Making sense of client data: clinical experience and confirmationism revisited

The purpose of this study was to examine if the order in which case file material is presented to clinicians and length of clinical experience affect clinical judgment. Using think-aloud procedures, 36 clinicians (trainees and veterans) diagnosed the case files of a middle-aged hospital outpatient. In one version, a neutral but vivid datum was placed near the start; in the second version it was placed toward the end. Protocols generated were coded on the dependent variables, confirmation and disconfirmation of earlier inferences, and dispositional and situational inferences. MANOVA results indicate that there is an interactive order-by-experience effect on proportion of confirmatory inferences articulated by participants. Other analyses indicate that order of information presentation but not level of practitioner experience is related to the variance in the proportion of contextual and dispositional inferences articulated by participants. Implications for praxis and for training programs are examined.