Clinical Decision Support Systems (CDSS) applications in psychological suitability assessments.

Abstract

Psychological suitability assessments are an integral component of public safety recruitment and selection processes. Psychological suitability assessments can benefit from the implementation of decision support systems. Providing an estimate of the likelihood for outcomes can act to support psychologists in decision making processes. This thesis critiques a content focused approach to psychological suitability assessment, develops a classification algorithm that estimates profile outcome likelihoods of several possible psychological suitability decision categories, and assesses the effect of providing estimates to psychologists on psychological decision making processes when determining profile outcomes. The critique outlines that the assessment model dimensions were developed to suit the needs of the organization at the time and connected psychological data with anticipated behaviours and activities. However, the model was not developed within a systematic process and relied heavily on subjective accounts of on duty officers. The assessment model could be improved with the implementation of new and updated tools, such as the MMPI-2RF or the MPULSE. The classification algorithm established by the discriminant function analysis accurately classified 86.75% of cases (p<0.0001) in this assessment model. In testing the effect of providing outcome estimates to psychologists to assist in their decision making processes, a MANOVA analysis was conducted. When (n=14) psychologists were presented with a likelihood estimate that was in support of the expert decision, psychologists significantly improved in their overall match accuracy (p>0.05). Experience conducting these types of assessments was a significant covariate for the time it took to render a decision, and the time it took to render a decision was not affected by the presentation of a likelihood estimate. Overall, this study suggests that decision support systems can be implemented to support a temporary clinical lead in navigating the psychological data such that candidates are evaluated more consistently for psychological suitability evaluations. Implementing a decision support system in practice can act as a guide for interpreting psychological data, reduce the error of both experienced and inexperienced assessors, and improve the integrity of the assessment.