William M. Klykylo

Quantifying the Accuracy of Forensic Examiners in the Absence of a “Gold Standard”

This study asked whether latent class modeling methods and multiple ratings of the same cases might permit quantification of the accuracy of forensic assessments. Five evaluators examined 156 redacted court reports concerning criminal defendants who had undergone hospitalization for evaluation or restoration of their adjudicative competence. Evaluators rated each defendant’s Dusky-defined competence to stand trial on a five-point scale as well as each defendant’s understanding of, appreciation of, and reasoning about criminal proceedings. Having multiple ratings per defendant made it possible to estimate accuracy parameters using maximum likelihood and Bayesian approaches, despite the absence of any “gold standard” for the defendants’ true competence status. Evaluators appeared to be very accurate, though this finding should be viewed with caution.

Medical student abuse: perceptions and experience

Summary. A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10‐item attitude assessment about abusive behaviour were administered to the first‐and fourth‐year medical students at a mid‐west US university medical school. The first‐ and fourth‐year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth‐year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.

Incentives for Teaching Psychiatry

A questionnaire was sent to chairs and faculty in 137 academic departments of psychiatry regarding the methods used to promote teaching and their perceived value. The incentives most often used included promotion and retention, nomination to committees, and peer recognition. Least often used were bonuses and a designated teachers’ career track. Chairs and their faculty often disagreed as to whether some incentives were being used at all Recognition of teaching excellence was generally most highly valued as a useful incentive. Clarification of the nature and purpose of teaching incentives would likely improve their effectiveness.

Community vs. Private-Practice Psychiatrists: Lifestyle and Role as Related to Career Track

Around the late 1970s, the proportion Tasman, 1991; Clark & Vaccaro, 1987; Olafson, Klerman, & Pincos, 1993). Curof psychiatrists working in community mental health centers fell sharply. Some aurently, although some psychiatrists avoid even managed-care settings, others choose thors suggested that this was due to a change in psychiatrists’ roles in the public to work entirely in the public mental health sector. mental health system, which resulted in job dissatisfaction among all psychiatrists On the basis of the literature, we expected that psychiatrists currently working (Windle, Poppen, Thompson, & Marvella, 1988; Flaskeryd, 1986; Goldberg, Riba, & in community mental health centers would report a different “job description” than would psychiatrists in private, non-managed-care settings, and therefore would rePaulette Marie Gillig, M.D., Ph.D., is a Professor of Psychiatry in the Department of Psychiatry, port different reasons for choosing these School of Medicine, at Wright State University respective settings. We anticipated that in Dayton, Ohio. Ronald Markert, Ph.D.; David these choices would be based in part on Bienenfeld, M.D.; William Klykylo, M.D.; John lifestyle considerations, and in part on difRudisill, Ph.D.; Jerald Kay, M.D.; and James Bourgeois, O.D., M.D., also were affiliated with fering ideologies of the proper profesthe Department of Psychiatry at Wright State sional role of a psychiatrist (Baker & University. Baker, 1999). This research was supported by an educational research grant to Professor Gillig at Wright State University in Dayton, Ohio, from the Ohio Department of Mental Health. METHOD Address for correspondence: Paulette Marie Gillig, M.D., Ph.D., Professor of Psychiatry, Participants were a convenience sample Wright State University School of Medicine, of 272 full-time practicing psychiatrists seP.O. 927, Dayton, OH 45401. E-mail: pgillig@ your-net.com. lected from the American Psychiatric As-