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The internship program is designed to provide students with an opportunity to apply course-based learning. The internship offers a structured, applied experience that expands upon program curriculum learning objectives to assist student interns in developing effective professional skills. The program offers tailored internship experiences that relate to each of the two concentrations (clinical and management).
Students are expected to perform specific duties during the time on-site each week until they have completed a total of internship hours. Student interns may continue hours during the intersession following an enrolled semester. The exact schedule is negotiated between the internship site and the DBH student intern on a case-by-case basis. The DBH program evaluates a student intern's readiness to perform doctoral-level skills based upon performance evaluations by internship site staff, the DBH intern consultant, and completion of course-specific performance metrics.
Clinical interns are expected to function as members of a primary care/medical team. Each student is a licensed or license-eligible behavioral clinician and is expected to provide consultation to all members of the medical team (e.g. PCP, MA, RN). The student intern is expected to join appropriate team meetings and clinical rounds. Our training program emphasizes developing the collaboration skills needed for providing rapid access by any team member for real-time consultation and patient assessment, intervention, and recommendations. For example, in a "hallway handoff" the physician or nurse will approach the student intern, briefly describe a case, introduce the student intern to the patient, and return to his/her regular duties. The student intern will assess the patient, initiate behavioral interventions, and report to the referring clinician. DBH student interns are trained in behavioral interventions that "fit" the medical setting. The intern conducts brief assessments (15 minutes average) and interventions (20 minutes average), manages multiple cases at one time during busy periods, and clearly communicates and consults with other members of the team to ensure continuity of care.
Management interns are expected to function as a resource to a healthcare management team. Each student is expected to regularly engage in direct, face-to-face contact with the site management team. Student interns are expected to interact with personnel performing relevant management activities in areas such as operations, project management, quality improvement or finance in the internship setting. Student interns will consult with internship site personnel and participate in relevant meetings and related activities. Students who are working in organizations offering clinical services will be expected to observe clinical rounds or meetings as part of their activities. DBH student interns are trained in health care management strategies that are designed to meet the emerging demand for integrated health care programs. The intern will work on at least one management project and clearly communicate with members of the management team to ensure performance meets expectations.
Clinical interns focus on brief, focused treatment of: 1) common behavioral disorders in medical settings (e.g., depression, anxiety and panic, substance abuse and ADHD); prevention and disease management for chronic medical conditions (e.g., diabetes, hypertension) and; 3) lifestyle modification (e.g., nutrition, physical activity, pain management) that are major contributors to poor outcome for chronic medical conditions. Finally, student interns commonly address complex co-morbidities, such as diabetes and depression, or coronary heart disease and anxiety. Clinical interns also complete an internship project that is focused on population-based approaches to patient care by designing, implementing, and evaluating a program. Areas of focus include:
Management interns conduct several business case studies that analyze situations at the internship, identify root issues, and recommend a course of action. Student interns work with site leadership to identify and prioritize the list of case studies. Each case addresses a real situation that represents a complex situation with no ready solutions. Cases typically reflect the complexity of multiple stakeholder perspectives and approaches to addressing the situation under study. There is no specific right or wrong solution. Instead, the case should stimulate discussion of multiple approaches and anticipated outcomes. The student intern’s role is to evaluate how the situation unfolds, gather relevant information that is necessary to evaluate the situation, and recommend approaches to effectively address the situation. The intern also completes a management project that builds upon one of the case studies with more extensive assessments, data analyses, and concludes with a final executive report and presentation. The business case study topics include:
Clinical interns employ various evidence-based assessment and intervention strategies that are based on a stepped-care approach. The behavioral interventions, ranging in degree of clinician and patient time and commitment, are designed to match the patient needs. At one end of the spectrum, brief interventions include assigning patients to read educational materials and self-help manuals. At the other end of the spectrum, targeted individual or, more likely, group treatments address patients with common problems using structured approaches to help them learn to manage their symptoms, stress, and adherence to treatment regimens for chronic illness. A hallmark of the DBH program is the use of e-health technology such as: email or text communications between student intern and patient, web-based automated assessments and self-help modules, mobile phone health apps, and referrals to virtual support groups. Management interns may choose to develop or evaluate evidence-based assessment and intervention strategies based on stepped-care as an intern project. Management students may also introduce e-health technology in a healthcare setting.
Student interns are expected to practice without formal supervision within the scope of practice for their master's experience and/or license in most cases. The DBH program provides all student interns with formal consultation support with a doctoral-level consultant who is actively performing clinical or management roles and responsibilities in the healthcare field. Each consultant leads weekly meetings with a small group of student interns via a HIPAA-compliant, videoconferencing system.
The internship site provides two supportive roles: a site liaison and a preceptor. During the pre-internship period, the student works with the site to establish an internship site liaison who agrees to provide administrative support leading up to and during the internship experience. The student also identifies a preceptor with whom he/she will work most closely and who agrees to provide the student with direction and feedback during the internship rotation. Typically the preceptor is a clinician (e.g., PCP) for clinical interns and a manager or supervisor for management interns.
A key component of the DBH program is a focus on performance measurement and improvement. Student interns collect, analyze, and report on data related to areas such as: patient clinical outcomes and satisfaction, cost and utilization rates, and program and service evaluations. Quality improvement activities carried out by the student intern are highly sensitive to the existing demands of administrative paperwork required by medical and management teams. The student intern's activities are designed to be as brief and nonintrusive as possible. In many cases the intern will work on assisting with the analysis and actionable follow-up activities in the context of existing and ongoing quality improvement programs at the internship site.