Iowa Admin. Code r. 645-244.3 - Educational requirements for conditional prescription certificate-joint rule
An
(1)
Degree. An applicant shall possess a postdoctoral master of
science degree in clinical psychopharmacology from a program designated by the
APA as a program for the psychopharmacology training of postdoctoral
psychologists. The degree program must be a minimum of 30 credit hours, not
including the practicum, and shall include coursework in basic science;
neuroscience; clinical medicine; pathological basis of disease; clinical
pharmacology; psychopharmacology; and professional, ethical and legal issues. A
minimum of one-third of the coursework must be completed in a live interactive
format. A program must be designated by the APA at the time the degree is
conferred.
(2)
Clinical
experience. An applicant shall have completed a clinical experience in
accordance with the requirements of this subrule. During the clinical
experience, a psychologist shall learn clinical assessment techniques and
pathophysiology through direct observation and hands-on training with a
training physician . During the clinical experience, a psychologist shall become
competent in health history interviews, physical examinations, and neurological
examinations with a medically diverse patient population. The clinical
experience must be associated with the psychopharmacology training program from
which the psychologist obtained the postdoctoral master of science degree in
clinical psychopharmacology.
a.
Scope. At the beginning of the clinical experience, the
psychologist shall directly observe the training physician performing clinical
assessments of patients. After the training physician determines the
psychologist has gained sufficient knowledge, the clinical experience shall
transition to the psychologist 's performance of clinical assessments of
patients under the direct observation of the training physician . After the
training physician determines the psychologist has gained sufficient knowledge
and experience, the psychologist may perform clinical assessments of patients
without being directly observed by the training physician , provided that the
training physician is on site at all times when the psychologist is with
patients and is reviewing all medical records. A psychologist and a training
physician shall have ongoing discussions regarding the psychologist 's clinical
assessment skills and progress in the clinical experience.
b.
Minimum experience. The
clinical experience shall consist of a minimum of 600 patient encounters that
shall be completed by the end of the practicum.
c.
Conflict of interest. A
training physician shall not be an employee of the psychologist or otherwise
have a conflict of interest that could affect the training physician 's ability
to impartially evaluate the psychologist 's performance. A psychologist may
utilize more than one training physician .
d.
Milestones. To
satisfactorily complete the clinical experience, a psychologist shall
demonstrate competency in each of the following:
(1) Perform a health history interview to
obtain pertinent information regarding a patient's chief complaint, history of
the present illness, past medical and surgical history, family history,
allergies, medications, and psychosocial history. The psychologist shall
perform a review of systems to elicit a health history and shall appropriately
document the health history.
(2)
Perform a physical examination in a logical sequence, ensuring appropriate
positioning of the patient, proper patient draping, and proper application of
the principles of asepsis throughout the examination. The psychologist shall
verbalize and assess the components of a general survey and be able to
accurately assess all of the following: vital signs, including pulse,
respiration, and blood pressure; skin, hair and nails; head, face and neck;
eyes; ears, nose, mouth and throat; thorax, lungs and axillae; heart;
peripheral vascular system; abdomen; and musculoskeletal system. The
psychologist shall be proficient in utilizing any equipment needed to conduct a
physical examination.
(3) Complete
a neurological examination demonstrating knowledge of the history related to
the neurological system and the ability to assess the following: mental status,
cranial nerves, motor system, sensory system, and reflexes. The psychologist
shall differentiate normal laboratory values from abnormal laboratory values
and correlate abnormal laboratory values with impaired physiological systems.
The psychologist shall identify adverse drug reactions and identify laboratory
data and physical signs indicating an adverse drug reaction.
e.
Informed
consent. At the initial contact, the psychologist shall inform the
patient, or the patient's legal guardian when appropriate, of the
psychologist 's training role in the clinical experience. The psychologist shall
provide sufficient information regarding the expectations and requirements of
the clinical experience to obtain informed consent and appropriate releases.
Upon request, the psychologist shall provide additional information regarding
the psychologist 's education, training, or experience.
f.
Training documentation.
The psychologist and the training director shall maintain documentation
accounting for all clinical experience patient encounters, including the dates,
times, and locations of all clinical experience patient encounters, and
documentation of completion of the milestones defined in these rules. The
applicant shall provide additional documentation to the board upon
request.
g.
Certification. The training physician (s) and the training
director shall certify on forms provided by the board that the applicant has
successfully completed the minimum number of clinical experience patient
encounters required and demonstrated competence in clinical assessment
techniques and pathophysiology through completion of the milestones defined in
these rules.
(3)
Practicum. An applicant shall have completed a practicum in
accordance with the requirements of this subrule. During the practicum, a
psychologist shall develop competencies in evaluating and treating patients
with mental disorders through pharmacological intervention via observation and
active participation. The practicum must be associated with the
psychopharmacology training program from which the applicant obtained the
postdoctoral master of science degree in clinical psychopharmacology and must
be completed in a period of time not less than six months and not more than
three years.
a.
Scope. At the
beginning of the practicum, the psychologist shall directly observe the
training physician evaluating and treating patients with mental disorders.
After the training physician determines the psychologist has gained sufficient
knowledge, the practicum shall transition to the psychologist 's evaluation and
treatment of patients under the direct observation of the training physician .
After the training physician determines the psychologist has gained sufficient
knowledge and experience, the psychologist may evaluate and treat patients
without being directly observed by the training physician , provided that the
training physician is on site at all times when the psychologist is with
patients, has personal contact with the patient at each visit, and is reviewing
all pertinent medical records. During the practicum, the training physician
shall make all final treatment decisions, with consultation from the
psychologist prior to making a final determination regarding the
psychopharmacological treatment of a patient.
b.
Minimum number of hours.
A practicum shall consist of a minimum of 400 hours. Only hours spent face to
face evaluating and treating patients with mental disorders and hours spent
discussing treatment plans with a training physician may count as practicum
hours. Time spent by the psychologist providing services that are within the
scope of practice of a licensed psychologist , such as psychological
examinations and psychotherapy, shall not be counted as practicum
hours.
c.
Minimum number of
patients. A psychologist shall see a minimum of 100 individual
patients throughout the practicum. A patient can be counted toward this
requirement if the patient has a diagnosed mental disorder and pharmacological
intervention is considered as a treatment option, even if a decision is made
not to prescribe a psychotropic medication to the patient. Over the course of
the practicum, the psychologist shall observe, evaluate, and treat patients
encompassing a range of ages and a variety of psychiatric diagnoses.
d.
Settings. At least 100
hours of the 400 hours must be completed in a psychiatric setting. At least 100
hours of the 400 hours must be completed in a primary care or community mental
health setting.
e.
Conflict
of interest. A training physician shall not be an employee of the
psychologist or otherwise have a conflict of interest that could affect the
training physician 's ability to impartially evaluate the psychologist 's
performance. A psychologist may utilize more than one training
physician .
f.
Milestones. To successfully complete the practicum, a
psychologist shall demonstrate competency in each of the following:
(1) Physical examination and mental status
examination. The psychologist shall perform comprehensive and focused physical
examinations and mental status evaluations, demonstrate proper use of
instruments, and recognize variation associated with developmental stages and
diversity.
(2) Review of systems.
The psychologist shall integrate information learned from patient reports,
signs, symptoms, and a review of each major body system, recognizing normal
developmental variations.
(3)
Medical history interview. The psychologist shall systematically conduct a
patient clinical interview, producing a patient's medical, surgical,
psychiatric, and medication history, as well as a family medical and
psychiatric history, and be able to communicate the findings in written and
verbal form.
(4) Assessment
indications and interpretation. The psychologist shall order and interpret
appropriate tests (e.g., psychometric, laboratory, and radiological) for the
purpose of making a differential diagnosis and monitoring therapeutic and
adverse effects of treatment.
(5)
Differential diagnosis. The psychologist shall determine primary and alternate
diagnoses using established diagnostic criteria.
(6) Integrated treatment planning. The
psychologist shall identify and select, using all available data, the most
appropriate treatment alternatives, including medication, psychosocial, and
combined treatments, and sequence treatment within the larger biopsychosocial
context.
(7) Consultation and
collaboration. The psychologist shall understand the parameters of the role of
a prescribing psychologist and work with other professionals, including a
patient's primary care physician, in an advisory or collaborative manner to
effectively treat a patient.
(8)
Treatment management. The psychologist shall apply, monitor, and modify as
needed the treatment of a patient and learn to write valid and complete
prescriptions.
(9) Medical
documentation. The psychologist shall demonstrate appropriate medical
documentation for the patient-psychologist interaction to include subjective
and objective assessment; mental status, physical examination findings, or
both; formulation; diagnostic impression; and comprehensive treatment
plan.
g.
Informed consent. At the initial contact, the psychologist
shall inform the patient, or the patient's legal guardian when appropriate, of
the psychologist 's training role in the practicum. The psychologist shall
provide sufficient information regarding the expectations and requirements of
the practicum to obtain informed consent and appropriate releases. Upon
request, the psychologist shall provide additional information regarding the
psychologist 's education, training, or experience.
h.
Training documentation.
The psychologist and the training director shall maintain documentation
regarding all patients observed, evaluated, and treated by the psychologist as
part of the practicum. The documentation shall clearly identify the training
physician for each patient. The psychologist and the training director shall
maintain documentation of all practicum hours, including the dates, times, and
locations of all practicum hours, and documentation of completion of the
milestones defined in these rules. The applicant shall provide additional
documentation to the board upon request.
i.
Certification. The
training physician (s) and the training director shall certify on forms provided
by the board that the psychologist has successfully completed the minimum
number of practicum hours, treated the minimum number of patients, and
demonstrated competence in the evaluation and treatment of patients with mental
disorders through pharmacological intervention through completion of the
milestones defined in these rules.
(4)
Examination. A
psychologist shall pass the Psychopharmacology Examination for Psychologists
(PEP) administered by the APA Practice Organization's College of Professional
Psychology or by the Association of State and Provincial Psychology Boards. The
passing score utilized by the board shall be the passing score recommended by
the test administrator. The examination score shall be sent directly from the
testing service to the board .
Notes
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