Professional Judgment Research Articles

Managing Risk and Uncertainty in the Context of Child Protection Decision Making

Abstract Uncertainty is a concept related to, but distinct from, risk. Risk has been defined as the portion of the continuum from complete certainty to total ignorance that can be estimated using tools of probability. Uncertainty, on the other hand lies in the portion of the continuum of knowability that is incalculable and uncontrollable. It is well established that estimating risk probabilistically in the child protection context is unreliable and prone to error under conditions of high uncertainty—particularly when making decisions on the long-term needs of a child. This is true whether risk is estimated using professional judgement, statistical algorithms or a combination of both. In other disciplines, tools have been developed that transition decision making away from the probabilistic reasoning associated with judgments of risk (the ‘Predict and Act’ paradigm) to procedures that do not rely on the probabilistic estimation of risk (the ‘Monitor and Adapt’ paradigm). A pragmatic approach to adapting existing assessment procedures developed within the Predict and Act paradigm to align more closely with the Monitor and Adapt approach is presented. It is suggested that a key component of such an adaptation would be integrating case formulation into routine child protection practice.

Teachers’ Professional Judgment in Malaysia Classroom-Based Assessment: The Iconic Runaway in Education?

Teachers’ Professional Judgment in Malaysia Classroom-Based Assessment: The Iconic Runaway in Education?

Surgical correction of 7 abdominal wall hernias using a hybrid technique

Incisional hernias are defects of the abdominal wall under previous scarring. They are an important epidemiological factor, as they account for 11% of laparotomy surgeries performed by surgeons. They have local and systemic symptoms, including pain, fullness, bulging, and edema, which can even lead to ischemia and tissue necrosis. Comorbidities are important aggravating factors and the surgical techniques used for correction, which consist of laparotomy and video-laparoscopy, both must be effective to avoid complications, including recurrences. The herniorrhaphy and hernioplasty techniques are constantly described in the literature, but using a mixed technique is something little seen that challenges the knowledge of the medical team and addresses the professional's judgment to encompass both prior knowledge and the patient's social and comorbid profile.

Interrater reliability of the violence risk assessment checklist for youth: a case vignette study

BackgroundFacilities providing health- and social services for youth are commonly faced with the need for assessment and management of violent behavior. These providers often experience shortage of resources, compromising the feasibility of conducting comprehensive violence risk assessments. The Violence Risk Assessment Checklist for Youth aged 12–18 (V-RISK-Y) is a 12-item violence risk screening instrument developed to rapidly identify youth at high risk for violent behavior in situations requiring expedient evaluation of violence risk. The V-RISK-Y instrument was piloted in acute psychiatric units for youth, yielding positive results of predictive validity. The aim of the present study was to assess the interrater reliability of V-RISK-Y in child and adolescent psychiatric units and acute child protective services institutions.MethodsA case vignette study design was utilized to assess interrater reliability of V-RISK-Y. Staff at youth facilities (N = 163) in Norway and Sweden scored V-RISK-Y for three vignettes, and interrater reliability was assessed with the intraclass correlation coefficient (ICC).ResultsResults indicate good interrater reliability for the sum score and Low-Moderate-High risk level appraisal across staff from the different facilities and professions. For single items, interrater reliability ranged from poor to excellent.ConclusionsThis study is an important step in establishing the psychometric properties of V-RISK-Y. Findings support the structured professional judgment tradition the instrument is based on, with high agreement on the overall risk assessment. This study had a case vignette design, and the next step is to assess the reliability and validity of V-RISK-Y in naturalistic settings.

Endocrine and Targeted Therapy for Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer-Capivasertib-Fulvestrant: ASCO Rapid Recommendation Update.

ASCO Rapid Recommendation Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only).

Psychometric Evaluation of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Mixed Methods Study.

With the rapid aging of the global population, the prevalence of mild cognitive impairment (MCI) and dementia is anticipated to surge worldwide. MCI serves as an intermediary stage between normal aging and dementia, necessitating more sensitive and effective screening tools for early identification and intervention. The BrainFx SCREEN is a novel digital tool designed to assess cognitive impairment. This study evaluated its efficacy as a screening tool for MCI in primary care settings, particularly in the context of an aging population and the growing integration of digital health solutions. The primary objective was to assess the validity, reliability, and applicability of the BrainFx SCREEN (hereafter, the SCREEN) for MCI screening in a primary care context. We conducted an exploratory study comparing the SCREEN with an established screening tool, the Quick Mild Cognitive Impairment (Qmci) screen. A concurrent mixed methods, prospective study using a quasi-experimental design was conducted with 147 participants from 5 primary care Family Health Teams (FHTs; characterized by multidisciplinary practice and capitated funding) across southwestern Ontario, Canada. Participants included health care practitioners, patients, and FHT administrative executives. Individuals aged ≥55 years with no history of MCI or diagnosis of dementia rostered in a participating FHT were eligible to participate. Participants were screened using both the SCREEN and Qmci. The study also incorporated the Geriatric Anxiety Scale-10 to assess general anxiety levels at each cognitive screening. The SCREEN's scoring was compared against that of the Qmci and the clinical judgment of health care professionals. Statistical analyses included sensitivity, specificity, internal consistency, and test-retest reliability assessments. The study found that the SCREEN's longer administration time and complex scoring algorithm, which is proprietary and unavailable for independent analysis, presented challenges. Its internal consistency, indicated by a Cronbach α of 0.63, was below the acceptable threshold. The test-retest reliability also showed limitations, with moderate intraclass correlation coefficient (0.54) and inadequate κ (0.15) values. Sensitivity and specificity were consistent (63.25% and 74.07%, respectively) between cross-tabulation and discrepant analysis. In addition, the study faced limitations due to its demographic skew (96/147, 65.3% female, well-educated participants), the absence of a comprehensive gold standard for MCI diagnosis, and financial constraints limiting the inclusion of confirmatory neuropsychological testing. The SCREEN, in its current form, does not meet the necessary criteria for an optimal MCI screening tool in primary care settings, primarily due to its longer administration time and lower reliability. As the number of digital health technologies increases and evolves, further testing and refinement of tools such as the SCREEN are essential to ensure their efficacy and reliability in real-world clinical settings. This study advocates for continued research in this rapidly advancing field to better serve the aging population. RR2-10.2196/25520.

Illuminating the dark side: Life story and formulation work to understand criminogenic capacities and human harmfulness

The assessment of risk is a central component of forensic practice with clinicians regularly being required to undertake formal risk assessments using Structured Professional Judgment tools. While these tools guide practitioners to identify areas of concern, they do little to establish the function of risk factors or the context(s) that influenced the consolidation of harmful capacities. In this paper we argue for a compassionate approach to risk assessment that incorporates a functional analysis of the influence of learning experiences and promotes insight into the initial function of risks. We attempt to illustrate this process using case studies throughout.

Enhancing Parkinson’s Disease Prediction Using Deep Learning-Based Convolutional Neural Networks

Recently significant advances in the field of medical diagnostics can be seen. Nonetheless, diagnosing Parkinson's disease (PD) remains difficult, especially in terms of timeliness and precision. The inability of present technological methods to identify this complicated neurodegenerative disease emphasizes the urgent need for more research. PD is a complicated neurological condition that is becoming more commonplace worldwide. A timely and precise PD diagnosis is critical because it directly determines the quality of patient care and the success of treatment. However, our current diagnostic approaches, which primarily rely on clinical assessments, have substantial limits in terms of sensitivity and specificity. Thus, the need for a more reliable and objective diagnosing procedure is essential. Convolutional neural networks (CNNs) are employed in this study to investigate complex spiral and wave patterns and to overcome this significant challenge. Drawings from both PD patients and their healthy counterparts were included in the large dataset that was used to train the robust CNN model, which is a key component of the research technique. The training and intensive testing of the model on this dataset confirms its capacity to distinguish between PD instances and non-PD cases. The results of this investigation demonstrate how well the CNN model can predict Parkinson's disease (PD) based on spiral and wave patterns, with a 93% classification accuracy. The high sensitivity and specificity of the model are especially impressive because they significantly lower the chances of false positives and false negatives. The discussion that follows offers a considered evaluation of these findings, emphasising the model's potential for early diagnosis, its capacity to support professional judgments, and its crucial role in enhancing patient outcomes. This study highlights the great potential of deep learning methods for disease diagnosis, especially for PD. The effective integration of the CNN model into a React application for real-time prediction and continuous monitoring of patient performance has important implications for telemedicine and remote healthcare management. This breakthrough makes Parkinson's disease treatment more approachable and proactive.

Artificial intelligence in accounting

Artificial Intelligence (AI) technologies open up broad horizons for enhancing business efficiency and advancing various professional domains, boosting their productivity and compe­titiveness. There is an active exploration of approaches to incorporating AI technologies in the accounting sphere, promising a seamless transition from human to machine involvement. The aim of this article is to summarize the acquired experience, identify perspectives, constraints, and risks associated with the use of AI technologies in the professional activities of accountants. The research is based on the hypothesis that widespread use of AI in the professional activity of an accountant with an insufficient level of professional skepticism and caution carries significant threats and risks for both the accountant and the business as a whole. Scientific search methods, comparative and critical analysis, theoretical generalization, and synthesis were used. A prerequisite for imple­menting AI technologies in accounting is expert information systems and ERP systems. The analysis of AI technology implementation experience in various industries demonstrates their relevance in the accounting field for performing routine tasks (automated recognition of primary documents, processing incoming signals, and other standard operations with a simultaneous reduction in the probability of errors), analyzing large datasets, and providing information support for decision-making (pro­ces­sing business data and regulatory docu­ments), training professionals, and organi­zing internal and external communication (parti­cularly between humans and machines). Identi­fied potential risks include breaches of privacy and data security, misinterpretation of output data, and the disregard of activity context, external and internal environments, especially due to the absence of emotional intelligence, which influences the trust level in integrated information systems. The requirement for the application of professional assessments and judgments, mandated by regulatory documents, limits the scope of AI technology utilization in accounting. Future research should focus on exploring the possibilities of widespread integ­ration of AI technologies in information systems for accounting and improving legislation based on the principle of risk assessment.

Students’ Constructions of Professional Judgement in Teacher Education, Medical Education and Police Education

Professional higher education encompasses the development of relational skills and professional judgement, especially in welfare professions where close contact with people is essential, such as policing, teaching and health care. In the current article, using a cross-professional analysis, we explore how students from three different professional education programmes – teacher education, police education and medical education – construct professional judgement in group discussions and interviews. The results show that participants construct professional judgement as a relationship between three different dimensions: personal ethics, educational standards and professional practice. The examples in this article show how students utilise these three different dimensions when discussing professional dilemmas to account for choices that they (would) make as being morally or ethically sound. We argue that these results shed light on the importance of providing students with opportunities to reflect openly on professional judgement in different ways, even though this may not currently be examined or graded in their education. Furthermore, the analysis demonstrates similarities between the three examined programmes, as well as similar student reflections on essential aspects of the professions.

Rational Thinking on Accounting Firms' Assurance of Corporate Internal Control Reports

In the current corporate governance environment, the role of accounting firms in certifying internal control reports is increasingly emphasized. The internal control system of a company is crucial for risk management and the quality of information disclosure. It not only encompasses the definition and composition of the internal control system but also includes the principles and objectives for achieving corporate goals. Within this framework, the certification work of accounting firms is particularly important, as it not only verifies the effectiveness of internal controls but also plays a crucial role in maintaining market order and protecting investor interests. However, accounting firms face numerous challenges and constraints in the process of certifying internal control reports. These challenges include the complexity of internal control systems, as well as issues related to maintaining independence and objectivity, and enhancing professional judgment. Rational analysis of these challenges and constraints is crucial for improving the quality and efficiency of certification work. To address these challenges, a series of strategies and suggestions have been proposed. Firstly, strengthening the independence and objectivity of accounting firms is fundamental, requiring firms to optimize their organizational structure and business processes accordingly. Secondly, enhancing the ability to exercise professional judgment is key, necessitating accountants to continually improve their professional knowledge and practical experience. Finally, developing effective strategies to address challenges, such as adopting advanced technological tools and methods, can significantly improve the accuracy and efficiency of certification work. In conclusion, accounting firms play an indispensable role in certifying internal control reports. By continuously improving certification methods and enhancing professional capabilities, not only can the quality of internal control reports be enhanced, but also contribute to the healthy development of the market. Despite facing challenges, rational analysis and effective strategies can ensure that accounting firms maximize their value in this process.

Concordance of judgement: A tool to foster the development of professionalism in dentistry.

Developing professionalism notably involves learning how to make professional judgements in ambiguous situations. The Concordance of Judgement Test (CJT) is a learning tool that was proposed to develop professionalism competencies, but it was never performed in dentistry or used with a synchronous methodology. The present study evaluated the feasibility of the use of CJT in the context of dental education, to foster professionalism and stimulate reflexivity and discussion. After different steps of optimization, a questionnaire presenting 12 vignettes was submitted to 33 Canadian students. Second, after an additional optimization, a questionnaire of 7 vignettes was submitted to 87 French students. An immediate educational feedback was proposed after each vignette to promote reflexivity and discussions during the experience. The overall experience of the students was reported as good, thanks to the feedback of real-life situations. This promoted reflexivity and stimulated discussion between students and educators regarding professionalism issues. The students considered CJT as a relevant and well-adapted tool, and reported positive feelings regarding the inter-university aspect of the activity. The mean score of the panel members was close to 80/100 and the mean score of the students was 5 to 10 points lower, which is in agreement with docimological performance. The results suggested that the use of CJT in a synchronous way was a feasible and relevant tool to motivate the students to improve their professionalism, and to stimulate their reflexivity and discussion. The students reported positive experience with CJT, and we believe that this tool can be integrated in the dental curriculum.

Evaluation and Self-Evaluation of Teachers During the Educational Process

The position of teachers in modern teaching and changes related to educational reforms require a high degree of professionalism from teachers themselves, which, as Marentic Pozarnik (2000, p. 4) points out, is essentially “the ability of detailed professional judgment appropriate to the situation (reflection) as well as methods and procedures”. It is important for "trained” teachers to know, in a special, responsible way, to learn from their practice. At the same time, experiential and reflective approaches to learning imply a changed role of teachers, and only in the second step the application of specific methods and techniques are suitable for encouraging experiential learning (Vizek Vidovic & Vlahovic Stetic, 2007, p. 303). In the concept of "critical professional", the teacher in the educational and wider social field implies an awareness of the responsibilities of his profession at an individual level and society as a whole. A critical professional is able to think critically, both about his practical work and about the context of his work. He has developed an implicit understanding of the practical situation and the wider context. Professionals - experts at a higher level of professional activity are able to monitor and reflect, reconstruct and articulate knowledge gained from experience (Valencic Zuljan, 2001, p. 136). The very concept of reflection comes from the Latin reflectere that means reflection, contemplation, judgment. It is a process of experiential learning based on in-depth analysis of one's own practice and cognition, in other words connecting and directing the thinking and actions of an individual (metacognitive process) (Bell et al., 1993, as cited in Skok, 2002, p. 14).

Towards clinically meaningful subtyping of youth with violent behavior: application of latent profile analysis to a risk-strengths based risk assessment model*

ABSTRACT The ultimate goal of forensic interventions is reducing risk level by targeting criminogenic needs. Person-centered approaches are used to identify subgroups with similar patterns of needs, informing treatment targeting differential criminogenic areas. In line with risk and strengths-based theories on offender rehabilitation, this paper identified subgroups based on risk and protective factors. In 297 justice involved youth with a history of violence, subgroups were identified using latent profile analysis on subscale ratings of the SAVRY and SAPROF-YV. For 216 youths these profiles were related to recidivism. Four latent profiles were identified varying in risk and protection level. These profiles showed strong concordance with structured professional judgement classifications and differentiating offending patterns were observed between subgroups. Results show how risk factors and protective factors tend to co-occur for subgroups of young individuals, which could facilitate allocation of intervention resources and inform better tailored case management strategies aimed at reducing risk factors and improving strengths to enhance resilience.

The development and implementation of the district nursing Welsh Levels of Care Tool.

District nurses provide a vital service to individuals and their families and carers in the community. With increasing complexity of care and changes in the needs of the UK population, developing evidence-based workforce and workload tools which are fit for purpose is essential. This article describes the development, piloting and implementation of the District Nursing Welsh Levels of Care (DN WLoC), acuity and dependency tool which has been designed to be used alongside nurses professional judgment, to evidence the acuity and dependency of patients, and to help inform decisions of nurse staffing requirements in district nursing services. The initial pilot successfully achieved its objective and demonstrated that the draft DN WLoC tool is applicable in practice by district nurses across Wales, with limited but positive findings in the reliability and validity of the WLoC tool when applied in clinical practice.

Assessment of the Capability of Artificial Intelligence for Psychiatric Diagnosis

IntroductionPsychopathological exploration (PPE) involves an assessment of the mental state of patients, where psychological signs and symptoms are analyzed, which collectively form a syndrome. To conduct this assessment, the clinician must utilize their expertise to identify the presence and authenticity of a series of symptoms that, once recognized, allow for a diagnosis (1). The presence of this subjective component could explain why, despite the continuous growth of artificial intelligence (AI), its application in clinical psychiatry practice remains limited. However, the combination of the clinician's work with AI could enhance diagnostic accuracy and our understanding of diseases (2).ObjectivesThe objective of this study is to investigate whether AI can make accurate diagnoses through an initial psychopathological evaluation.MethodsA random sample was selected from our medical records of all patients admitted to our acute mental health inpatient unit through the hospital's emergency services in the year 2022. An anonymized database was created, including sociodemographic information, the results of the psychopathological assessment in the emergency department, and the diagnosis at the time of discharge. The psychopathological assessment conducted in the emergency department was provided to the AI chatbot ChatGPT, with a request to establish a diagnosis according to the DSM-5. Diagnoses such as brief psychotic disorder, schizophreniform disorder, and schizophrenia were considered, given their acute symptom similarities, as well as major depressive disorder (unipolar) and bipolar disorder. The level of agreement between both diagnoses was evaluated using the kappa coefficient.ResultsThe sample consisted of 15 patients, of whom 60% were male, with a mean age of 45 years (standard deviation = 15.6). 73.3% of the patients had prior mental health follow-up, and 66.7% had been previously hospitalized. Diagnoses included psychotic disorder in 33.3% of cases, bipolar disorder with manic episode in 26.7%, depressive disorder in 13.3%, delusional disorder in 13.3%, schizoaffective disorder in 6.7%, and borderline personality disorder in 6.7%. A kappa value of 0.561 was obtained, indicating a moderate degree of agreement between the diagnoses.ConclusionsDespite the inherent subjectivity in psychopathological assessment, this study suggests that AI, in the form of natural language processing chatbots like ChatGPT, can be a useful tool to assist mental health professionals in the diagnostic process. While AI shows promising potential, it should not entirely replace the experience and clinical judgment of mental health professionals. Instead, the importance of potential collaboration between AI and clinicians for achieving more precise and comprehensive diagnoses is highlighted.Disclosure of InterestNone Declared

The concept of professional judgment of accountant: concept, essence and content

Object: The study aims to consider one of the accounting tools — the professional judgment of an accountant and to generate the most suitable definition from the point of the authors` view for this economic category.
 Methods: The studies have used comparative, logical analysis, typology and grouping, methods of induction and deduction. To ensure the reliability of the study, the literature review utilized the works of various renowned authors on accounting. The comparison of various findings of different studies were scrutinized and based on the analysis of professional judgment resources, a definition of the phenomenon was proposed. IFRSs, which require professional judgment of an accountant, have also been studied and the rationale for the study of the essence of this economic category has been provided.
 Findings: Various approaches of authors related to the concept and classification of accountant's professional judgment were analyzed, and the author's definition of this economic category was formed. The question of the place and role of professional judgment as one of the accounting tools in the accounting system is considered. Justifications are given about its use for measuring accounting objects, reflecting the facts of economic activity of subjects and pre senting financial information to users for correct decision making within the framework of the current accounting standards. The need to analyze the accountant's professional judgment as the main category of accounting theory and develop the concept of professional judgment was justified.
 Conclusions: Professional judgment of the accountant is one of the important economic categories of accounting, which in the current realities plays an important role in the preparation of financial statements of the company and its disclosure, which depends on education, special knowledge of the specialty, experience and other personal characteristics, also on the information on the situation to be solved.

Automatic detection and classification of disease in citrus fruit and leaves using a customized CNN based model

India's commercial advancement and development depend heavily on agriculture. A common fruit grown in tropical settings is citrus. A professional judgment is required while analyzing an illness because different diseases have slight variations in their symptoms. In order to recognize and classify diseases in citrus fruits and leaves, a customized CNN-based approach that links CNN with LSTM was developed in this research. By using a CNN-based method, it is possible to automatically differentiate from healthier fruits and leaves and those that have diseases such fruit blight, fruit greening, fruit scab, and melanoses. In terms of performance, the proposed approach achieves 96% accuracy, 98% sensitivity, 96% Recall, and an F1-score of 92% for citrus fruit and leave identification and classification and the proposed method was compared with KNN, SVM, and CNN and concluded that the proposed CNN-based model is more accurate and effective at identifying illnesses in citrus fruits and leaves

Principals’ Professional Learning as Praxis-Oriented Change – Leading Digitalisation in Preschool Education

This article takes a practice perspective on professional learning to contribute through an empirical example of how professional learning can be arranged to enable change in and for professional practice, as well as for nurturing praxis. The theory of practice architectures is used to analyse the process of an action research (AR) in which principals investigated and changed their ways of leading digitalisation in preschool education. The theorising of the co-production of practices was used to visualise how the changes were enabled in this process, as the practices for professional learning and leading became interdependent through shared practice architectures. The findings describe how such a co-production of practices enabled a process in which the principals went from a technical to a practical approach to change, when leading digitalisation, which further resulted in a critical stance. This was a process that manifested professional learning as praxis-oriented change in which the principals’ professional judgement increased.

A Second Proof of Concept Investigation of Strengths Using the Structured Assessment of Violence Risk in Youth Tool With Justice-Involved Youth: Item Level Risk-Based Effects and Interactions.

Despite efforts to incorporate protective factors or 'strengths' in applied risk assessments for criminal reoffending, there has been limited progress towards a consensus regarding what is meant by such terms, what effects predictors can exert, or how to describe such effects. This proof of concept study was undertaken to address those issues. A structured professional judgment tool was used to create lower and higher historical/static risk groups with a sample of 273 justice-involved male youth with sexual offenses followed over a fixed 3-year period. Using risk and protective poles to create pairs of dichotomous variables from trichotomously rated risk and protective items, risk-based exacerbation and risk-based protective effects were found. These varied in terms of whether the effect on the outcome of a new violent (including sexual) offense was larger, smaller, or absent for youth at higher or lower historical/static risk. Some of these potentially dynamic dichotomous variables were shown to have a protective (or risk) effect after controlling for both historical/static risk and that same item's risk (or protective) effect. Some moderated the association between historical/static risk and recidivism, strengthening or reducing it. Terms for these effects and implications of incorporating strengths in research and applied practice were considered.