Spitzer R L, Skodol A E, Williams J B, Gibbon M, Kass F
Arch Gen Psychiatry. 1982 Nov;39(11):1299-1305. doi: 10.1001/archpsyc.1982.04290110053009.
Psychiatric diagnoses based on data collected during routine clinical intake evaluations done by trainees are often later used in research studies and in program evaluation. It is commonly assumed that the supervisory process can effectively overcome errors that trainees make in diagnosis. We designed a study to assess the adequacy of patient-in-absentia supervision for ensuring accurate psychiatric diagnoses. In 30% of the cases there were major diagnostic disagreements between the supervised diagnoses and consensus diagnoses based on information provided by both the trainee and an experienced clinician who sat in on the trainee's initial interview. These findings have implications for clinical care, training, and research.
基于实习生在常规临床接诊评估过程中收集的数据所做出的精神科诊断，常常会在后续的研究及项目评估中被使用。人们通常认为，督导过程能够有效克服实习生在诊断中所犯的错误。我们设计了一项研究，以评估不在场患者督导对于确保准确精神科诊断的充分性。在30%的病例中，基于实习生和参与其初次问诊的经验丰富的临床医生所提供的信息，受督导诊断与共识诊断之间存在重大诊断分歧。这些发现对临床护理、培训及研究均有影响。
