Feedback with patients who produce invalid testing: Professional values and reported practices

Area of Science:

• Neuropsychology
• Clinical Psychology
• Psychological Assessment

Background:

• Providing feedback on invalid neuropsychological test data poses challenges.
• Limited existing guidance leads to idiosyncratic approaches by neuropsychologists.
• Professional values in assessment and patient care influence feedback decisions.

Purpose of the Study:

• To discuss professional values informing feedback on invalid test data.
• To present survey results on how neuropsychologists approach feedback in such cases.
• To explore variability in feedback strategies across clinical scenarios.

Main Methods:

• Survey of 209 adult-focused clinical neuropsychologists.
• Respondents analyzed three case vignettes with invalid test data.
• Open-ended responses coded for feedback approaches, statements, and goals.

Main Results:

• Nearly all (98%) included descriptions of invalid findings in feedback.
• Most provided explanations for invalidity (67%) and its impact (75%).
• Little agreement existed on specific feedback approaches or implied goals (Inform, Investigate, Treat, Educate, Correct).

Conclusions:

• Minimal consensus exists on feedback approaches for invalid neuropsychological test data.
• A need for developing and validating specific feedback methods is highlighted.
• Findings discussed in the context of evidence-based assessment, patient-doctor collaboration, beneficence, and fidelity.