The Science of Practice and the Practice of Science: The Scientist-Practitioner Model in Clinical Neuropsychology

Article excerpt

Abstract

The mutual leavening of, and interplay between, science and practice in clinical neuropsychology is addressed in terms of several principles that are thought to have rather general applicability. An example of these interactions in the case of the development of the syndrome of nonverbal learning disabilities and the "white matter" model designed to account for its developmental manifestations and dynamics is provided. It is concluded that clinical practice and the science of neuropsychology should continue to reap considerable benefit from the principles nascent in the scientist - practitioner model.

Introduction

Discussion of the interactions between science and practice on the occasion of this award arises because of two reasons: (1) my conviction that the scientist - practitioner model has been of crucial importance with respect to my own scientific and professional endeavours; and, (2) the very positive impact that it has had on the education and training of graduate students in clinical neuropsychology with whose preparation for science and professional practice I have had the privilege to be involved. The model has been useful, fruitful, and heuristic on both counts.

What follows are some reflections on the dimensions of science - practice interactions that I feel are particularly important at this juncture in the evolution of Canadian psychology in general, and clinical neuropsychology in particular. They reflect my experiences as a scientist - practitioner and they articulate many of my views regarding the important dimensions of the science and practice of neuropsychology for the foreseeable future (Rourke, 1991a).

A Note on Format

Each of the sections that follow begins with a statement of the principle involved; this is followed by an elaboration of it. Principles involving the scientific dimensions of practice are followed by those relating to the impact of practice on science. Hopefully, notions regarding some of the important science practice interactions nascent within these principles will emerge as a result of this exercise.

The Science of Practice

RELIABILITY (CONSISTENCY)

Principle 1: Replicability is one of the basic hallmarks of science. It is a sine question for scientific advances. It is obvious that considerations of reliability permeate scientific endeavours in psychology. Indeed, it is with some pride that psychologists boast of their commitment to the establishment of reliable procedures and to their objective measurement. An important step in the establishment of reliable results in psychological investigatory efforts is the adoption of a standard procedure that is well described and amenable to straightforward replication in other laboratories.

The analogue of these dimensions in professional practice is the necessity for reliable assessment instruments and standardized administration and scoring protocols for them. Indeed, one would expect that virtually all aspects of assessment, including communication between practitioners, would be enhanced as a function of the extent to which standardized procedures are adopted and utilized. Of course, the measurement of the extent to which reliability is achieved should be the norm rather than the exception if confident conclusions regarding clients are to be framed.

But, reliability, however well established, is not validity. This is especially troublesome for professional communications when inter - rater reliability is confused with validity. For example, consider the ordinary scenario that unfolds when a naive audience observes the machinations of a skilled illusionist. The illogical conclusions regarding cause and effect that members of the audience formulate as a result of the performances transpiring before their eyes are, in effect, a type of consensual validation; otherwise the illusionist would need to keep his day job. In any case, the point to be made here regarding replicability is simple: Reliable (i. …