Effects of training on confidence in clinical judgments.

Abstract

Previous research has shown that the clinician's subjective confidence about clinical judgments varies according to the information available, the item judged, and the 'personality' o f the judge ( 2 ) . Contradictory findings, however, have been reported concerning the effects of the experience of the clinician ( 1, 3, 4 ) . A variable closely related to the experience of the clinician, training in psychology, has received little attention in the literature. Of the studies reviewed, only Voelz ( 5 ) treated training as an independent variable. H e found increasing amounts of training did not significantly improve accuracy of clinical judgment. The purpose of this study was to compare the subjective confidence of students in psychology whose training in psychology was different. The study compared ( a ) the over-all confidence ratings of graduate srudents and freshmen and ( b ) the composition of the confidence ratings, i.e., rating profiles, of graduate students and freshmen. I n brief, the procedure required 1 0 freshmen majors in psychology and 10 first-year graduate students in clinical psychology ro view a 5-min. role-played videotaped interview of a 22-yr.-old white female college student who was experiencing 'symptoms of neurotic depression.' After viewing the videotape the students were asked to act like clinical psychologist and rate the client and themselves on the followine 10 seleeed variables pertaining to the personality of the client and clinician: actranlveness, lntrospectlon, motivation, candor, verbal ability, intelligence, severity of pathology, interest in the client, liking for the client, and whether they thought they could help the client. The student-clinicians were required to estimate their confidence about each of the ratings and assign the client to a psychotherapeutic treatment. Analysis of the student-clinicians' confidence ratings yielded the following results. A t test between the over-all mean confidence ratings of the two groups was not significant (t17 = 1.39, p > .O5). A discriminant analysis used to test the second question was also insignificant (Mahalanobis D' = 10.83, 10 d f , p > .05) . Further analysis of specific mean differences also yield no significant differences berween the two groups. Graduate students' mean ratings on each of the variables were strikingly similar to those of freshman majors. It may be concluded that college training in psychology has little effect on confidence in clinical judgments. One possible explanation might be that neither graduate nor undergraduate srudents actively utilize their training when making clinical judgments; instead they base their judgments on first impressions and intuition. Research should ferret out the exact cognitive processes and personality-related traits that mediate confidence in clinical judgments.