Summary
REFERENCES
The mental health program we are developing at the Yale School of Public Health has as its basic element a broad introduction to the concepts and principles of public health and mental health administration and is rooted in concern for community well-being. It is our belief that this combination of public health mental health t r a i n i n g will p r o d u c e administrators for mental health, psychiatric and human resource agencies who will be able to design, implement, manage, and evaluate programs that improve mental health and help communities evaluate and structure the human services they need.
Feldman, S. (ed.) The Administration of Mental Health Services. Chas. C. Thomas, Springfield, Ill. 1973. Barton, W. Vanishing americans--mental hospital administrators and commissioners. Mental Hospitals, 55-61, February, 1972. Schumach, M. "State Mental System Called One of Worst." N.Y. Times, Sept. 25, 1974. 1:3. Feldman, S. Educating the future mental health executive - a graduate curriculum. Administration in Mental Health, 76, Summer 1974. Yale School of Public Health, Report to the Council on Education for Public Health, 18, 1975.
The Faculty-Fellow Consultation Firm: An Integrative Learning Experience by William G. Hollister In our search for more effective ways to educate and potentiate mental health administrators and program leaders for work in community programs, we have been experimenting for five years with faculty and trainee fellows cooperatively engaging in a "consulting firm" that contracts to do real live work. For 12 years, we have been involved in helping psychiatrists, psychologists, psychiatric nurses, social workers, hospital administrators and others acquire the performance skills that would enable them to William G. Hollister is Professor and Director, Community Psychiatry Division, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill.
serve in leadership roles in mental health centers and other community mental health programs. As we attempted to blend tutorials, field placements, program development projects, apprenticeships, consultee-ships, and didactic seminars into an individualized curriculum to fit learning needs, we have become impressed with our trainees' critical need for integrative experiences. These are learning opportunities that "put it all together," that blend the didactic and the experiential learnings into new and more effective personal performance abilities. Supervised field experiences, on-thej o b projects, tutorials, role plays, and simulation laboratories help the trainees 49
achieve this assimilation of learnings and translate them into new personal capabilities. Now the feedback from our trainees indicates that the "faculty-fellow-firm" is an important and effective addition to our teaching armamentarium, a methodological innovation worthy of replication and testing elsewhere.
Beginning the Firm At the beginning of each teaching year, all of the faculty and advanced fellows enrolled in our 12 or 24 month programs to "train the executive staffs of mental health centers" set aside an hour a week to meet together as a total group. Simple as this may sound, it has taken a great deal of effort to get all of our six or seven interdisciplinary faculty to maintain their commitment to this weekly meeting. Feedback from the fellows has repeatedly underlined the emotional meaning, increasingly important as the year progresses, of such a faculty commitment. "It's the one time we are all together" or "it's the one place where we get to see and to practice interdisciplinary decision making." At the beginning, we utilize these meetings to acquaint the trainees with our training philosophy (individualized curriculum not a "cafeteria of courses"), with the competencies and limitations of fellows and staff as resources to one another, and with our allied resources as well as the range of learning methods available. We emphasize that our faculty-fellow relationship is a constantly evolving series of learning contracts that dynamically evolve and change as each fellow contracts new knowledges and experiences during the year(s). We emphasize their responsibility for their own learning and for continuing communication to us of their learning needs. We commit our support and services to them. After this initial phase of the faculty-fellow meetings during which we communicate the idea of developing a faculty-fellow consultation firm as one learning method, the group plunges into the work of reviewing, critiquing, and choosing their one day a week 50
"'live work" sites and the program development projects they might engage in af these work sites. A little later, the faculty begins to introduce requests from programs in the field for consultations, needs assessment studies, inservice training or program studies and reviews. As the fellows hear about these bids to do "real live work", many issues arise for discussion: " H o w would we do such a job?" "What are the criteria for choosing one j o b over another? .... Would serving on a facultyfellow team to do this j o b meet some of my learning needs?" " H o w much time will it take?" "What do I have to offer or what must I do to prepare?" In some years, this difficult decision and commitment making stage is the one in which the fellows begin to break out of dependency on staff, to test whether they really do have a voice in decisions and to check out whether they have been relegated back to "student status" or are regarded by staff as professionals in their own right. Fortuitously, the need and time pressure on the facultyfellow firm to make decisions, to accept some jobs, to set up teams and begin to work together helps create a realistic opportunity for our fellows to demonstrate their competence. We have found that this process of "uncorking the group" of fellows out of their long accustomed roles as dependent students into working colleagues can be difficult and stormy. It is a period that carries with it the potential of producing group cohesion and a working partnership for the rest of the training period. Key to the success of this transition is a staff mature enough to enjoy an egalitarian style of working with fellows side by side in mutual problem solving projects. This style of learning climate appears more conducive to the preparation of self-potentiated leaders than the usual graduate school ambiance of "satisfying the requirements set forth."
The Work of the Firm In order to provide real live jobs for the learning program, our staff advertises through
a brochure, a series of workshops it will conduct for staff members of mental health programs. Included in this brochure is a statement that we are also available to do on site training, p r o g r a m studies, needs assessments, evaluations, and consults. In order to have opportunities on hand at the right time, our faculty has to send this brochure out before the teaching year begins and accepts the risk of doing the workshops alone, as a public service, should they not meet the learning needs of our future trainees. However, we have learned to schedule w e e k e n d w o r k s h o p s on c o n s u l t a t i o n , prevention, mental health education and mental health center operations at the time of, or just after, these topics are discussed in our seminars. This helps the fellows see the workshops as an opportunity to apply the new knowledges they have acquired and to teach these ideas to others as a way of consolidating their own mastery of the material. Each year the brochure and other contacts have brought in a number of inquiries to be assessed at the weekly faculty-fellow firm meetings. In various years we have used subcommittees or a faculty-fellow executive committee to screen j o b requests and to set criteria for selection. After some painful mistakes, we have decided that each j o b team must have one faculty member and faculty will only accept jobs if they can include an advanced fellow. We are basically in the training business and give first priority to those jobs that give us an opportunity to help our trainees learn leadership tasks. This policy has rarely led to refusals. Once people in the field hear that our fellows are well established professionals in their own right, they have welcomed them and have frequently paid their travel and expenses. Key to the success of such a program is the employment of a faculty who have actually practiced community mental health programming, who still practice what they preach not less than one day a week, and whose consultation is valued by agencies in the field.
Over the past few years, faculty-fellow teams have engaged in a wide variety of work in the field. Large teams have gone into catchment areas to conduct area-wide needs assessments using social area analysis, key informant interviews, and sample survey methodologies. Other teams have conducted three day to year long studies of mental health center program operations. Faculty-fellow work teams have done desk audits of role functions and training needs in mental health centers and interviewed representatives of area mental health boards to ascertain board training needs. One year, we carried out a contract to study the various state patterns of "state matching of local funds" and "development of quality controls." From data gathered by questionnaires from 36 states, we chose seven state departments of mental health and interviewed their top level leadership. This helped delineate the operational problems of funding local programs and requiring quality controls. Obviously, preparation for such surveys required team meetings to organize, design instruments, devise approaches, and divide up responsibilities. Simultaneously, fellows reviewed the literature about similar operations, practiced "dry run" interviews, and after the survey they become involved in the data tabulation and interpretation phases. Other types of faculty-fellow team projects include consultations to assist local programs develop new services, improve their board relationships, assess program priorities, set criteria for decisions, and cope with operational problems. By far the most popular use of our firm, is providing in-service training in such areas as consultation, group psychotherapy, organization of children's programs, school mental health, prevention, and rural satellite programs. We also train local teams to do their own needs assessments, program evaluations, peer review, and medical audits. The fellows on such teams generally serve as apprentice faculty members on the workshops we give on these same topics. They later serve as full fledged staff members in the field. 51
Problems Encountered Our experience indicates that success in this type of training requires a year long commitment of both faculty and fellows to the weekly "firm" meetings, to the maturation of the work groups, and to the philosophy of team building. It also requires a committment to the execution of the clean-up, write-up tasks that so many would like to avoid at theend of a job. As indicated earlier, coordinating the arrival of jobs and the readiness of teams to perform requires that the faculty send out j o b bids in August. The fall weekend workshops at the university as training for fellows who may not be able to participate in the jobs must also be arranged in advance. Beyond these minor risks, there are times when the rather easygoing, "let's take time to think" academic ambiance conflicts with the urgent "we need you now, not next month'" demands from mental health centers for quick decisions and rapid productivity. Fellows who also have seminars, cases in therapy, a weekly field site job, and other commitments must allocate their time on a faculty-fellow j o b over many weeks. This so delays our firm's productivity that we lose some credibility with our consultees as a result, Occasionally, the time required to make the job a fellow-centered learning experience gets compromised by our need to swing into action to meet the needs of the client. As frequently happens in program-centered consultation, a team prepared to do a specific j o b arrives at a field site, engages in further diagnosis, and finds that the real agenda is not the same as was previously communicated to us. Learning to redesign on the spot to meet emerging consultee needs is often a painful but rewarding learning experience. Faculty who had spent many years building a sound reputation occasionally were anxious about how well a team would perform. They 52
feared that the consultee's expectations would not be met and they might never again be invited in. Faculty response to these anxieties has varied from taking too much responsibility for the project, "coaching the fellows", and sharing the anxiety with the team, which in one instance made the team more anxious. Fortunately, with few exceptions, fellows have risen to the challenge and have won plaudits for their work.
Fellows' Reactions to the Firm The notes of the weekly faculty-fellow meetings and a poll of a sample of fellows have provided us with feedback on process and substantive learnings, problems, and values the fellows have experienced. In regard to process learning, the fellows reported that the projects "coagulated the importance of planning better than any lecture," "gave us practical experience in interdisciplinary blending of competencies," "confronted us with the realities of time limited project management," "underlined the difficult communication problems in serving others and the value of involving the servicees in preplanning'" and "working alongside a faculty member, modeled and coalesced my own image of myself acting as a consultant." "Most of all it taught me how to use my capabilities in an organized yet flexible way to serve operating programs." Besides "stimulating us to read and discuss ideas with an intensity never encountered in classroom work", the fellows reported that the faculty-firm "provided immediate application of the systems and management theory we had in class." "Because the firm had different disciplines, it helped us experience and conceptualize various levels of programming, both clinical and administrative." "The cross talent exchange seemed to enrich the solution alternatives we generated." "We learned basic
issues of organization and service delivery first hand" and "we saw and sensed the importance, beyond knowing the theory of management, of understanding the personal needs, motivations, inter-personal problems, and the pathologies of the client group." F r o m their p e r s p e c t i v e , the fellows perceived problems as follows: "Leadership roles were not always clearly defined, so sometimes fellows were hesitant to lead." "It is difficult to find the most efficacious way to provide a valuable experience to the fellows without detriment to the project, to meet learning needs, yet meet target dates and fulfill contracts." Other problems included "taking on some projects in which there was low fellow interest," "accepting projects without sufficient expertise", "deciding the optimum number on a team" and "role conflicts ensuing in operating a firm on a horizontal relationship pattern." Fellow responses seem to be polarized around faculty "giving us more responsibility" versus "faculty leadership is needed to provide adequate structure, motivation and organization without stifling the creativity of the fellows or faculty taking on too much workload." "Co-leadership of a faculty and a fellow can be useful but has problems of role definitions." Another said, "A leader must assume responsibility before and after the field trip to avoid faltering involvement." A most important problem to the trainees was finding time for proper planning and preparation. One suggested we get-clients to put up sufficient funds to underwrite the planning costs as well as the field execution of a project, a proposal we find difficult to sell to our prospective employers. Most of the trainees have summarized their faculty-fellow firm learnings as more valuable than the didactic program "largely because community mental health care delivery is an
action and practice centered field, so textbook type information is not yet very useful." Some said the faculty-fellow firm provided them with "the closest relationship with a faculty person they had ever experienced" and "provided an opportunity for the consolidation of a professional identity growing out of a shared experience around a concrete problem." "The model of you in action helped me solidify my self-image as a mental health professional." Other values designated were opportunities to interact with other disciplines, "a valuable idea and image interchange," and the "involvement from the creation to the evaluation of the tasks gave us a feeling of ownership of the project." Some fellows reported experiences that offered them broader, more immediate, and vital perspectives on activities and issues than previous training had provided as well as contact with problems and roles that "stretched you" and "involved you in realities and processes beyond and outside your previous role expectations.'" "It constantly involved us in attempting new roles and functions and helped us appreciate where our capabilities lie and what new competencies to build." Some indicated that the engagement with a variety of j o b projects and training activities "allowed for the integration of experience on all levels - local, state, regional, university, and national by being able to work at all levels and contact people at all these levels." One fellow summarized as follows: "I think the firm, because there were contracts for real work within real time frames, kept us all reality based. It is easy in the academic role to get overconcerned about how things ideally ought to be done, and to forget the pressures and demands of the real world. Constant contact with these realities helps us keep one foot in the world as it really is" and "helped me focus my investment in advanced training." 53
REFERENCES
The mental health program we are developing at the Yale School of Public Health has as its basic element a broad introduction to the concepts and principles of public health and mental health administration and is rooted in concern for community well-being. It is our belief that this combination of public health mental health t r a i n i n g will p r o d u c e administrators for mental health, psychiatric and human resource agencies who will be able to design, implement, manage, and evaluate programs that improve mental health and help communities evaluate and structure the human services they need.
Feldman, S. (ed.) The Administration of Mental Health Services. Chas. C. Thomas, Springfield, Ill. 1973. Barton, W. Vanishing americans--mental hospital administrators and commissioners. Mental Hospitals, 55-61, February, 1972. Schumach, M. "State Mental System Called One of Worst." N.Y. Times, Sept. 25, 1974. 1:3. Feldman, S. Educating the future mental health executive - a graduate curriculum. Administration in Mental Health, 76, Summer 1974. Yale School of Public Health, Report to the Council on Education for Public Health, 18, 1975.
The Faculty-Fellow Consultation Firm: An Integrative Learning Experience by William G. Hollister In our search for more effective ways to educate and potentiate mental health administrators and program leaders for work in community programs, we have been experimenting for five years with faculty and trainee fellows cooperatively engaging in a "consulting firm" that contracts to do real live work. For 12 years, we have been involved in helping psychiatrists, psychologists, psychiatric nurses, social workers, hospital administrators and others acquire the performance skills that would enable them to William G. Hollister is Professor and Director, Community Psychiatry Division, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill.
serve in leadership roles in mental health centers and other community mental health programs. As we attempted to blend tutorials, field placements, program development projects, apprenticeships, consultee-ships, and didactic seminars into an individualized curriculum to fit learning needs, we have become impressed with our trainees' critical need for integrative experiences. These are learning opportunities that "put it all together," that blend the didactic and the experiential learnings into new and more effective personal performance abilities. Supervised field experiences, on-thej o b projects, tutorials, role plays, and simulation laboratories help the trainees 49
achieve this assimilation of learnings and translate them into new personal capabilities. Now the feedback from our trainees indicates that the "faculty-fellow-firm" is an important and effective addition to our teaching armamentarium, a methodological innovation worthy of replication and testing elsewhere.
Beginning the Firm At the beginning of each teaching year, all of the faculty and advanced fellows enrolled in our 12 or 24 month programs to "train the executive staffs of mental health centers" set aside an hour a week to meet together as a total group. Simple as this may sound, it has taken a great deal of effort to get all of our six or seven interdisciplinary faculty to maintain their commitment to this weekly meeting. Feedback from the fellows has repeatedly underlined the emotional meaning, increasingly important as the year progresses, of such a faculty commitment. "It's the one time we are all together" or "it's the one place where we get to see and to practice interdisciplinary decision making." At the beginning, we utilize these meetings to acquaint the trainees with our training philosophy (individualized curriculum not a "cafeteria of courses"), with the competencies and limitations of fellows and staff as resources to one another, and with our allied resources as well as the range of learning methods available. We emphasize that our faculty-fellow relationship is a constantly evolving series of learning contracts that dynamically evolve and change as each fellow contracts new knowledges and experiences during the year(s). We emphasize their responsibility for their own learning and for continuing communication to us of their learning needs. We commit our support and services to them. After this initial phase of the faculty-fellow meetings during which we communicate the idea of developing a faculty-fellow consultation firm as one learning method, the group plunges into the work of reviewing, critiquing, and choosing their one day a week 50
"'live work" sites and the program development projects they might engage in af these work sites. A little later, the faculty begins to introduce requests from programs in the field for consultations, needs assessment studies, inservice training or program studies and reviews. As the fellows hear about these bids to do "real live work", many issues arise for discussion: " H o w would we do such a job?" "What are the criteria for choosing one j o b over another? .... Would serving on a facultyfellow team to do this j o b meet some of my learning needs?" " H o w much time will it take?" "What do I have to offer or what must I do to prepare?" In some years, this difficult decision and commitment making stage is the one in which the fellows begin to break out of dependency on staff, to test whether they really do have a voice in decisions and to check out whether they have been relegated back to "student status" or are regarded by staff as professionals in their own right. Fortuitously, the need and time pressure on the facultyfellow firm to make decisions, to accept some jobs, to set up teams and begin to work together helps create a realistic opportunity for our fellows to demonstrate their competence. We have found that this process of "uncorking the group" of fellows out of their long accustomed roles as dependent students into working colleagues can be difficult and stormy. It is a period that carries with it the potential of producing group cohesion and a working partnership for the rest of the training period. Key to the success of this transition is a staff mature enough to enjoy an egalitarian style of working with fellows side by side in mutual problem solving projects. This style of learning climate appears more conducive to the preparation of self-potentiated leaders than the usual graduate school ambiance of "satisfying the requirements set forth."
The Work of the Firm In order to provide real live jobs for the learning program, our staff advertises through
a brochure, a series of workshops it will conduct for staff members of mental health programs. Included in this brochure is a statement that we are also available to do on site training, p r o g r a m studies, needs assessments, evaluations, and consults. In order to have opportunities on hand at the right time, our faculty has to send this brochure out before the teaching year begins and accepts the risk of doing the workshops alone, as a public service, should they not meet the learning needs of our future trainees. However, we have learned to schedule w e e k e n d w o r k s h o p s on c o n s u l t a t i o n , prevention, mental health education and mental health center operations at the time of, or just after, these topics are discussed in our seminars. This helps the fellows see the workshops as an opportunity to apply the new knowledges they have acquired and to teach these ideas to others as a way of consolidating their own mastery of the material. Each year the brochure and other contacts have brought in a number of inquiries to be assessed at the weekly faculty-fellow firm meetings. In various years we have used subcommittees or a faculty-fellow executive committee to screen j o b requests and to set criteria for selection. After some painful mistakes, we have decided that each j o b team must have one faculty member and faculty will only accept jobs if they can include an advanced fellow. We are basically in the training business and give first priority to those jobs that give us an opportunity to help our trainees learn leadership tasks. This policy has rarely led to refusals. Once people in the field hear that our fellows are well established professionals in their own right, they have welcomed them and have frequently paid their travel and expenses. Key to the success of such a program is the employment of a faculty who have actually practiced community mental health programming, who still practice what they preach not less than one day a week, and whose consultation is valued by agencies in the field.
Over the past few years, faculty-fellow teams have engaged in a wide variety of work in the field. Large teams have gone into catchment areas to conduct area-wide needs assessments using social area analysis, key informant interviews, and sample survey methodologies. Other teams have conducted three day to year long studies of mental health center program operations. Faculty-fellow work teams have done desk audits of role functions and training needs in mental health centers and interviewed representatives of area mental health boards to ascertain board training needs. One year, we carried out a contract to study the various state patterns of "state matching of local funds" and "development of quality controls." From data gathered by questionnaires from 36 states, we chose seven state departments of mental health and interviewed their top level leadership. This helped delineate the operational problems of funding local programs and requiring quality controls. Obviously, preparation for such surveys required team meetings to organize, design instruments, devise approaches, and divide up responsibilities. Simultaneously, fellows reviewed the literature about similar operations, practiced "dry run" interviews, and after the survey they become involved in the data tabulation and interpretation phases. Other types of faculty-fellow team projects include consultations to assist local programs develop new services, improve their board relationships, assess program priorities, set criteria for decisions, and cope with operational problems. By far the most popular use of our firm, is providing in-service training in such areas as consultation, group psychotherapy, organization of children's programs, school mental health, prevention, and rural satellite programs. We also train local teams to do their own needs assessments, program evaluations, peer review, and medical audits. The fellows on such teams generally serve as apprentice faculty members on the workshops we give on these same topics. They later serve as full fledged staff members in the field. 51
Problems Encountered Our experience indicates that success in this type of training requires a year long commitment of both faculty and fellows to the weekly "firm" meetings, to the maturation of the work groups, and to the philosophy of team building. It also requires a committment to the execution of the clean-up, write-up tasks that so many would like to avoid at theend of a job. As indicated earlier, coordinating the arrival of jobs and the readiness of teams to perform requires that the faculty send out j o b bids in August. The fall weekend workshops at the university as training for fellows who may not be able to participate in the jobs must also be arranged in advance. Beyond these minor risks, there are times when the rather easygoing, "let's take time to think" academic ambiance conflicts with the urgent "we need you now, not next month'" demands from mental health centers for quick decisions and rapid productivity. Fellows who also have seminars, cases in therapy, a weekly field site job, and other commitments must allocate their time on a faculty-fellow j o b over many weeks. This so delays our firm's productivity that we lose some credibility with our consultees as a result, Occasionally, the time required to make the job a fellow-centered learning experience gets compromised by our need to swing into action to meet the needs of the client. As frequently happens in program-centered consultation, a team prepared to do a specific j o b arrives at a field site, engages in further diagnosis, and finds that the real agenda is not the same as was previously communicated to us. Learning to redesign on the spot to meet emerging consultee needs is often a painful but rewarding learning experience. Faculty who had spent many years building a sound reputation occasionally were anxious about how well a team would perform. They 52
feared that the consultee's expectations would not be met and they might never again be invited in. Faculty response to these anxieties has varied from taking too much responsibility for the project, "coaching the fellows", and sharing the anxiety with the team, which in one instance made the team more anxious. Fortunately, with few exceptions, fellows have risen to the challenge and have won plaudits for their work.
Fellows' Reactions to the Firm The notes of the weekly faculty-fellow meetings and a poll of a sample of fellows have provided us with feedback on process and substantive learnings, problems, and values the fellows have experienced. In regard to process learning, the fellows reported that the projects "coagulated the importance of planning better than any lecture," "gave us practical experience in interdisciplinary blending of competencies," "confronted us with the realities of time limited project management," "underlined the difficult communication problems in serving others and the value of involving the servicees in preplanning'" and "working alongside a faculty member, modeled and coalesced my own image of myself acting as a consultant." "Most of all it taught me how to use my capabilities in an organized yet flexible way to serve operating programs." Besides "stimulating us to read and discuss ideas with an intensity never encountered in classroom work", the fellows reported that the faculty-firm "provided immediate application of the systems and management theory we had in class." "Because the firm had different disciplines, it helped us experience and conceptualize various levels of programming, both clinical and administrative." "The cross talent exchange seemed to enrich the solution alternatives we generated." "We learned basic
issues of organization and service delivery first hand" and "we saw and sensed the importance, beyond knowing the theory of management, of understanding the personal needs, motivations, inter-personal problems, and the pathologies of the client group." F r o m their p e r s p e c t i v e , the fellows perceived problems as follows: "Leadership roles were not always clearly defined, so sometimes fellows were hesitant to lead." "It is difficult to find the most efficacious way to provide a valuable experience to the fellows without detriment to the project, to meet learning needs, yet meet target dates and fulfill contracts." Other problems included "taking on some projects in which there was low fellow interest," "accepting projects without sufficient expertise", "deciding the optimum number on a team" and "role conflicts ensuing in operating a firm on a horizontal relationship pattern." Fellow responses seem to be polarized around faculty "giving us more responsibility" versus "faculty leadership is needed to provide adequate structure, motivation and organization without stifling the creativity of the fellows or faculty taking on too much workload." "Co-leadership of a faculty and a fellow can be useful but has problems of role definitions." Another said, "A leader must assume responsibility before and after the field trip to avoid faltering involvement." A most important problem to the trainees was finding time for proper planning and preparation. One suggested we get-clients to put up sufficient funds to underwrite the planning costs as well as the field execution of a project, a proposal we find difficult to sell to our prospective employers. Most of the trainees have summarized their faculty-fellow firm learnings as more valuable than the didactic program "largely because community mental health care delivery is an
action and practice centered field, so textbook type information is not yet very useful." Some said the faculty-fellow firm provided them with "the closest relationship with a faculty person they had ever experienced" and "provided an opportunity for the consolidation of a professional identity growing out of a shared experience around a concrete problem." "The model of you in action helped me solidify my self-image as a mental health professional." Other values designated were opportunities to interact with other disciplines, "a valuable idea and image interchange," and the "involvement from the creation to the evaluation of the tasks gave us a feeling of ownership of the project." Some fellows reported experiences that offered them broader, more immediate, and vital perspectives on activities and issues than previous training had provided as well as contact with problems and roles that "stretched you" and "involved you in realities and processes beyond and outside your previous role expectations.'" "It constantly involved us in attempting new roles and functions and helped us appreciate where our capabilities lie and what new competencies to build." Some indicated that the engagement with a variety of j o b projects and training activities "allowed for the integration of experience on all levels - local, state, regional, university, and national by being able to work at all levels and contact people at all these levels." One fellow summarized as follows: "I think the firm, because there were contracts for real work within real time frames, kept us all reality based. It is easy in the academic role to get overconcerned about how things ideally ought to be done, and to forget the pressures and demands of the real world. Constant contact with these realities helps us keep one foot in the world as it really is" and "helped me focus my investment in advanced training." 53
