric, neurological, and general medical conditions on cognitive functioning.
Consultation requests are varied and include outpatient assessment of neurodegenerative disorders of aging (e.g., mild cognitive impairment, Alzheimer’s disease, vascular dementia, etc.), neurologic conditions (e.g., multiple sclerosis, movement disorders, chronic sequelae of stroke or traumatic brain injury), decision making capacity, psychiatric disorder (especially depression, posttraumatic stress disorder, substance abuse disorders), as well as attention disorders and learning disabilities. Inpatient referrals are typically for characterization of current cognitive status and differential diagnosis to guide treatment and discharge planning. Clinical psychology residents may have the opportunity to conduct assessments of military deployment-related traumatic brain injury in the Polytrauma/TBI Clinic. Clinical psychology residents may also have the opportunity to participate empirically validated psychoeducational cognitive training protocols with patients who do not have dementia. Care is largely provided using a face-to-face format, although some virtual care is offered for veterans living at a geographical distance from the medical center. Feedback of neuropsychological test results are also offered virtually based on veteran preference. The frequency and amount of virtual care will also vary in accordance with the COVID-19 pandemic based on infection and vaccination rates in the community.
The VA neuropsychology rotation is designed to emphasize the role of the neuropsychologist as an independent consultant to both outpatient and inpatient services. Clinical psychology residents will be provided with time for report writing and to fulfill their commitments to their year-long research and supplemental therapy placements.
Clinical psychology residents have full access to test manuals and other resources needed for efficient test administration, scoring, and interpretation. Computer word-processing templates are provided to aid in report writing and computerized scoring programs are available for many tests. All report writing is finalized within the VA's electronic medical record system. Directed readings are provided as need to supplement the training experience.