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Commentary on the controversies, challenges, and missteps of the Minnesota Guidelines process from the perspective of
Anny Reyes1, Veronica Bordes Edgar2, Suzanne Penna3
1Epilepsy Center and Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract:
Objective: To provide the Steering Committee's perspective on the challenges, controversies, and missteps that emerged during the development of the Minnesota Conference (MNC) Training Guidelines, with a focus on two primary areas of major discussion: Content and Process. This commentary also highlights emerging issues relevant to the future implementation and evolution of the guidelines. Methods: Meeting records, draft documents, stakeholder feedback, and public commentary were reviewed and synthesized to identify and categorize major areas of controversy and challenges during the development of the Minnesota Guidelines. Results: Process-related issues centered on concerns about the involvement of trainees and early-career neuropsychologists in the conference, perceived lack of transparency and communication throughout the process, unclear role expectations, and challenges surrounding the voting process. Emerging issues post-conference included how to effectively implement the guidelines amid current legal and political challenges. Content-related controversies and challenges included the inclusion of the two-year clinical fellowship requirement, the initial omission of a Brain and Behavior competency, and the broader shift toward a competency-based training model. Further discussions involved the proposed removal of the self-care competency, inclusion of a stand-alone forensic competency, clarification of expectations for scholarly activity, and the presentation of diversity-related language throughout the Guidelines. Conclusion: The development of the Minnesota Guidelines highlighted controversies and challenges related to both content and process, underscoring the complexity of reaching consensus among diverse, multi-level stakeholders. These challenges provide insights and concrete recommendations to prevent similar issues and guide future revisions of the Guidelines.
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