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首页> 外文期刊>BMC Medical Education >Correcting biases in psychiatric diagnostic practice in Northwest Russia: Comparing the impact of a general educational program and a specific diagnostic training program
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Correcting biases in psychiatric diagnostic practice in Northwest Russia: Comparing the impact of a general educational program and a specific diagnostic training program

机译：纠正俄罗斯西北部精神病诊断实践中的偏见：比较一般教育计划和特定诊断培训计划的影响

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Background A general education in psychiatry does not necessary lead to good diagnostic skills. Specific training programs in diagnostic coding are established to facilitate implementation of ICD-10 coding practices. However, studies comparing the impact of these two different educational approaches on diagnostic skills are lacking. The aim of the current study was to find out if a specific training program in diagnostic coding improves the diagnostic skills better than a general education program, and if a national bias in diagnostic patterns can be minimised by a specific training in diagnostic coding. Methods A pre post design study with two groups was carried in the county of Archangels, Russia. The control group (39 psychiatrists) took the required course (general educational program), while the intervention group (45 psychiatrists) were given a specific training in diagnostic coding. Their diagnostic skills before and after education were assessed using 12 written case-vignettes selected from the entire spectrum of psychiatric disorders. Results There was a significant improvement in diagnostic skills in both the intervention group and the control group. However, the intervention group improved significantly more than did the control group. The national bias was partly corrected in the intervention group but not to the same degree in the control group. When analyzing both groups together, among the background factors only the current working place impacted the outcome of the intervention. Conclusion Establishing an internationally accepted diagnosis seems to be a special skill that requires specific training and needs to be an explicit part of the professional educational activities of psychiatrists. It does not appear that that skill is honed without specific training. The issue of national diagnostic biases should be taken into account in comparative cross-cultural studies of almost any character. The mechanisms of such biases are complex and need further consideration in future research. Future research should also address the question as to whether the observed improvement in diagnostic skills after specific training actually leads to changes in routine diagnostic practice.
机译：背景知识精神病学的一般教育不一定会导致良好的诊断技能。建立了诊断编码方面的特定培训计划，以促进ICD-10编码实践的实施。但是，缺乏比较这两种不同教育方法对诊断技能影响的研究。当前研究的目的是找出诊断编码方面的特定培训计划是否比普通教育计划更好地提高诊断技能，以及通过诊断编码方面的特定培训是否可以最大程度地降低全国性的诊断模式偏见。方法在俄罗斯大天使县进行了两组前期设计研究。对照组（39名精神科医生）参加了必修课（通识教育课程），而干预组（45名精神科医生）接受了诊断编码方面的专门培训。使用从整个精神疾病谱系中选择的12个书面病例短片评估了他们在教育前后的诊断技能。结果干预组和对照组的诊断技能均有显着改善。但是，干预组的改善远大于对照组。干预组部分纠正了民族偏见，而对照组则没有得到同等程度的纠正。当一起分析两组时，在背景因素中，只有当前工作场所会影响干预的结果。结论建立国际认可的诊断似乎是一项特殊技能，需要进行专门的培训，并且必须明确地作为精神科医生的专业教育活动的一部分。似乎没有经过专门培训就不会磨练该技能。在几乎任何性质的比较性跨文化研究中都应考虑到国家诊断偏见的问题。这种偏差的机制很复杂，需要在未来的研究中进一步考虑。未来的研究还应解决以下问题：经过专门培训后，所观察到的诊断技能的提高是否实际上导致了常规诊断实践的改变。

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