Neuropsychology Rotations

Availability: Major rotation only

Supervisor: Maria E. Cottingham. Ph.D. and Elizabeth Fenimore, Ph.D.

Setting: The neuropsychological assessment rotation provides an opportunity to learn about brain-behavior relationships, the field of neuropsychology, various methods of assessment, and the functioning of a neuropsychology service within a medical center setting. Neuropsychology is a consultative service that receives referrals from various sources including neurology, neurosurgery, psychiatry, primary care, and other specialty clinics/services (e.g., transplant). The service primarily provides differential diagnostic assessment and recommendations for treatment, with most patients being seen on an outpatient basis. Typical cases involve the assessment of cortical and subcortical dysfunction associated with various medical conditions, illnesses, and injuries, including degenerative dementias (e.g., Lewy-body, Alzheimer’s, frontotemporal), multiple sclerosis, cerebrovascular diseases/CVAs, epilepsy, traumatic brain injury, “normal aging” memory complaints, and pseudodementia. Due to the nature of the VA population, many evaluations also include the assessment of psychiatric disorders, such as Major Depression and Post-Traumatic Stress Disorder, and their impact on cognitive performance. Because changes in mood and personality may occur in certain neurological conditions, personality assessment (e.g., PAI, MMPI-2-RF) may also play an important role in a neuropsychological assessment. Since the majority of our patients have comorbid medical conditions (e.g., diabetes, hypertension, sleep apnea, COPD), interns have the opportunity to learn about the impact of non-neurological conditions and medications on cognitive functioning.

What Interns Will Do: The neuropsychological assessment format employs a modified "flexible battery" approach, with typical tests including the WAIS-IV, CVLT-II, RBANS, RULIT, GPB, COWAT, WCST and others. Interns are expected to conduct one to two supervised assessments per week, depending upon their level of experience and training needs. Interns will learn how to conduct a neuropsychological clinical interview, administer and score commonly-used neuropsychological tests, interpret the results, develop useful recommendations, write a comprehensive but relatively brief (4-5 page) neuropsychological report, and provide feedback to patients, families, and other medical staff. Through the clinical cases, neuropsychology seminar, and outside readings, interns will have the opportunity to learn functional neuroanatomy to integrate into the report and recommendations. Interns may attend Neurology Rounds at Vanderbilt and other didactics. Supervision includes 1-2 hours of scheduled individual time, as well as ad hoc supervision. Supervision is also provided via written detailed feedback on each of the intern’s neuropsychological reports. Because the services provided by neuropsychology are often communicated to the referral source solely in writing, interns will be expected to have, or be willing to develop, accurate written communication skills during the rotation. The overall goal of this rotation is to help the intern gain a broad understanding of brain-behavior relationships that will enhance his or her general clinical skills. For those who are interested in pursuing post-doctoral neuropsychological training, this rotation will also provide a firm foundation for the post-doctoral residency.

Availability: Major rotation only

Supervisor: Randy Petersen, Ph.D.

Setting: The Neuropsychology Rotation is a consultation service that receives referrals from various sources, including Primary Care, Psychiatry, Psychology, and Neurology. The service primarily provides differential diagnostic assessment and recommendations for treatment, with most patients being seen on an outpatient basis. The clinic provides exposure to a variety of patient populations ranging in age from the mid 20's to the upper 80's. Typical cases involve the assessment of cognitive dysfunction associated with various medical conditions, illnesses, and injuries – including degenerative dementias (e.g., Alzheimer’s Disease, frontotemporal), cerebrovascular disease/CVA, traumatic brain injury, “normal aging” memory complaints, and pseudodementia. Patients often have multiple comorbid medical conditions (e.g., high blood pressure, diabetes, sleep apnea, COPD, etc.), and interns have the opportunity to learn about the impact of non-neurological conditions and medications on cognitive functioning. Due to the nature of the VA population, patients also frequently present with comorbid psychiatric disorders (Major Depression, Post-Traumatic Stress Disorder, Substance Abuse, etc.) which can also adversely impact cognitive performance. Throughout the rotation, interns will gain exposure to patients with a variety of medical, psychiatric, and motivational factors that may influence cognitive test performance. 

What Interns Will Do: The intern will be responsible for conducting one to two supervised neuropsychological assessments per week, depending upon their level of experience and training needs. Interns will learn how to conduct a neuropsychological clinical interview, administer and score commonly-used neuropsychological tests, interpret the results, develop useful recommendations, write a comprehensive but relatively brief (4-5 pages) neuropsychological report, and provide feedback to patients, families, and other medical staff. The typical format of testing utilizes a “flexible battery” and grouping of measures that can be modified to fit patient needs or limitations. Tests commonly used include the WAIS-IV, CVLT-II, BVMT-R, COWAT, WCST, Trails, BNT, FTT, GPB, TOMM and MSVT. Supervision is at structured times during the week (1-2 hours) and also occurs informally whenever needed, such as before, during, and after an evaluation. All tests are computer scored using an integrated scoring program and summary sheet that allows for simultaneous computation of standard scores based on multiple sources of normative data (e.g., Heaton, MetaNorms, MOANS/MOAANS, test manuals, etc.). Ample readings and up-to-date research findings relevant to clinical cases as well as a broad range of neuropsychology-related topics are also provided.