ASPPB to make EPPP Part 1 and 2 Standard

[WisNeuro]

Long overdue change, and the new timeline should streamline things.

https://www.asppb.net/resource/resmgr/eppp_/eppp_announcement_october_20.pdf

https://www.asppb.net/resource/resmgr/eppp_/eppp_factual_overview.pdf

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[texanpsychdoc]

I'm glad I got licensed when I did in Texas and Ohio. I have no intention in doing step 2.

 

[bluecolourskies]

Yuppp same here. Super relieved I got licensed in 2 states when I did

 

[super.ego]

I volunteered to take the step 2 exam as part of its development. Not impressed.

 

[WisNeuro]

Well, y'all have til 2026, depending on the state. And it looks like part 1 will be much closer to program graduation.

 

[Justanothergrad]

So the thing about a need for incremental validity is....


Seriously, this was BEYOND a poor decision. I like the idea of a performance based standard rather than a knowledge based standard. The EPPP-1 lacks any real validity or indication of relationship with quality of practice (e.g., ethics violations, treatment outcome, etc) and does not serve to gate keep long-term, which would be one benefit that is likely to lead to improved practice at least in theory (people just retake, we see that here on this forum). Given the lack of this data for Step1, keeping it in its current form is logically questionably and unsupported empirically. Adding a second test that has not yet demonstrated an impact on any of those same key issues. The result is increased cost/burden/etc and no evidence of greater validity in a field that is already viewed as a mid-tier with modest earning relative to comparable education standards. This wont lead to greater rates, it just creates more overhead and lengthier processes. Heck, we dont even know 'why' therapy works so how can we have an effective evidence based determination of 'what is right'. Answer, we have to dodge that issue (i.e., no clear mechanistic proof) to construct a test intended to measure treatment as a CRITICAL part of our job. Then, of course, there are all the issues with DEI which seem to have been entirely ignored - they are present on the EPPP-1 and there are new/additional ones now.

Within assessment (my broad and explicit area of focus for those who don't know who I am), we do not have explicit standards of education set by most of the major organizations/boards, the exception is neuro which has led in a lot of ways about educational standards (still not convinced boarding is effective or good, for all the same reasons). Heck, even board certified neuropsychologists aren't consistent in labeling, interpretation, and data use (see Guilmette et al., 2008; Schoenberg et al., 2017- links below), leading to recent consensus work (Guilmette et al., 2020) that still hasn't born the fruit needed to claim success. We dont even have good information on HOW to educate folks (i.e., what exercises work, what areas are critical) and the research on performance-based competency is minimal (Ingram et al., 2022).


Heres the question, for all the folks excited - what evidence are you going to look for as a change in the field that would support this substantial shift?
>> Decreased rates of malpractice for ethical issues?
>> Increased effectiveness and consistency in assessment report interpretations?
>> Improved metrics for treatment outcome?
>> Increased reimbursement as an outsider recognized sense of validity for this change?

If none of the above can be demonstrated, how is this a science based decision?

A relevant few references

APA PsycNet

psycnet.apa.org

https://www.tandfonline.com/doi/full/10.1080/13854046.2020.1722244

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores

Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause …

www.sciencedirect.com

APA PsycNet

psycnet.apa.org

Maybe a Flexner moment would have been a better start if the issue is supposed to be education. Just a thought.

 

[Justanothergrad]

I'm glad I got licensed when I did in Texas and Ohio. I have no intention in doing step 2.

If you change your mind and want to throw money away, you can send it to me directly and I'll at least mail you a bottle of whiskey to say thanks.

 

[WisNeuro]

So the thing about a need for incremental validity is....


Seriously, this was BEYOND a poor decision. I like the idea of a performance based standard rather than a knowledge based standard. The EPPP-1 lacks any real validity or indication of relationship with quality of practice (e.g., ethics violations, treatment outcome, etc) and does not serve to gate keep long-term, which would be one benefit that is likely to lead to improved practice at least in theory (people just retake, we see that here on this forum). Given the lack of this data for Step1, keeping it in its current form is logically questionably and unsupported empirically. Adding a second test that has not yet demonstrated an impact on any of those same key issues. The result is increased cost/burden/etc and no evidence of greater validity in a field that is already viewed as a mid-tier with modest earning relative to comparable education standards. This wont lead to greater rates, it just creates more overhead and lengthier processes. Heck, we dont even know 'why' therapy works so how can we have an effective evidence based determination of 'what is right'. Answer, we have to dodge that issue (i.e., no clear mechanistic proof) to construct a test intended to measure treatment as a CRITICAL part of our job. Then, of course, there are all the issues with DEI which seem to have been entirely ignored - they are present on the EPPP-1 and there are new/additional ones now.

Within assessment (my broad and explicit area of focus for those who don't know who I am), we do not have explicit standards of education set by most of the major organizations/boards, the exception is neuro which has led in a lot of ways about educational standards (still not convinced boarding is effective or good, for all the same reasons). Heck, even board certified neuropsychologists aren't consistent in labeling, interpretation, and data use (see Guilmette et al., 2008; Schoenberg et al., 2017- links below), leading to recent consensus work (Guilmette et al., 2020) that still hasn't born the fruit needed to claim success. We dont even have good information on HOW to educate folks (i.e., what exercises work, what areas are critical) and the research on performance-based competency is minimal (Ingram et al., 2022).


Heres the question, for all the folks excited - what evidence are you going to look for as a change in the field that would support this substantial shift?
>> Decreased rates of malpractice for ethical issues?
>> Increased effectiveness and consistency in assessment report interpretations?
>> Improved metrics for treatment outcome?
>> Increased reimbursement as an outsider recognized sense of validity for this change?

If none of the above can be demonstrated, how is this a science based decision?

A relevant few references

APA PsycNet

psycnet.apa.org

https://www.tandfonline.com/doi/full/10.1080/13854046.2020.1722244

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores

Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause …

www.sciencedirect.com

APA PsycNet

psycnet.apa.org

Maybe a Flexner moment would have been a better start if the issue is supposed to be education. Just a thought.

Regarding Guilmette and standard labeling in neuropsych, that's actually come a long way, at least in my region. Majority of reports I see from other clinically and forensically use the consensus labeling system.

 

[Justanothergrad]

Regarding Guilmette and standard labeling in neuropsych, that's actually come a long way, at least in my region. Majority of reports I see from other clinically and forensically use the consensus labeling system.

For sure, I hope so at the level of work you're doing. We have one domain (cog) that we've seen improvement in this area. We're still miles from it on other domains like personality/diagnostic pathology (broadly defined). As a side note, Guilmette and Hagan were good friends my closest/most influential training supervisor. It was a fun thing to get contemporary perspectives on this stuff directly not that many years ago.

 

[iliketohelppeople]

Is there anyone who supports implementation of the EPPP-2? I have yet to meet anyone who is really onboard with this change. As justanothergrad notes, is there really any evidence that this is a good/helpful/needed test?

The only motivating factor I can really think of is $$$.

 

[WisNeuro]

Is there anyone who supports implementation of the EPPP-2? I have yet to meet anyone who is really onboard with this change. As justanothergrad notes, is there really any evidence that this is a good/helpful/needed test?

The only motivating factor I can really think of is $$$.

ASPPB developed this at the request of state boards, and it is generally a revenue neutral process. They've been pretty transparent the whole way. We recently spoke to on of the board members as a state organization

 

[Justanothergrad]

plenty of boards have even openly opposed this (eg. GA).

 

[WisNeuro]

plenty of boards have even openly opposed this (eg. GA).

Wasn't Georgia an early adopter? Did the state legislature override the licensing board and implement it?

 

[texanpsychdoc]

If you change your mind and want to throw money away, you can send it to me directly and I'll at least mail you a bottle of whiskey to say thanks.

I'll take a single-malt Scotch

 

[Justanothergrad]

Wasn't Georgia an early adopter? Did the state legislature override the licensing board and implement it?

You're right. It was the GA Psych association of Students who objected. Not enough coffee to track fully lol. There are plenty though

 

[WisNeuro]

You're right. It was the GA Psych association of Students who objected. Not enough coffee to track fully lol. There are plenty though

Ah ok, because that wouyld have been weird as teh Board has to be the one to approve it in the first place. I definitely would have heard about a state legislature overiding a board in this. Not surprised about the student assns though, that will be a constant.

 

[iliketohelppeople]

ASPPB developed this at the request of state boards, and it is generally a revenue neutral process. They've been pretty transparent the whole way. We recently spoke to on of the board members as a state organization

Yes, and I see this in the notes. This makes me think even more about who stands to benefit from this implementation? I guess I just think that it is going to cost more $$$ for applicants for limited, if any, benefits for the field/society.

 

[Justanothergrad]

Ah ok, because that wouyld have been weird as teh Board has to be the one to approve it in the first place. I definitely would have heard about a state legislature overiding a board in this. Not surprised about the student assns though, that will be a constant.

What benefits are boards expecting, in reality, from this new thing

 

[WisNeuro]

Yes, and I see this in the notes. This makes me think even more about who stands to benefit from this implementation? I guess I just think that it is going to cost more $$$ for applicants for limited, if any, benefits for the field/society.

And these are fair questions, but ASPPB making money of this is baseless. BTWs if anyone is ever interested, their tax returns are public information.

What benefits are boards expecting, in reality, from this new thing

A more abstract goal is the alignment with other doctoral professions in having both skills and practice assessed in some way for licensing, as we are currently the only one without. The question of how performance on these relates to meaningful career outcomes, is a valid question. Personally, seeing the backslide of the rigor of psychology and the increasing adoption of pseudoscience within our ranks, I'm generally for increasing the stringency of our standards. Though, I'd like to see more emphasis on understanding of statistics, psychometrics, and ability to critically evaluate research.

 

[AbnormalPsych]

What is even going to be on this test? At one point I heard examinees would be talking to a robot or something wild as part of it.

 

[foreverbull]

If they think a skills based test is necessary, why double the size of the existing rote knowledge-based exam and charge (almost) double? (ASPPB says they’re dropping the price 25% off the EPPP2, but that’s still far more than the EPPP1 to pay for both).

I do think skills-based is closer than broad knowledge if we talk aliginimg exams with our practice efficacy at face value, but why not split the current EPPP into half knowledge half skill and pilot that instead of a whole separate exam?

And agree with others about needing more evidence to support why this change is needed. @Justanothergrad ’s questions about indirect outcomes are crucial to answer and measure as data points. If this doesn’t ensure a higher standard of practice via those outcomes, then this exam is a colossal waste of time, money, and energy despite the good intentions as discussed in the 2nd document @WisNeuro shared.

 

[Psych20122]

So…… if I passed Part 1 a few weeks ago… all is good?

 

[WisNeuro]

So…… if I passed Part 1 a few weeks ago… all is good?

If you are licensed in a non early adopter state before 2026, yes.

 

[super.ego]

What is even going to be on this test? At one point I heard examinees would be talking to a robot or something wild as part of it.

No conversations with robots. There are a few videos that play out clinical scenarios that must be responded to using multiple choice.