Abstract
Objective
Sound clinical judgment is the cornerstone of medical practice and begins early during medical education. The authors consider the effect of personality characteristics (hostility, anger cynicism) on clinical judgment and whether a briefintervention can affect this process.
Methods
Two sophomore medical classes (experimental, comparison) were assessed on several personality dimensions and responded to a series of clinical vignettes. The experimental group received cognitive behavior training to improve stress, coping, and interpersonal skills. Participants were reassessed within 1 week of the initial assessment.
Results
Significant associations between hostility and cynicism and maladaptive responses to the clinical vignettes were noted. Following the intervention, hostility, cynicism, anger, and aggression were significantly reduced, with concomitant reductions in maladaptive decision-making.
Conclusion
The relationship between the quality of clinical decision-making and personality characteristics was confirmed. The potential to modify this relationship using a brief cognitive behavior intervention suggests that such interventions should be an essential component of medical education.
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References
Leith KP, Baumeister RF: Why do bad moods increase self-defeating behavior? Emotion, risk-taking, and self-regulation. J Pers Soc Psychol 1996; 71: 1250–1267
Yuen K, Lee T: Could mood state affect risk-taking decisions? J Affect Disord 2003; 75: 11–18
Thomas EM, Buehner TM, Weiss SM, et al: Effect of Physician Hostility, Depression and Fear of Death on Clinical Decision Making. Washington, D.C., Research in Medical Education: 38th Annual Meeting (abstract), 1999
Williams VP, Williams RB: Lifeskills: 8 simple ways to build stronger relationships, communicate more clearly, and improve your health. New York, Times Books/Random House, 1997
Gidron Y, Davidson K, Bata I: The short-term effects of a hostility-reduction intervention in CHD patients. Health Psychol 1999; 18: 416–420
Bishop GD, Kaur DJ, Tan VLM, et al: Effect of a psychosocial skills training workshop on psychophysiological and psychosocial risk in patients undergoing coronary artery bypass grafting. Am Heart J 2005; 150: 602–609
Kirby ED, Williams VP, Hocking MC, et al: Psychosocial benefits of three formats of a standardized behavioral stress management program. Psychosom Med 2006; 68: 816–823
Williams V, Williams RB: Facilitators Manual for LifeSkills. Durham, N.C., Williams LifeSkills, Inc., 1993
Williams RB, William VP: Anger Kills: Seventeen Strategies For Controlling The Hostility That Can Harm Your Health. New York, HarperCollins, 1994
Williams RB, Williams VP: In Control. New York, Rodale, 2006
Collett LJ, Lester D: The fear of death and the fear of dying. J Psychol 1969; 72: 179–181
Radloff LS: A self-report depression scale for research in the general population. Applied Psychological Measurement 1977; 1: 385–401
Hair JF, Anderson RE, Tatham RL, et al: Multivariate Data Analysis, 4th ed. New York, Prentice Hall, 1996
Kim J, Mueller CW: Factor Analysis: Statistical Methods and Practical Issues. Thousand Oaks, Calif., Sage Publications, 1978
Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. J Pers Soc Psychol 1986; 51: 1173–1118
Yedidia MJ, Gillespie CC, Kachur E, et al: Effect of communication training on medical student performance. JAMA 2003; 290: 1157–1165
Mukohara K, Kitamura K, Wakabayashi H, et al: Evaluation of a communication skills seminar for students in a Japanese medical school: a non-randomized controlled study. BMC Med Educ 2004; 4: 24
Concato J, Shah N, Horwita RI: Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Eng J Med 2000; 342: 1887–1892
D’Agostino RB Jr, D’Agostino RB Sr: Estimating treatment effects using observational data. JAMA 2007; 297: 314–316
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Redford Williams and Virginia Williams are founders and major stockholders in Williams LifeSkills, Inc.
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Campo, A.E., Williams, V., Williams, R.B. et al. Effects of LifeSkills Training on Medical Students’ Performance in Dealing with Complex Clinical Cases. Acad Psychiatry 32, 188–193 (2008). https://doi.org/10.1176/appi.ap.32.3.188
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DOI: https://doi.org/10.1176/appi.ap.32.3.188