Clinical judgment, clinical training, and professional experience.

Abstract

Reviews studies on training, experience, and clinical judgment. The results on the validity of judgments generally fail to support the value of on-the-job experience in mental health fields. The validity results do provide limited support for the value of training. Other results suggest that experienced clinicians are better than less experienced judges at knowing which of their judgments are likely to be correct and which are likely to be wrong. Reasons why clinicians have trouble learning from experience are given. Recommendations are made for improving training and clinical practice.

Influence of information related to child physical abuse on professional ratings of adjustment and prognosis

“…The results of the present study appear consistent with the fi ndings of prior research which suggests that clinical experience is not necessarily associated with signifi cant improvements in clinical judgment, while increased level of professional training may be helpful (Garb, 1989). Overall, the social service group seemed the most infl uenced by the presence of an abuse label.…”

“…Clinical judgment is known to be infl uenced by a variety of factors, and errors in judgment can have a negative impact on the individual being evaluated (Faust, 1986;Garb, 1989;Lopez, 1989;Nezu & Nezu, 1989).The present study examined the infl uence of information related to a history of physical abuse on judgments related to treatment and social functioning. Participants were two diverse groups of professionals, representing social work and clinical psychology.…”

“…Research suggests that although clinical experience is not necessarily associated with signifi cant improvements in clinical judgment, increased levels of professional training may be associated with improved accuracy (Garb, 1989).…”

Making Sense of Client Data: Clinical Experience and Confirmationism Revisited

“…e.g., Dawes, 1994;Dumont, 1991;Garb, 1989Garb, , 1998Spengler & Strohmer, 1994;Peterson, 1995). Although studies in expert systems provide ample evidence that process in clinical medical disciplines can be profoundly affected by level of expertise (e.g., Azevedo, Lajoie, & Fleiszer, 1996;Chi, Glaser, & Farr, 1989;Johnson et al, 1981), such experience has not been related to many characteristics of information processing in psychotherapy.…”

“…There exists a body of evidence, accumulated over the past generation, that demonstrates there are few discernible changes in competency indicators and in in-session clinical process as a function of level of clinical experience (see Garb, 1989Garb, , 1998Spengler & Stromer, 1994 of psychotherapeutic outcome, the validity of clinical judgments, the accuracy of psychodiagnoses, and the validity of personality assessments, among other factors have not yielded desired outcomes. These findings have yet to be satisfactorily addressed.…”