Training Activities

Clinical Training Activities

Primary:

Clinical Service Requirements (70%):

• Outpatient
  • Assessment—All Sites: Fellows will participate in general outpatient neuropsychological assessment of patients aged 18-100 with referral issues primarily including Memory Loss and Dementia, with additional referrals in Moderate to Severe Traumatic Brain Injury, Mild Traumatic Brain Injury, Stroke, Epilepsy, MS, Movement Disorders, Psychiatric Issues, Infectious Disease, Substance Abuse, and so forth. Outpatient assessments also include pre-surgical evaluations for epilepsy surgery, transplant, and placement of DBS hardware. Outpatient assessments are typically based on a flexible battery approach and are completed with psychometrist assistance, once fellows have demonstrated competence in administration and scoring. Fellows are expected to complete 3-5 outpatient evaluations per week with the option to carry a small therapy caseload.

• Interdisciplinary Clinics—OMC Jefferson Highway: Fellows will participate in several multidisciplinary clinics throughout their training:
  • Huntington’s Disease and at-risk Huntington’s Disease Clinic: The only Huntington’s Disease Society of America Center of Excellence in the Gulf South. Other disciplines involved include neurology, social work, speech and language pathology, and genetic counseling, among others. Fellows will complete interviews and targeted intervention with patients and caregivers and consult with other professionals.
  • Memory Clinic: Part of the Brain Health and Cognitive Disorders Program. Collaborative disciplines include neurology, social work, and allied health professionals. Fellows will complete interviews and brief cognitive evaluations with patients and consult with patients, their families, and other professionals.
  • DBS Case Conference – Case discussion with neurology and neurosurgery faculty and residents regarding candidates for deep brain stimulation surgery, including pre-surgical workup, surgery decision-making, and post-surgical outcomes.
  • Epilepsy Case Conference– Case discussion with neurology and neurosurgery faculty and residents regarding candidates for epilepsy surgery, including pre-surgical workup, surgery decision-making, and post-surgical outcomes.

• Inpatient Assessment—OMC Jefferson Highway: Fellows will primarily be involved in clinical interview/diagnosis of individuals with Psychogenic Non-Epileptic Events (PNEE or Conversion Disorder; 1-2 a week on average), Psychogenic Movement disorders, or Psychogenic Stroke-like events. They will consult on cases with Delirium/Capacity Issues, as they come up.
• Treatment /Management - All Sites:
  • PNEE Management via Tele-Health
  • Care Management via Tele-Health

First-year fellows will begin by observing the attending neuropsychologist via Direct Supervision. They will be observed administering neuropsychological tests, either by Direct Supervision by the attending neuropsychologist or via Indirect Supervision by trained psychometrist. Interpretation of neuropsychological data will occur via Oversight, and all neuropsychological evaluative reports will be reviewed and signed by the supervisor. 

Second-year fellows will conduct evaluations with the use of trained psychometrists, with administration of tests when clinically necessary. Fellows will conduct interviews with a combination of Direct and Indirect Supervision. All neuropsychological evaluative reports will be reviewed and signed by the supervisor.

Secondary:

• Forensic—OMC Jefferson Highway, Ochsner Baptist, OHC Covington: Fellows will have an opportunity to observe and assist in criminal and civil forensic evaluations. Forensic opportunities will be granted on a case by case basis, depending on fellow interest, availability, and progress in meeting clinical requirements. Criminal evaluations may include pre-trial competence to stand trial and criminal responsibility evaluations, aid in sentencing evaluations, Miranda capacity evaluations, and risk assessments. Civil evaluations may include independent medical evaluations, worker’s compensation evaluations, and evaluations related to civil litigation, including personal injury and capacity/guardianship.

• Consultation: Fellows have an opportunity to assist with consultative evaluations at Covington Behavioral Health, an inpatient psychiatric facility in Covington. Consultation opportunities will be granted on a case by case basis, depending on fellow interest, availability, and progress in meeting clinical requirements

Client Population Served

Founded in 1942 by five physicians, Ochsner Health is one of the largest independent academic health systems in the United States and Louisiana’s largest nonprofit health system. With 40 owned, managed and affiliated hospitals and specialty hospitals and more than 100 health centers and urgent care centers, nearly 25,000 employees, over 1,300 employed physicians in more than 90 medical specialties and subspecialties, Ochsner is Louisiana’s largest health system. Ochsner is the only Louisiana hospital recognized by U.S. News & World Report as a "Best Hospital" in three different specialty categories. Ochsner conducts more than 700 clinical research studies annually and is proud to provide a tobacco-free environment for our employees and our patients. Ochsner serves patients from across Louisiana, every state in the nation, and more than 80 different countries.

The Neuropsychology group receives referrals from throughout the Ochsner Health and regionally primarily from neurologists, but also primary care, neurosurgery, physical medicine, psychiatry, and other disciplines. The neuropsychologists all follow a generalist model, assessing inpatients and outpatients in ages from 10-100 with referral issues including: Memory Loss, Dementia and its various subtypes, TBI/Concussion, Stroke, Epilepsy, MS, Movement Disorders, Psychiatric Issues, especially functional neurologic disorders, Infectious Disease, Substance Abuse, and so forth. Our neuropsychology team leads the Cognitive Disorders and Brain Health Program along with the interdisciplinary memory clinic and innovative tele-health dementia care management programs. They also participate in the ALS Clinic, Huntington’s Clinic, Pre-Surgical Evaluations prior to DBS placement, Epilepsy Surgery, Organ Transplant, and Forensic/Medical-Legal matters (e.g., Criminal/Civil matters).

Non-Clinical Training Activities

Specific Training Activities (25%): Fellows are required to take part in neuropsychology-specific training activities including:

• Didactics – Fellows, attendings, students, and affiliate faculty will provide training on core neuropsychology topics, special topics of interest, and associated fields (e.g., clinical neurology, social work, etc.).
  • Fellows will lead didactics three times each training year.
• Neurology Resident Lecture Series – Fellows will each lead one didactic per year for our neurology residents.
• Journal Club – Fellows, attendings, and students choose current research articles, relevant book chapters, and/or other readings to lead discussion regarding the practice of neuropsychology and related fields.
• Case Conference – Fellows and students present recent cases, lead discussion, and receive feedback from peers and attendings regarding conceptualization, interpretation, and recommendations.
• Mock Oral Exams – Attendings will lead fellows and students through mock oral exams, including case sample review, fact finding, and ethics vignettes.

They are also encouraged to attend complementary training activities including;

• Neurology Grand Rounds – Local and national speakers present on a range of topics relevant to the practice of neurology and related disciplines.
• Neurology Case Presentations – Neurology faculty and residents present cases for group discussion on conceptualization, interpretation, and recommendations
• Psychiatry Grand Rounds – Local and national speakers present on a range of topics relevant to the practice of psychiatry and related disciplines.
• Psychology Hangout – Psychologists from across the Ochsner system meet monthly to discuss current events and professional issues.
• Neuroradiology Rounds- Case discussion with neurology and radiology faculty and residents regarding interesting neuroradiology findings.
• Neurovascular Journal Club-Article discussion with neurology and neurosurgery faculty and residents.
• DBS Case Conference – Case discussion with neurology and neurosurgery faculty and residents regarding candidates for deep brain stimulation surgery, including pre-surgical workup, surgery decision-making, and post-surgical outcomes.
• Epilepsy Case Conference – Case discussion with neurology and neurosurgery faculty and residents regarding candidates for epilepsy surgery, including pre-surgical workup, surgery decision-making, and post-surgical outcomes.