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首页> 外文期刊>Advances in Medical Education and Practice >Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning
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Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

机译：精神病学中的问题解决策略：专家和新手在诊断准确性和推理方面的差异

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Background: The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry. Methods: Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of a selected case with both Axis I and Axis III diagnoses. Results: Expert psychiatrists made significantly more successful diagnoses for both the primary psychiatric and medical diagnoses than clinical clerks. Expert psychiatrists also gave fewer differential options. Analyzing the think-aloud protocols, expert psychiatrists were much more organized, made fewer mistakes, and utilized significantly less time to access their knowledge than clinical clerks. Both novices and experts seemed to use the hypothetic-deductive and scheme-inductive approaches to diagnosis. However, experts utilized hypothetic-deductive approaches significantly more often than novices. Conclusion: The hypothetic-deductive diagnostic strategy was utilized more than the scheme-inductive approach by both expert psychiatrists and clinical clerks. However, a specific relationship between diagnostic reasoning and diagnostic success could not be identified in this small pilot study. The author recommends a larger study that would include a detailed analysis of the think-aloud protocols.
机译：背景：这项研究的目的是检查和比较新手和精神病学专家之间的诊断成功及其与诊断推理过程的关系。方法：9名志愿者，包括5名专家精神病医生和4名临床服务员，在尝试对DSI-IV（精神障碍诊断和统计手册，第四版）诊断出既有I轴又有I轴的选定病例时，完成了一项思考法Axis III诊断。结果：专家精神科医生对主要精神病学和医学诊断的诊断要比临床职员显着得多。专家精神科医生也提供了较少的差异选择。通过分析“思考方式”协议，与临床文员相比，专家精神病医生更有条理，出错的次数更少，并且使用的时间少得多。新手和专家似乎都使用假设推论和方案推论方法进行诊断。但是，专家比新手更频繁地使用假设演绎方法。结论：专家精神科医生和临床服务员使用假想推论的诊断策略比使用方案推论的方法更多。但是，在这项小型先导研究中，无法确定诊断推理与诊断成功之间的特定关系。作者建议进行更大范围的研究，其中应包括对思考方式协议的详细分析。

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