Children on child protective service caseloads: prevalence and nature of serious emotional disturbance.

A multivariate, criterion-referenced approach was used to assess prevalence of serious emotional disturbance among children on protective service case loads. Of 140 recipients of protective services, 72% were statistically indistinguishable from children in Washington State's most intensive mental health treatment programs. School problems, substance abuse, and antisocial behaviors were common in the sample, as were family histories of mental illness or substance abuse. Greatest service needs included family support groups, outpatient treatment, school-based treatment, and diagnostic services. These results underline the importance of structural changes to facilitate cross-system collaboration between mental health and protective services.

A prospective study of cognitive and noncognitive selection criteria as predictors of resident performance.

The primary purpose of this study was to compare objective measures of diagnostic radiology resident applicant performance, such as National Board (NBME) scores, with nonobjective measures, such as conscientiousness and interpersonal skills, in their prediction of resident performance. A second purpose of the study was to examine the predictive usefulness of the Accomplishment Interview (AI), a behavioral selection interview. Thirty resident applicants were interviewed using standard interviews, the AI, and objective data on the applicants were gathered. Four years later, during their diagnostic radiology residency, evaluations were gathered on these applicants, allowing for comparison of current resident performance with past predictive data. Results indicated that noncognitive factors were as important as cognitive factors in the prediction of resident behavior. Further, objective measures, such as NBME scores, failed to adequately predict residents' performance. The implications of these findings for resident selection are discussed.

Children's mental health services: a parent perspective.

Parents of severely emotionally and behaviorally disturbed children rarely have the opportunity to participate in the policy-making processes that affect their children's welfare. In the present study, a structured parent interview was developed as part of Washington State's Child and Adolescent Services System Program (CASSP). Thirty-five parents of disturbed children provided information about their children's problems and services histories. Respondents identified unmet needs and barriers to timely, effective intervention. The nature and quality of services received were examined in the context of CASSP service standards. The study confirmed that parents of disturbed children can provide information rich in implications for system change.

An empirical specification of residency performance dimensions.

A critical aspect of any residency is the process of selection and evaluation. However, the research literature has failed to provide an adequate behavioral specification of performance components to assist in selection and evaluation decisions. In this investigation, we applied a widely accepted method of job analysis from personnel psychology, the critical incident technique, to define those behaviors and attitudes necessary for successful resident performance in obstetrics and gynecology. Nine mutually exclusive categories of behavior were identified, including conscientiousness, recognition of limits, confidence in skills and training, ability to handle crisis/emergency situations, integration of knowledge with practice, technical skills, relationships with staff, relationships with patients, and ethical actions. These categories appear to be reliable, as physician raters were able to sort incidents into appropriate categories with 94% reliability. Identification of these categories represents a beginning step toward determining necessary aspects of performance in a structured and replicable manner and toward defining these performance aspects in a manner that allows precise and reliable measurement.

Clinical effectiveness in radiologic technology students: an empirical perspective.

This article describes two studies that examine the nature of effective clinical performance among radiologic technology students. The first study includes the perspective of staff technologists on student performance, while the second study includes the perspective of clinical instructors, important dimensions of performance that are identified include organization, relationship with peers and staff, relationships with patients, flexibility, and initiative. These dimensions are linked to specific student behaviors in clinical practice.

Critical analysis of radiologist-patient interaction.

A critical incident interview technique was used to identify features of radiologist-patient interactions considered effective and ineffective by patients. During structured interviews with 35 radiology patients and five patients' parents, three general categories of physician behavior were described: attention to patient comfort, explanation of procedure and results, and interpersonal sensitivity. The findings indicated that patients are sensitive to physicians' interpersonal styles and that they want physicians to explain procedures and results in an understandable manner and to monitor their well-being during procedures. The sample size of the study is small; thus further confirmation is needed. However, the implications for training residents and practicing radiologists in these behaviors are important in the current competitive medical milieu.

A resident perspective on the radiology residency. The critical incident technique.

A recent job analysis of the radiology residency from the perspective of staff physicians revealed that radiology staff emphasized nonacademic factors such as conscientiousness, curiosity, and interpersonal skills in considering resident performance. The present study comprises a replication and extension of that work, considering the role of the resident from the perspective of the trainees. Critical incident interviews were conducted with residents at all levels in the residency (years 1 through 4). Two types of analyses were conducted, one in which residents independently developed taxonomies for these incidents, and one in which resident incidents were compared with faculty incidents in the taxonomy developed in the earlier study. Similarities to and differences from the faculty perspective were noted. Results provided support for the importance of evaluating factors other than academics in resident performance.