Virtual patients and clinical decision-making skills: How students learn to diagnose depending on their psychological characteristics (Preprint)

2020 ◽  
Author(s):  
Bartosz Zalewski ◽  
Maciej Walkiewicz ◽  
Mateusz Guziak

BACKGROUND The process of conducting a clinical assessment is a highly complex task. Virtual Patient (VP) technology may be a useful tool to complement educational activities based on real patients and it is widely used in medical education. OBJECTIVE The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of VP. METHODS Authors’ VP was used for measuring the ability to learn the decision-making in 29 last-year clinical psychology students by: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. RESULTS Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect. CONCLUSIONS Our study indicates which properties of students support and which weaken the acquisition of the ability to make a diagnosis.

2020 ◽  
Author(s):  
Bartosz Zalewski ◽  
Maciej Walkiewicz ◽  
Mateusz Guziak

Abstract Background:The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of virtual patient (VP).Methods: Authors’ VP was used for measuring the ability to learn the decision-making: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. Results: Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect.Conclusions:Our study indicates which properties of participants support and which weaken the acquisition of the ability to make a diagnosis.


Author(s):  
Katy W. Martin-Fernandez ◽  
Yossef S. Ben-Porath

Attempts at informal personality assessment can be traced back to our distant ancestors. As the field of Clinical Psychology emerged and developed over time, efforts were made to create reliable and valid measures of personality and psychopathology that could be used in a variety of contexts. There are many assessment instruments available for clinicians to use, with most utilizing either a projective or self-report format. Individual assessment instruments have specific administration, scoring, and interpretive guidelines to aid clinicians in making accurate decisions based on a test taker’s answers. These measures are continuously adapted to reflect the current conceptualization of personality and psychopathology and the latest technology. Additionally, measures are adapted and validated to be used in a variety of settings, with a variety of populations. Personality assessment continues to be a dynamic process that can be utilized to accurately and informatively represent the test taker and aid in clinical decision making and planning.


2007 ◽  
Vol 73 (6) ◽  
pp. 548-553 ◽  
Author(s):  
Jeffrey S. Young ◽  
Robert L. Smith ◽  
Stephanie Guerlain ◽  
Barbara Nolley

Medical errors are a major cause of morbidity and mortality, and cognitive errors account for many of these events. This study examined the basic science of the cognitive performance of trainees. We created a low-intensity medical simulator to perform a preliminary study of the ability of residents to recall and process patient information presented verbally. The subjects were separated into three categories based on critical care experience: novice (≤8 weeks of critical care experience), intermediate (8–16 weeks of critical care experience), and expert (>16 weeks of critical care experience). The subjects were presented with three clinical cases. In the first case, the presentation contained 55 separate data points and subject recall was analyzed. In the second and third cases, a patient report was given, and the subjects were asked by a “medical student” to outline and explain their treatment decisions. Fifteen subjects completed the experiment (five novices, six intermediates, and four experts). Case 1 (recall): No significant differences among groups with regard to errors or total data points recalled (however, subjects who chose not to take notes had significantly poorer recall and committed more errors). Cases 2 and 3 (cognition and decision making): Intermediates and experts made significantly fewer errors. More importantly, the reasoning process (forward hypothesis based) of the more experienced residents differed from novices. This preliminary study demonstrates that the cognitive processes used by residents experienced in critical care are quantitatively and qualitatively different from those used by novices. These processes were also associated with far fewer cognitive errors in clinical decision making.


2020 ◽  
Vol 173 (8) ◽  
pp. 679
Author(s):  
Daniel Restrepo ◽  
Katrina A. Armstrong ◽  
Joshua P. Metlay

2020 ◽  
Vol 172 (11) ◽  
pp. 747-751 ◽  
Author(s):  
Daniel Restrepo ◽  
Katrina A. Armstrong ◽  
Joshua P. Metlay

2020 ◽  
Vol 173 (8) ◽  
pp. 678-679
Author(s):  
Robert L. Trowbridge ◽  
Joseph J. Rencic ◽  
Thilan P. Wijesekera ◽  
Andrew P.J. Olson

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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