title: Interprofessional differences in disposition decisions: results from a standardized web-based patient assessment.
abstract: OBJECTIVE
  This study examined differences in disposition decisions among mental health professionals using a standardized Web-based simulation.
  
  
  METHODS
  Using a Web-based simulation that described, across users, the same complex psychiatric patient, credentialed clinicians in a psychiatry department conducted a violence risk assessment and selected a level of follow-up care.
  
  
  RESULTS
  Of 410 clinicians who completed the simulation, 60% of psychiatrists were more likely than other types of clinicians to select higher levels of care (inpatient or emergency services) for the standardized virtual patient (odds ratio=2.67, 95% confidence interval=1.67-4.25), even after adjustment for other factors. Virtual actions taken, such as contracting with the patient for safety and discussing hospitalization, elucidated these training differences.
  
  
  CONCLUSIONS
  Training backgrounds were important determinants of clinicians' actions and the dispositions they recommended for a psychiatric patient at high risk of self-harm and harm to others in the educational setting and may suggest the need for further training to standardize and optimize care.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA. tristan.gorrindo@mgh.harvard.edu
authors.forename: Tristan
authors.initials: T
authors.lastname: Gorrindo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goldfarb
authors.forename: Lydia
authors.initials: L
authors.lastname: Chevalier
authors.forename: Bettina B
authors.initials: BB
authors.lastname: Hoeppner
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Birnbaum
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meller
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Alpert
authors.forename: John
authors.initials: J
authors.lastname: Herman
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Weiss
mesh_terms: D000328:Adult; D003198:Computer Simulation / Q000706:statistics & numerical data*; D003657:Decision Making; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards*; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000592:standards*; D018570:Risk Assessment / Q000592:standards*