The (In)visibility of Psychodiagnosticians' Expertise

Abstract

This study investigates decision making in mental health care. Specifically, it compares the diagnostic decision outcomes (i.e., the quality of diagnoses) and the diagnostic decision process (i.e., pre‐decisional information acquisition patterns) of novice and experienced clinical psychologists. Participants' eye movements were recorded while they completed diagnostic tasks, classifying mental disorders. In line with previous research, our findings indicate that diagnosticians' performance is not related to their clinical experience. Eye‐tracking data provide corroborative evidence for this result from the process perspective: experience does not predict changes in cue inspection patterns. For future research into expertise in this domain, it is advisable to track individual differences between clinicians rather than study differences on the group level. Copyright © 2015 John Wiley & Sons, Ltd.

The relationship between gaze behavior, expertise, and performance: A systematic review.

“…In medicine, all perceptual-cognitive tasks involved detection of pathology or abnormality from XR-scans (e.g., Donovan & Litchfield, 2013), CT-scans (e.g., Bertram et al, 2016), PET/CT-scans (Gegenfurtner, Lehtinen, Jarodzka, & Säljö, 2017), lesion images (e.g., Dreiseitl, Pivec, & Binder, 2012), video clips (e.g., Balslev et al, 2012), MRI scans (Crowe, Gilchrist, & Kent, 2018), electrocardiogram (Wood, Batt, Appelboam, Harris, & Wilson, 2014), or monitoring during an anesthesia procedure (Grundgeiger, Klöffel, Mohme, Wurmb, & Happel, 2017). In all studies that included a detection task, except two (Schulte-Mecklenbeck, Spaanjaars, & Witteman, 2017; Wood et al, 2013), participants were either instructed to provide a report of their diagnosis or indicate with a mouse click the location of a possible pathology or abnormality, but no explicit instructions were given on the accuracy or speed of execution. Therefore, tasks in all these studies were classified as nonexplicit tasks.…”

“…Therefore, tasks in all these studies were classified as nonexplicit tasks. Only in two studies did participants receive specific instructions concerning speed and accuracy; these tasks were categorized as maximizing-optimizing tasks (Schulte-Mecklenbeck et al, 2017; Wood et al, 2013).…”

“…The eye-movement characteristics underlying differences in selective attention allocation between experts and novices were examined in 13 of the 19 studies. Significant differences between expertise group in fixation duration/dwell time on AOIs and/or number of fixations/dwells to AOIs were reported in all but one study (Schulte-Mecklenbeck et al, 2017). However, contradictory results, even within the same expertise domain, were reported in different studies for these characteristics.…”

“…In these two cases, faster search rates were related to higher accuracy in examining mammography's and proton-nuclear-magnetic resonance (proton-NMR) spectra. Schulte-Mecklenbeck et al (2017) reported a relationship between longer dwell times on diagnostic cues and a higher accuracy. This relationship between longer dwell/fixation times and a higher accuracy has been reported in sport (see Table 6) and aviation (Schriver, Morrow, Wickens, & Talleur, 2008).…”

Deliberative versus Intuitive Psychodiagnostic Decision

“…While it is self-evident that clinical psychologists who have worked longer in the field gain more experience, it has also been shown that they do not necessarily gain more expertise in psychodiagnostic decision-making (Spengler et al, 2009;Vollmer et al, 2013): Even after years of experience, clinical psychologists are relatively poor at categorizing mental disorders into DSM categories (Brailey et al, 2001;Schulte-Mecklenbeck et al, 2015) and make judgments strikingly similar to those of novices (e.g., AEgisdóttir et al, 2006;Garb, 1998;Strasser & Gruber, 2004;Witteman & Van den Bercken, 2007).…”