Objective Neuropsychological assessments with monolingual Spanish and bilingual Spanish/English-speaking adults present unique challenges. Barriers include, but are not limited to, the paucity of test norms, uncertainty about the equivalence of translated neuropsychological tests, and limited proficiency in the provision of culturally competent services. Similar issues generalize to telephone- and video-based administration of neuropsychological tests or teleneuropsychology (TeleNP) with Hispanics/Latinos (as), and few studies have examined its feasibility and validity in this group. The sudden onset of the COVID-19 pandemic prompted neuropsychologists to identify alternative ways to provide equitable care. Clinicians providing TeleNP to this population during (and after) the pandemic must consider safety, professional factors, and systemic barriers to accessing and benefitting from virtual modalities. Method This clinical process manuscript describes how cross-cultural neuropsychologists across five U.S. academic institutions serving Hispanics/Latinos (as) developed TeleNP models of care during the pandemic. Results Workflows, test batteries, and resources for TeleNP assessment with monolingual and bilingual Spanish-speaking patients are included. Factors guiding model development and informing decisions to incorporate virtual administration of neuropsychological tests into their practice are also discussed. Conclusions Provision of TeleNP is a promising modality. Additional research in this area is warranted with focus on cultural and contextual factors that support or limit the use of TeleNP with this community.
Objective Practicum experiences are critical to internship readiness. While established guidelines for practicum training in clinical neuropsychology exist, the application of such guidelines across training sites has received little attention. The objective of this study is to compare practicum training models across different sites. Methods We surveyed training supervisors regarding the cost and benefit of training practicum students in their setting. Results Despite wide variability across settings, results indicated that on average, practicum sites spent around 6 hours per week in direct active training and onboarding during the first 1–3 months of the training year. After 3–4 months, the hours spent on supervision decreased to about 1–2 hours of individual supervision and 1–2 hours of group supervision per week. By the 8th month, each practicum student provided the clinic with approximately 36 hours of direct service (considered an administrative benefit to the clinic). Conclusion Training practicum students is a labor of love, with overall net administrative benefits to the clinic. An advantage was seen in settings with multiple trainees, trainees at multiple levels, and tiered supervision models with access to diverse didactic experiences.
Multimorbidity—the coexistence of multiple chronic conditions within an individual—is the new normal in hospital settings. Individuals with higher levels of multimorbidity require a multidisciplinary and holistic approach to meet their needs, though the complexity of their neurocognitive profiles is still poorly researched. This study reported on the neurocognitive profile of a 69-year-old, left-handed, Latino cisgender male with 10 years of education. He was deemed to have a short-term mortality in 2018, yet is still enjoying a good quality of life in 2022. This case report illustrated (a) a rather common neurocognitive profile of a patient with complex multimorbidity, (b) the advantages of being served in a center of excellence with linguistically and culturally appropriate services that evaluate patients’ cognitive functioning and inform and provide continuity of care, and (c) the benefits of a holistic and multidisciplinary approach to the care of the multimorbidity population.
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