The challenges observed in health-service-psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic but became more visible during the global health crisis. In a position article written by 23 trainees across different sites and training specializations, we use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe long-standing dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. We make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.
Given the challenges to the notion of objectivity posed by social psychological research on investigator effects, constructivist and critical epistemological perspectives, and the introduction of qualitative research methods in psychology, the investigators examined how leading methodologists understand the function of objectivity and subjectivity in psychological science. The aim of the study was to learn how contemporary methodologists view these issues so as to communicate converging perspectives to the field and inform methods education. A brief historical review of the concept of objectivity in psychology is presented to contexualize this examination. Eleven accomplished methodologists with expertise in a range of methods and epistemological perspectives were interviewed. Findings from a grounded theory analysis demonstrated that all the participants expressed concern about the belief that science is unaffected by scientists' perspectives, believing researchers and educators should problematize this perspective. Recommendations from participants included that science be viewed as a value-laden endeavor in which scientists systematically conduct research from multiple epistemological perspectives, and/or utilize diverse methods tailored to address their questions. Scientific procedures were detailed that could curtail dangers of either unchecked subjectivity or a false sense of objectivity. A functional analysis of these constructs, objectivity and subjectivity, suggested they both serve a similar scientific and an ethical purpose-to prevent the premature foreclosure of possible understanding because of the expectations of researchers. The mainstreaming of disclosures about the perspectives and positions of investigators, as well as their management, and the implementation of epistemological and methodological pluralism are encouraged to support this ethic.
Pre-exposure prophylaxis (PrEP) has altered the public health landscape for gay, bisexual, and other men who have sex with men (GBM) by significantly increasing protection against HIV infection. Early epidemiologic data showed GBM generally used PrEP as prescribed, i.e., as an additional protective tool over and above barrier protection, although subsequent reports have been equivocal. Irrespective of population-level trends, some GBM appear to have reevaluated their HIV risk tolerance and changed their interactions with sex partners. Scant published data have focused on factors that influence PrEP-using GBM's decisions about sexual behavior-including condom use as well as sex with HIV-positive partners-and sexual communication practices. Thus, in this study, we investigated those research concerns qualitatively via content analysis of individual interviews conducted with 103 GBM in New York City (M age 32.5 years, 50% White, 64% on PrEP > 6 months). Emergent themes reflect (1) participants' strong HIV knowledge; (2) changing GBM community norms about condom use on PrEP; (3) increased focus on risk tolerance with individual differences in post-PrEP condom use; (4) appreciation for routine sexually transmitted infection (STI) screening in PrEP care concomitant with some STI knowledge deficits; (5) decreased stigma concerning, and greater comfort with, HIVpositive sex partners; and (6) increased confidence discussing HIV status and condom use preferences with partners. Findings have implications for future research as well as for clinical practice, such as enhanced STI education and provider-initiated discussions about risk compensation, serosorting, and sexual communication skills.
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