Publication: Programas de entrenamiento para la práctica de la psicoterapia: desarrollo de protocolos y estándares de medida basados en pruebas
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2021-06-30
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UCM
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Abstract
PsiCall UCM, el servicio de atención psicológica por vía telemática a estudiantes de la UCM, recibe y forma a un porcentaje importante de cada promoción del MPGS, en un sistema de práctica clínica supervisada que recibe excelentes valoraciones. Sin embargo, hay espacio para la mejora de este sistema de supervisión, incorporando valoraciones objetivas de competencias clínicas mediante la observación directa. Para este fin El objetivo de este proyecto ha sido traducir al castellano y adaptar las escalas al contexto práctico de PsiCall UCM, para proceder a la hetero y auto observación sistemática de las competencias del estudiantado que se forma en PsiCall, antes, durante, y al final del sus prácticas.
En el inicio del proyecto se partió de la traducción de las escalas CTS-R y CTACS. Una vez traducidas las escalas, se desarrollo un proceso de reflexión en varias rondas para señalar la adecuación de las diferentes competencias incluidas en las mismas al contexto de la Clínica Universitaria de Psicología UCM y el PsiCall UCM. Posteriormente, se desarrolló una ronda de revisión con los equipos de dirección, los becarios de ambos servicios, y con los profesionales externos. Todos ellos estudiaron el borrador de la escala y aportaron sugerencias que dieron lugar a modificaciones menores (cambios en la redacción del manual) o mayores (cambios en la estructura de la escala). Una vez alcanzada una versión final de la Escala de Competencias Clínicas, se derivaron versiones auto y hetero aplicadas mediante formularios en la suite de formularios de Google Drive. Se seleccionaron al azar una serie de interacciones de atención que fueron valoradas por el Coordinador del servicio, cuya valoración de las mismas mediante la escala se estableció como criterio experto. Posteriormente, los supervisores del PsiCall accedieron a las grabaciones ya valoradas, en primer lugar a modo de demostración, teniendo disponibles las valoraciones del Coordinador, en segundo lugar a modo de ensayo, pudiendo comparar sus valoraciones con las del Coordinador tras emitirlas mediante un formulario adaptado como cuestionario, y finalmente a modo de prueba de competencia con la escala. A partir de las valoraciones de esta última ronda se calculó el Índice de Correlacion Intraclase mediante un modelo mixto de acuerdo absoluto, con un intervalo de confianza del 95%. Se observo un buen índice de correlación intraclase de acuerdo con los valores convencionales de Fleiss (1986) (ICCA = 0,704; IC95% [,391 - ,897]; Fvv0(11,66) = 4,052, p < ,001).
Este proceso ha culminado con el desarrollo de una escala de 12 elementos, en versiones auto y hetero aplicadas. Además de su validación mediante la consulta y las aportaciones del conjunto de profesionales implicados, la escala, en su versión hetero aplicada ha sido estudiada psicométricamente en cuanto a su fiabilidad interjueces, encontrado valores muy adecuados de acuerdo al índice de correlación intraclase en un modelo mixto de acuerdo absoluto. Las escalas, por tanto, están desarrolladas y listas para su uso en el contexto asistencial y docente del PsiCall UCM. Se dispone de un manual, de una guía de respuestas, y de formularios de recogida de información implementados en la plataforma Google Drive que permiten la recogida de datos de manera automatizada y totalmente pseudononimizada.
PsiCall UCM, the online psychological care service for UCM students, receives and trains a significant percentage of each MPGS promotion in a supervised clinical practice system that receives excellent ratings. However, there is room for improvement in this supervision system, incorporating objective assessments of clinical competencies through direct observation. To this end, the objective of this project has been to translate into Spanish and adapt the scales to the practical context of PsiCall UCM, in order to proceed to the hetero and systematic self-observation of the competencies of the students who are trained in PsiCall, before, during, and at end of their practices. At the beginning of the project, we started with the translation of the CTS-R and CTACS scales. Once the scales were translated, a process of reflection was developed in several rounds to indicate the adequacy of the different competencies included in them to the context of the University Clinic of Psychology UCM and the PsiCall UCM. Subsequently, a review round was developed with the management teams, the interns from both services, and with external professionals. All of them studied the draft of the scale and provided suggestions that led to minor modifications (changes in the wording of the manual) or major (changes in the structure of the scale). Once a final version of the Clinical Competences Scale had been reached, self and hetero applied versions were derived using forms in the Google Drive suite of forms. A series of care interactions were randomly selected and assessed by the Service Coordinator, whose assessment of them using the scale was established as an expert criterion. Subsequently, the PsiCall supervisors accessed the already assessed recordings, firstly as a demonstration, having the Coordinator's assessments available, secondly as a trial, being able to compare their assessments with those of the Coordinator after issuing them using an adapted form as a questionnaire, and finally as a test of competence with the scale. From the evaluations of this last round, the Intraclass Correlation Index was calculated using a mixed model of absolute agreement, with a 95% confidence interval. A good intraclass correlation index was observed according to the conventional values of Fleiss (1986) (ICCA = 0.704; 95% CI [.391 - .897]; Fvv0 (11.66) = 4.052, p <.001). This process has culminated in the development of a 12-element scale, in auto and hetero applied versions. In addition to its validation through consultation and the contributions of the group of professionals involved, the scale, in its hetero-applied version, has been psychometrically studied in terms of its inter-judge reliability, finding very adequate values according to the intraclass correlation index in a mixed model in absolute agreement. The scales, therefore, are developed and ready for use in the PsiCall UCM healthcare and teaching context. There is a manual, a response guide, and information collection forms implemented on the Google Drive platform that allow the collection of data in an automated and totally pseudonymised way.
PsiCall UCM, the online psychological care service for UCM students, receives and trains a significant percentage of each MPGS promotion in a supervised clinical practice system that receives excellent ratings. However, there is room for improvement in this supervision system, incorporating objective assessments of clinical competencies through direct observation. To this end, the objective of this project has been to translate into Spanish and adapt the scales to the practical context of PsiCall UCM, in order to proceed to the hetero and systematic self-observation of the competencies of the students who are trained in PsiCall, before, during, and at end of their practices. At the beginning of the project, we started with the translation of the CTS-R and CTACS scales. Once the scales were translated, a process of reflection was developed in several rounds to indicate the adequacy of the different competencies included in them to the context of the University Clinic of Psychology UCM and the PsiCall UCM. Subsequently, a review round was developed with the management teams, the interns from both services, and with external professionals. All of them studied the draft of the scale and provided suggestions that led to minor modifications (changes in the wording of the manual) or major (changes in the structure of the scale). Once a final version of the Clinical Competences Scale had been reached, self and hetero applied versions were derived using forms in the Google Drive suite of forms. A series of care interactions were randomly selected and assessed by the Service Coordinator, whose assessment of them using the scale was established as an expert criterion. Subsequently, the PsiCall supervisors accessed the already assessed recordings, firstly as a demonstration, having the Coordinator's assessments available, secondly as a trial, being able to compare their assessments with those of the Coordinator after issuing them using an adapted form as a questionnaire, and finally as a test of competence with the scale. From the evaluations of this last round, the Intraclass Correlation Index was calculated using a mixed model of absolute agreement, with a 95% confidence interval. A good intraclass correlation index was observed according to the conventional values of Fleiss (1986) (ICCA = 0.704; 95% CI [.391 - .897]; Fvv0 (11.66) = 4.052, p <.001). This process has culminated in the development of a 12-element scale, in auto and hetero applied versions. In addition to its validation through consultation and the contributions of the group of professionals involved, the scale, in its hetero-applied version, has been psychometrically studied in terms of its inter-judge reliability, finding very adequate values according to the intraclass correlation index in a mixed model in absolute agreement. The scales, therefore, are developed and ready for use in the PsiCall UCM healthcare and teaching context. There is a manual, a response guide, and information collection forms implemented on the Google Drive platform that allow the collection of data in an automated and totally pseudonymised way.