Research On Psychiatrists' Expertise In Clinical Diagnosis

Owing to lack of knowing the cause and reliable laboratory examination evidence, psychiatrists' protracted clinical experience plays a more important role in clinical diagnosis on psychopathy. Expertise forms as psychiatrists' clinical experience interact with their knowledge structures and reasoning strategies. Expertise indicates the competence of experts whose performances are more excellent than others. And now, expertise is an important issue in psychology.In this thesis, the trajectory of research on expertise has been retrospected, and the expertise in the field of mental disorder diagnosis has been researched by expert-novice study. In this research we examined 30 psychiatrists and 30 students to find the differences of knowledge structures and reasoning mechanism between experts and novices when they diagnose the illness as schizophrenia. The main methods adopted are Q sorting method, multi-dimensional scale method and verbal protocol analysis. The results show that:'1. The knowledge structures that experts and novices possess differ from each other. The experts' knowledge structures revealed high differentiation and clear structure and dimension meaning, while the novices' knowledge structures are lack of clear differentiation and structure.2. The reasoning mechanism of experts contrast with that of novices. Experts are apt at deep, comprehensive and systematical reasoning, and have good adaptability to problem situation, while novices are apt at superficial reasoning, treating information solitarily, and their diagnostic hypotheses are more stereotypical.3. There are significant differences between experts and novices in the accuracy and time of diagnosis, the quality of the searched information and the number of diagnostic hypotheses, etc.4. The process of clinical diagnosis is a process of mental model expanding continuously. Knowledge structure and reasoning mechanism act on each other. The in-domain knowledge is the basis of the smooth reasoning, while the results of reasoning can improve the original knowledge structure.