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Biomedical subjects

P C Mohl

Publications and source records attributed to P C Mohl.

At least 19 recordsLinked to original sources
PubMed1996

Confessions of a concurrent reviewer.

The author describes his two years of experience as a physician reviewer for two managed care companies. With case examples, he illustrates how the training process and his early activities as a reviewer increased his awareness of the need for accountability in psychiatric practice. He describes several issues that he had to clarify before he felt comfortable in the reviewer's role. Among them were the need for psychiatrists to practice more crisis intervention; the difference between intensive treatment and 24-hour inpatient care; the need to find alternative solutions to situations in which patients are hospitalized for social or logistical reasons; the need for careful discharge planning; and the need to recognize and deal with the adversarial relationships that develop with colleagues whose cases are reviewed. The author offers a typology of the interactions that occur between physician reviewers and attending psychiatrists. He concludes that reviewing may have both salutary and detrimental effects on psychiatric practice.

Concurrent Review↗
PubMed1993

Critical thinking in preclinical course examinations.

PURPOSE: To examine the relationship between preclinical medical school course examinations and critical-thinking skills by correlating examination results with the Watson-Glaser Critical Thinking Appraisal (WGCTA), an 80-item critical-thinking inventory. METHOD: The 196 students in the class of 1993 at the University of Texas Southwestern Medical Center at Dallas Southwestern Medical School were given the WGCTA during the second half of their freshman year. A composite WGCTA score and five subtest scores were calculated for each student. The course examinations were 25 tests, each with a majority of multiple-choice items, from courses given during the first two years of the school curriculum. The students' undergraduate grade-point average (GPAs), medical school GPAs, and Medical College Admission Test (MCAT) scores were also included in the analysis. Pearson product-moment correlations were calculated between the students' WGCTA scores and their examination scores, MCAT scores, and GPAs. RESULTS: Sixteen of the examinations--in the behavioral sciences, psychiatry, ethics, pathology, introduction to clinical medicine, genetics, endocrinology, and cell biology--had significant positive correlations with the WGCTA, as did MCAT scores and first-year GPAs. Correlations were more robust with the WGCTA subscales for interpretation (18 examinations), evaluation of arguments (15), and deduction (13), and less robust with the subscales for inference (7) and recognition of assumptions (3). CONCLUSIONS: The results suggest that objective multiple-choice examinations can at least partially reflect critical-thinking skills.

Educational Measurement↗
PubMed1992

Quantitative assessment of the behavior of psychotherapy supervisors.

OBJECTIVE: The aim of this study was to explore the behavior of psychotherapy supervisors by using the Psychotherapy Supervision Inventory. METHOD: The authors used the Psychotherapy Supervision Inventory to rate 53 videotaped supervision sessions of 34 different supervisors. They also used the variable of the rater's perception of the excellence of the supervisor as a teacher. The data were subjected to a cluster analysis and a K-means analysis. Discriminant function analyses were applied to the comparison of the behavior of 19 supervisors with two different residents and the behavior of all 34 supervisors with residents in three different years of training. The relationship between rater-perceived excellence and Psychotherapy Supervision Inventory scores was analyzed by using stepwise multiple regression. RESULTS: There was a high level of agreement among the four raters' judgments of supervisors' excellence. Empathy accounted for 72% of the variance in rater-perceived excellence and focus on the therapist accounted for an additional 5%. When empathy was dropped from the equation, experiential orientation accounted for 60% of the variance in ratings of excellence, clarification and interpretation accounted for an additional 16%, and depth accounted for another 3%. CONCLUSIONS: In the context of established relationships, supervisors have stable behavior patterns. Rater-perceived excellence is related to the supervisor's focusing on the resident's immediate experiences and making many synthesizing comments in depth. The Psychotherapy Supervision Inventory can be used to orient supervisors to supervision and provide feedback about their behavior.

Cluster Analysis↗
PubMed1992

Psychotherapy with Mexican-American patients.

OBJECTIVE: The authors sought to determine whether 20 years of cultural change have altered the clinical lore and earlier findings that Mexican-Americans are more resistant to psychotherapy than other ethnic groups and less likely to be referred for it. METHOD: All charts of patients seen on a university hospital psychotherapy service since its inception in 1979 were reviewed in three separate studies. The charts of all cases closed as of 1984, the charts of all active patients during 1985, and the charts of all patients screened for therapy in 1986 were included. Ethnic background, age, sex, education, income, treatment modality recommended, duration of therapy, and outcome (interrupted versus completed therapy) were recorded for each patient. RESULTS: There were minor significant differences between the Mexican-American patients and the Anglo-American patients in age and education. No other significant differences were found. CONCLUSIONS: Because of cultural change, altered psychiatric perspectives, and/or the effects of socioeconomic status as a confounding variable in previous studies, the accepted clinical lore and earlier findings about psychotherapy with Mexican-Americans may no longer apply.

Adult↗
PubMed1991

Early dropouts from psychotherapy.

Ninety-six patients requesting psychotherapy were studied prospectively at the time of screening interview by four senior psychiatrists using a variation on Luborsky's Helping Alliance questionnaire and the Osgood Semantic Differential. Significant differences were found at the time of screening between early dropouts and continuers, among screeners' rate of early dropouts, and among patients' perceptions of screeners. The screener with a high early dropout rate was seen as being more passive and less potent, and offering less new understanding than other screeners. Patients who dropped out early experienced a less strong helping alliance, felt they gained less new understanding, liked the clinician less well, felt less well liked and less respected, and saw the interviewer as more passive and psychotherapy as less potent than did continuers.

Attitude to Health↗
PubMed1991

The cognitive context of examinations in psychiatry using Bloom's taxonomy.

Psychiatric practice involves complex thinking patterns. In addition to commanding a huge number of facts, the student must learn to manipulate factual knowledge to solve diagnostic problems, develop treatment plans, and critically evaluate those plans. This study demonstrates an empirical method for evaluating the level of cognitive processes tested in multiple choice examinations. Use of Bloom's taxonomy in evaluating test items demonstrated the majority of test items on a psychiatry clerkship examination and a resident in-training examination fell into the most basic cognitive level, that of simple recall. The utility of Bloom's taxonomy is discussed along with implications for medical education.

Cognition↗
PubMed1990

Psychotherapy training for the psychiatrist of the future.

There is uncertainty about the future role of psychodynamic psychotherapy in psychiatric practice and education. The Association for Academic Psychiatry and the American Association of Directors of Psychiatry Residency Training formed a joint task force to review the issue. It developed a rationale for continued training in expressive psychotherapy and a model curriculum for such training that is both effective and realistic in terms of the diverse demands and structures of modern residencies. A minimum curriculum was also designed for resource-poor programs.

Adult↗
PubMed1989

Patients who leave the hospital against medical advice: the role of the psychiatric consultant.

Previous studies have identified characteristics of patients who threaten to leave non-psychiatric units against medical advice, but few have described the role of the psychiatric consultant in the patient's decision. This study compared the medical records of 31 patients who threatened to leave the hospital against medical advice (AMA) and who were seen in consultation with the records of AMA-discharged patients who were not seen by a psychiatric consultant. Most patients who received consultations remained hospitalized or were discharged in regular fashion. Those seen soon after admission were most likely to stay. Patients were more likely to remain hospitalized if the consultant's recommendations had a practical, rather than a psychological, orientation.

Adult↗
PubMed1989

A reliability assessment of the Psychotherapy Supervisory Inventory.

The authors investigated the reliability of the Psychotherapy Supervisory Inventory scales, which rate behaviors of supervisors on the basis of observation of supervision sessions. The scales assess focus on the therapist and the patient, intellectual and experimental orientation, number of clarifying and interpretive comments, intensity of confrontation, depth of exploration, verbal activity level of the supervisor, dominance of the supervisor and the therapist, comfort and tension levels, and empathy of the supervisor. Intraclass correlation coefficients were significant for all scales, indicating that trained observers can agree in distinguishing supervisory behaviors. These scales can be used in further research and for feedback to supervisors.

Dominance-Subordination↗