Alan Teo, M.D., a Robert Wood Johnson Foundation Clinical Scholar of the University of Michigan, and his team analyzed how well psychiatrists could predict violence in their psychiatric patients.
They determined that flipping a coin may have been as accurate as the new doctors' predictions. On the other hand, more experienced physicians had accuracy rates of 70% when it came to predicting violent behavior.
Surprisingly, the inexperienced doctors' accuracy skyrocketed to 67% - almost as high as the veteran doctors' rate, when they gave their patients a quick assessment.
"The tool we used, called the HCR-20-C, is remarkably brief and straightforward. Like a checklist a pilot might use before takeoff, it has just five items that any trained mental health professional can assess."
Recognizing the potential for violent behavior is extremely important, according to Teo. Horrific tragedies, such as the mass shooting in a movie theatre in Colorado this summer, may have been avoided if someone saw the behavior brewing.
He continued: "Given public concern about this issue, I think teaching our budding psychiatrists and others how to use a practical tool like this, and encouraging its use in high-risk settings is a no-brainer".
During the study, doctors' accuracy was measured by analyzing patients who had been violent towards workers at hospitals and comparable patients who were not.
When the patients were admitted to the hospital, they were all given an assessment to determine their risk of violence. Therefore, after looking at records, the experts could see whether the assessments were valid and if the psychiatrists accurately predicted the patients' violence risk.
Violent acts toward the staff usually included:
- throwing objects
Teo noted that this is the first trial of its kind to analyze whether inexperienced or experienced psychiatrists predicted violence of their patients more accurately. He said that violence assessment programs for these patients is very important.
"If trainees are indeed less able than trained and experienced clinicians to accurately perform risk assessments for violence, it's important to figure out a way to improve their accuracy. Our study shows that evidence-based structured tools might have the potential to augment training and improve risk assessment."
Written by Christine Kearney