A comparison of psychiatric decision-making by trainee general practitioners and trainee psychiatrists using a simulated consultation model

SynopsisA videotape-assisted simulated consultation model was used in a pilot study comparing a range of assessment and treatment decisions made by trainee general practitioners and trainee psychiatrists in response to two cases representing women with depressive disorders. The doctors were studied individually in their consulting rooms or offices. In relation to the methods of analysis chosen, levels of agreement within and between the two groups of trainees were generally low. The findings are discussed in relation to previous similar work undertaken with experienced clinicians studied in groups.

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The Oxford Handbook of Impulse Control Disorders

10.1093/oxfordhb/9780195389715.001.0001 ◽

2012 ◽

Cited By ~ 10

Keyword(s):

Decision Making ◽

Impulse Control ◽

Treatment Options ◽

Impulse Control Disorders ◽

Clear Understanding ◽

Intermittent Explosive Disorder ◽

Normal Behavior ◽

Assessment And Treatment ◽

Decision Making Processes ◽

Psychopathological Disorders

Impulsivity, to varying degrees, is what underlies human behavior and decision-making processes. As such, a thorough examination of impulsivity allows us to better understand modes of normal behavior and action as well as a range of related psychopathological disorders, including kleptomania, pyromania, trichotillomania, intermittent explosive disorder, and pathological gambling—disorders grouped under the term "impulse control disorders" (ISDs). Recent efforts in the areas of cognitive psychology, neurobiology, and genetics have provided a greater understanding of these behaviors and given way to improved treatment options. The Oxford Handbook of Impulse Control Disorders provides a clear understanding of the developmental, biological, and phenomenological features of a range of ICDs, as well as detailed approaches to their assessment and treatment. Bringing together founding ICD researchers and leading experts from psychology and psychiatry, this volume reviews the biological underpinnings of impulsivity and the conceptual challenges facing clinicians as they treat individuals with ICDs.

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Parents and educators: Partners working together in an inclusive setting

Journal of Psychologists and Counsellors in Schools ◽

10.1017/s1037291100002132 ◽

1993 ◽

Vol 3 ◽

pp. 33-49

Author(s):

Sebastian (Nello) Raciti

Keyword(s):

Decision Making ◽

School Level ◽

Collaborative Consultation ◽

Local School ◽

Participatory Decision Making ◽

Intervention Plan ◽

Consultation Model ◽

Working Together ◽

The Right ◽

Contextual Setting

Parents have the right to participate in the educational planning for their child with a disability, however they often need assistance when interacting with professionals to ensure the best programs for their children. Professionals also require guidelines and opportunities to develop appropriate communication skills when interacting with other professionals and parents. This paper investigates the level of participatory decision-making which exists between parents and professionals, and professionals amongst themselves. The present thrust for including children with a disability in mainstream schools is used as the contextual setting for this investigation. Furthermore, the author presents an intervention plan based on the Collaborative Consultation Model to enhance the participatory decision-making skills of parents and professionals at the local school level.

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Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211005090 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712110050

Author(s):

Hanna Tigerstrand Grevnerts ◽

Sofi Sonesson ◽

Håkan Gauffin ◽

Clare L. Ardern ◽

Anders Stålman ◽

...

Keyword(s):

Decision Making ◽

High Activity ◽

Treatment Decision ◽

Acl Injury ◽

Treatment Decisions ◽

Activity Level ◽

Knee Instability ◽

Acl Injuries ◽

Patient Reported ◽

And Function

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).

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