A topographical model of clinical decision making and interviewing

Area of Science:

• Psychiatry
• Medical Education

Background:

• Physician learning is influenced by unconscious responses to patients.
• Understanding physician responses is crucial for effective clinical practice.

Purpose of the Study:

• To present a psychoanalytic model linking clinical decision-making, interviewing skills, and countertransference.
• To provide a framework for teaching and understanding physicians' unconscious patient responses.

Main Methods:

• The model is derived from the psychoanalytical topographic model.
• It organizes thought, feeling, and action into unconscious, preconscious, and conscious aspects.

Main Results:

• The model offers a format for understanding physicians' unrecognized responses to patients (countertransference).
• Countertransference is identified as a key factor in physician learning.

Conclusions:

• The presented model enhances the understanding of countertransference in medical education.
• It improves the teaching of clinical decision-making and interviewing skills by addressing physicians' unconscious responses.