Given Baby P/Shipman whats more important, evidence based medicine or admission ?

[Doc Skin]

xXx H xXx that is exactly what I was thinking, Shipman probably flipped further down the line!

There could be lots of reasons why the Dr missed the signs in Baby P, but of course that is no excuse. Maybe the Dr was really stressed and this was affecting their job so they were not really fit to practice at that time?

The UKCAT personality test would be pretty easy for someone to fake IMO. Do you steal? Do you lie? It's too difficult to know what to answer if you want to show an honest personality!

I guess a better test could be used without such direct and easy questions but even that would not always weed out the ones that turn out bad.

[ipsiLoquitor]

Some interesting nonsense going on here, mainly predicated on lack of intellectual rigor.

If a doctor performs no examination/investigations, she has no results and no evidence i.e. no evidence base. This is the mistake in the Baby P case.

And what is happening here ?

Some commentators are doing exactly what the doctor in that case did - they are citing 'no reason to look' and 'no evidence given' as no reason to look. Is it not clear that this is what the doctor in that case said.

Does any one of you claiming 'naivety' know of any research in the area I have been discussing ? And isn't research/evidence based medicine the kind you are supposed to be practising ?

Clearly, unless 4th year medics, who will become doctors when they grow up, think then they will also 'not look for evidence' because it hasn't been done before. They see no reason to suspect that something may be going on.

Surely a congruent and ethical position here would be to admit the lack of research and to admit 'I don't know because I don't have information'. Once that admission, painful for most doctors, is made then there is some cognitive room to discuss the appropriate research methodologies and improvements that can be made.

Also missing is your antonym ? What is the opposite of naieve ? If I qualify for that label will my opinion be more or less valuable ?

Really, when a doctor doesn't know or has no evidence if they just admit it, they are in a position to practice ethically. Isn't it still a requirement to 'know the limits of our competence' ?

[BeanOfJelly]

But quasi-IQ tests have never actually been shown to test for anything significant to being a doctor. The UKCAT for example has never been tested for relevance/reliability. There is ZERO evidence to suggest doctors with higher UKCAT tests are better. By all means, start giving people the UKCAT, but don't use it in the admissions procedure until it has been found to identify better candidates (unfortunately only a few med schools accept this)
As for psychodynamic review, even if we did know that it was reliable, which we don't... it is completely unfeasible in terms of expense. If you were an administrator wanting to make medicine a little more diverse (getting the best doctors too) why not spend the absolute buckets of money(coming from thin air presumably) it would cost to hire-in psychoanalyst professionals for every candidate on making the degree a little cheaper?
The last thing a fair admissions process needs is even more arbitrary/unfair/unproven tests to distinguish between candidates.

[ipsiLoquitor]

There are a couple of points I think you're missing. First , that it is better to take a constructive approach. The second is that for some forms of psychopathy the demand that a quasi-IQ test is taken is a rather different test/proposition from the result itself. Don't forget that the point is to develop systems to help rule out, differentially, possible diagnoses, not to 'rule in' good mental health.
By way of an aside, I suspect that you haven't costed your comments because if you look at the costs of a psychodynamic review they are actually an incredibly cost-effective methodology, taking into account all the costs. This is something that often surprises people.

[BeanOfJelly]

But I could say: We need to get rid of bad doctors. I know, we'll test everyone by seeing in what manner they trip up on a banana skin.
Sure, more tests should equal better doctors? But if the tests themselves have not been tested to see if they are reliable, it's not fair to implement them.
As for "some forms of psycopathy" will be put off by having to do a test (i think this is what you're getting at)- the same can be said for my test- its a completely lame justification... and you know it

[ipsiLoquitor]

I think you might have missed a thread: consider entry exams to be Baby P and your response to the issue to be that of the 'doctor'.

"If a doctor performs no examination/investigations, she has no results and no evidence i.e. no evidence base. This is the mistake in the Baby P case.

And what is happening here ?

Some commentators are doing exactly what the doctor in that case did - they are citing 'no reason to look' and 'no evidence given' as no reason to look. Is it not clear that this is what the doctor in that case said.

Does any one of you claiming 'naivety' know of any research in the area I have been discussing ? And isn't research/evidence based medicine the kind you are supposed to be practising ?

Clearly, unless 4th year medics, who will become doctors when they grow up, think then they will also 'not look for evidence' because it hasn't been done before. They see no reason to suspect that something may be going on.

Surely a congruent and ethical position here would be to admit the lack of research and to admit 'I don't know because I don't have information'. Once that admission, painful for most doctors, is made then there is some cognitive room to discuss the appropriate research methodologies and improvements that can be made.

Also missing is your antonym ? What is the opposite of naieve ? If I qualify for that label will my opinion be more or less valuable ?

Really, when a doctor doesn't know or has no evidence if they just admit it, they are in a position to practice ethically. Isn't it still a requirement to 'know the limits of our competence' ?!"

[BeanOfJelly]

I can read thanks. So you disagree with me on the point that its wrong to use completely unsubstantiated tests to differ between candidates? And you talk like I'm the one in need of some respect for evidence!

[ipsiLoquitor]

I have become disappointed by the replies of soon-to-be doctors here. The degree of resistance exhibited seems to have been trained. True, medicine should be practised as a science but it occurs within a social context and thinking skills are also essential. I wonder if anyone is aware of research in relation to De Bono type skills ?

[ipsiLoquitor]

You have missed something again.

All tests are substantiated against criterion.
If you shift the criterion, the test becomes substantiated.

All legal rules and tests are subject in part to societal norms. What you are missing is that the public is thirsty for this change so it will come.

Why not get in on it now and lead it rather than become a resistant middle aged doctor in a decade's time ?

[BeanOfJelly]

You've started talking about something else because you don't want to admit that you think tests which have NO EVIDENCE TO SHOW THAT THEY ARE RELIABLE/MEANINGFUL are okay.
Lemme ask you this: what's the difference between my banana test and an IQ test which makes the IQ test more worthy as a tool to assess applicants- given that there is no evidence to suppose that a "positive" result for either makes a better doctor?

Ps: I'm sorry to have disappointed you. Or rather, you're just disappointed that no-one agrees with your views.