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Psychiatr Serv. 2013 Aug 1;64(8):808-11. doi: 10.1176/appi.ps.201200461.

Interprofessional differences in disposition decisions: results from a standardized web-based patient assessment.

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1
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA. tristan.gorrindo@mgh.harvard.edu

Abstract

OBJECTIVE:

This study examined differences in disposition decisions among mental health professionals using a standardized Web-based simulation.

METHODS:

Using a Web-based simulation that described, across users, the same complex psychiatric patient, credentialed clinicians in a psychiatry department conducted a violence risk assessment and selected a level of follow-up care.

RESULTS:

Of 410 clinicians who completed the simulation, 60% of psychiatrists were more likely than other types of clinicians to select higher levels of care (inpatient or emergency services) for the standardized virtual patient (odds ratio=2.67, 95% confidence interval=1.67-4.25), even after adjustment for other factors. Virtual actions taken, such as contracting with the patient for safety and discussing hospitalization, elucidated these training differences.

CONCLUSIONS:

Training backgrounds were important determinants of clinicians' actions and the dispositions they recommended for a psychiatric patient at high risk of self-harm and harm to others in the educational setting and may suggest the need for further training to standardize and optimize care.

PMID:
23903607
DOI:
10.1176/appi.ps.201200461
[Indexed for MEDLINE]
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