Eventually, will most psych assessments be computerized/digital?

[Rivi]

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Hello everyone,

So I have a theory that in approximately 20 years, MOST of our psychological assessments will be administered and automatically scored through a computerized format. I don't think this will include sitting on a laptop and clicking a mouse, but utilizing more advanced technologies that exist (think virtual reality, etc.). I think that this can be a good thing if we go about it the right way. There are a lot of improvements that it might bring:

-Improved touch screens (for tests like trail making tests) that can automatically score a participant's test results
-Eliminates human administration/scoring error and (most importantly) time

What do you guys think?

 

[Therapist4Chnge]

I think we are best served getting out in front of the technology; I have looked a bit into app development and standardization stuff related to iPad use....and it definitely is going to be a factor moving forward. However, the true value of (spec. neuro) assessment is in the interpretation and integration of the data. There will always be value in observation of the patient and their performance...whether it is a neurological exam or nuanced response after asking the right question.

 

[Ollie123]

Absolutely it will be. Though as T4C said, that doesn't really change the role of the psychologist all that much. The vast majority of tests can be administered just fine by a BA-level tech anyways, the doctorate is for making sense of all that data.

We have historically been a technology-phobic profession, and I think we're getting a little better but we've got a long way to go. Part of this is due to the absolutely miserable technical training that most receive - we're just not ready for it (as a field). There is still a pervasive culture of acceptance in the profession for those who are "bad at math", "Don't like technology", etc. that I think is going to hold us back. I think that's going to grow less and less acceptable over time as it becomes more and more difficult to escape technology (for better or worse) so as that happens I think we'll see more of a shift.

 

[cara susanna]

I don't think a computer could administer IQ tests.

 

[Iwillheal]

I don't think a computer could administer IQ tests.

"Computers in the future may weigh no more than 1.5 tons."

 

[cara susanna]

Can the computer grow arms and show clients how to do the block design task? 😛

 

[Rivi]

Can the computer grow arms and show clients how to do the block design task? 😛

I think block design, and subtests like it, will eventually be re-formatted to be administered via computer (i.e., click and manipulate designs on a computer or with a joystick, etc.). If not, there are plenty of ways to test visuospatial and motor skills through computer tests.

I wonder if vocabulary, information,and similarities subtests could be administered so the examinee types in the response, and the program then can query based on certain answers, etc.

 

[Psychadelic2012]

I think block design, and subtests like it, will eventually be re-formatted to be administered via computer (i.e., click and manipulate designs on a computer or with a joystick, etc.). If not, there are plenty of ways to test visuospatial and motor skills through computer tests.

I wonder if vocabulary, information,and similarities subtests could be administered so the examinee types in the response, and the program then can query based on certain answers, etc.

Don't you think it would have been done by now? We certainly have the brains in our modern world to do this--joysticks have been around since Atari. So many professions worry about their jobs being eliminated and handed over to machines. But, how realistic is it? Has it happened, by and large? No. We still need people to do things that machines can't. Human interaction counts. Human interpretation counts. Why in the world do we still have people answering phones? Human flight attendants? Human waiters? Human train operators? Human tech support? And on, and on?

 

[FadedC]

Well when it comes to block design, it's important to remember that the purpose of that subtest is not to see how they manipulate blocks. The purpose of it it is to get an imperfect snapshot of a narrow cognitive ability. That snapshot could be gained just as easily (and perhaps even with less construct irrelevent variance) by a computer friendly subtest.

At the same time I definitely agree that the human touch, and behaviors observed during testing, are really important. Ultimately though, the answer will be determined not just by our own opinions of our importance during testing, but also by the opinions and budgets of the hospitals, schools, and testing centers providing the testing.

 

[Therapist4Chnge]

I actually like Block Design because it gives me a much better idea of a person's fine motor movement, tactile abilities, perceptual abilities, etc. There is a ton of value watching someone with a TBI continue to flip and rotate the blocks because they can't find the 'right' side to match up with the missing design or observe someone with a stroke & right-sided neglect not use one of the blocks because they don't see it. I can get some of that info from an OT or neurological exam, but I like having it as part of a standard battery because I can aggregate the data and know there is at least some consistency to how the data was collected.

Can we replicate those things on an iPad....probably, though the start-up costs are more than most people realize. I put together a grant proposal a couple years ago that included the use of iPads and some basic database work and app development. I shelved it before submission (lack of time), but it helped get me up to speed with app development. A former mentor of mine is heading up a pilot study that involves some app development, and I'm really curious to see how it goes.

 

[Pragma]

I don't think a computer could administer IQ tests.

I think that they will, eventually. Remember, the tests themselves evolve from version to version. Who's to say we won't get computerized blocks that track positioning data, too? Or a special surface to work those tasks on?

We need to focus on staying on top of technology, not rigidly sticking to the past while we sink into irrelevance. Let's adapt.

 

[Iwillheal]

Can the computer grow arms and show clients how to do the block design task? 😛

Yes 😛

I think this depends on why we use block design. Certain information can be obtained by computer tests. Other ones can't, at least not presently. And as you know, we have made a lot of compromises in healthcare for financial and practical reasons, having settled for "good enough" approximations and "good enough" treatments. Research might show that the gist of what we're interested in with IQ testing can have computerized equivalents. Or in the case that certain aspects of neuropsychological functioning can not be assessed with a computer, a ten minute interview can always be arranged. Regardless, I think computerization of most of assessment procedures is inevitable. Unless something crazy happens, like a new imaging technique or blood or genetic test making NP assessment unnecessary. Or World War III. Or Martians (fingers crossed) invade the Earth.

 

[bmedclinic]

Absolutely it will be. Though as T4C said, that doesn't really change the role of the psychologist all that much. The vast majority of tests can be administered just fine by a BA-level tech anyways, the doctorate is for making sense of all that data.

We have historically been a technology-phobic profession, and I think we're getting a little better but we've got a long way to go. Part of this is due to the absolutely miserable technical training that most receive - we're just not ready for it (as a field). There is still a pervasive culture of acceptance in the profession for those who are "bad at math", "Don't like technology", etc. that I think is going to hold us back. I think that's going to grow less and less acceptable over time as it becomes more and more difficult to escape technology (for better or worse) so as that happens I think we'll see more of a shift.

couldnt agree with this more. Hi, I'm a total computer nerd who found their way into clinical psych. If I wasnt in clinical psych, I'd probably be a server administrator/programmer bc I'm naturally that nerdy.

It astounds me how true it is that we're technology-phobic, but we are. I've run into a few psychologists along the way that are so phobic, it's honestly hard for me to not outright laugh at them, because I dont think they know anything of my background, while they go on and on about how our clinic calendar cant be online because of "hackers" and there being no way to make it secure. In theory that's true, but at the same time, no "hacker" is going to attempt to beat 128 bit encryption for a student counseling center.

Luckily, I think technology is making itself more viable/unavoidable for our technology phobic field and this will force "stick in the mud" types with inaccurate technology related metacognition to alter their perception just enough to not leave the rest of us behind.

 

[bmedclinic]

I think we are best served getting out in front of the technology; I have looked a bit into app development and standardization stuff related to iPad use....and it definitely is going to be a factor moving forward. However, the true value of (spec. neuro) assessment is in the interpretation and integration of the data. There will always be value in observation of the patient and their performance...whether it is a neurological exam or nuanced response after asking the right question.

Agree with this, too.
Much of my dissertation data collection was done using undergrads in a primary care clinic administering a psych app on an ipad. Would have been cooler to have it automatically scanned into the medical record, but because that cost a few k too much, it didnt happen. Regardless, the app worked beautifully, and within 5 minutes of it being administered (screener for bipolar, anxiety (gad,ptsd) and depression was in the patient's medical record. Even cooler, I was able to work with the EMR administrator and track what physicians actually looked at the screener.

So I guess I'm kinda saying I think technology is useful to psychology 😍

 

[KillerDiller]

I think that psychology should embrace technology for some areas of the profession, but not all of them. Certainly clinic calendars and statistical analysis are greatly improved by advances in technology. I work in a clinic now that still runs on paper files in binders; it's cumbersome and frustrating.

However, I recently attended a great seminar about technology and outreach education. The speaker suggested that most outreach efforts psychologists currently engage in rely on giving people lists of tips, assessments, and bullet points--all of which are readily available to participants if they do a simple google search. This makes the outreach rather pointless for tech-savvy populations. Instead, this speaker suggested that the unique thing outreach can provide is the opportunity for interpersonal discussions and experiential exercises. He suggested moving away from technology and rote presentations. I think that makes a lot of sense for settings like college counseling centers or corporate environments, where clients are already using technology a ton throughout the day.

 

[Psychadelic2012]

I think that psychology should embrace technology for some areas of the profession, but not all of them. Certainly clinic calendars and statistical analysis are greatly improved by advances in technology. I work in a clinic now that still runs on paper files in binders; it's cumbersome and frustrating.

However, I recently attended a great seminar about technology and outreach education. The speaker suggested that most outreach efforts psychologists currently engage in rely on giving people lists of tips, assessments, and bullet points--all of which are readily available to participants if they do a simple google search. This makes the outreach rather pointless for tech-savvy populations. Instead, this speaker suggested that the unique thing outreach can provide is the opportunity for interpersonal discussions and experiential exercises. He suggested moving away from technology and rote presentations. I think that makes a lot of sense for settings like college counseling centers or corporate environments, where clients are already using technology a ton throughout the day.

This makes a lot of sense--integrate technology, but don't rely on it. Um, online courses/degrees, anyone?! Why do people have such a problem with those in our field, but somehow embrace a total switch to technology for an intelligence test??

 

[KillerDiller]

Um, online courses/degrees, anyone?! Why do people have such a problem with those in our field, but somehow embrace a total switch to technology for an intelligence test??

Because those are two very different uses of technology with very different goals (educating a person on the entire practice of psychology vs ascertaining a person's IQ score). Technology isn't some unified thing that the field is going to vote in or vote out.

 

[Psychadelic2012]

Because those are two very different uses of technology with very different goals (educating a person on the entire practice of psychology vs ascertaining a person's IQ score). Technology isn't some unified thing that the field is going to vote in or vote out.

I don't think they are very different uses of technology, though. And I'm certainly not saying we should go either completely with technology for everything, or without altogether. There are some parallels between what people are saying here, in regards to testing, and what has been expressed elsewhere in regards to online education. Both traditionally involve human interaction as standard basic requirement--to evaluate the other person, in both cases, if you will.

I am not necessarily a strong opponent of online degrees, but I do think they are becoming part of what will be the future (for better or worse). Also, so-called online degrees are not fully online. They incorporate an in-person component. So, I'm just trying to play devil's advocate here, because obviously these are not exactly the same, but why shun components of one and welcome it for the other? If human interaction is important in evaluating behavior, it's important. Integrate technology, but maintain the human portion. That also doesn't mean that it's necessarily better. Remember that these older dinosaur psychologists that we have now (who are afraid of technology) did pretty darn well for themselves before all of this. Technology might just be taking away our expertise and handing it over to computer geeks who think they can do everything if they just have an app for it 🙄.

 

[AcronymAllergy]

I don't think they are very different uses of technology, though. And I'm certainly not saying we should go either completely with technology for everything, or without altogether. There are some parallels between what people are saying here, in regards to testing, and what has been expressed elsewhere in regards to online education. Both traditionally involve human interaction as standard basic requirement--to evaluate the other person, in both cases, if you will.

I am not necessarily a strong opponent of online degrees, but I do think they are becoming part of what will be the future (for better or worse). Also, so-called online degrees are not fully online. They incorporate an in-person component. So, I'm just trying to play devil's advocate here, because obviously these are not exactly the same, but why shun components of one and welcome it for the other? If human interaction is important in evaluating behavior, it's important. Integrate technology, but maintain the human portion. That also doesn't mean that it's necessarily better. Remember that these older dinosaur psychologists that we have now (who are afraid of technology) did pretty darn well for themselves before all of this. Technology might just be taking away our expertise and handing it over to computer geeks who think they can do everything if they just have an app for it 🙄.

I think the issue in many people's minds (although I could be mistaken) regarding online education is that while advanced degrees do require some type of in-person contact, it's usually not to the extent that we would consider to be adequate. In my mind, for example, meeting with a POI once every few months for two or three days just doesn't seem comparable to seeing him/her a couple times per week to discuss research ideas, clinical interests and progress, etc. Additionally, my understanding is that the "vetting" process for the clinical practica can also be a bit iffy, although this might be more a function of the program rather than the distance learning process itself.

Additionally, particular with respect to doctoral-level education, I just think there's a huge amount of information gained from frequently interacting with other graduate students, as well as informal near-daily interactions with clincal supervisors and research preceptors. If you ask individuals who've moved from academic medicine to private practice what they miss most in their new settings, I'd wager that many of them would say the ability to walk down the hall and informally consult with colleagues; I'd make the argument that graduate training is very similar in this respect. And with the way distance education is currently setup, this just doesn't yet seem to have been emulated very well...after all, online message boards and chat rooms can only go so far.

Edit: And getting to your latter points, I strongly agree, and feel that when we start going with more tech-heavy approaches, we need to do a MUCH better job of self-advocacy and protecting our scope of practice. Otherwise, as you've said, countless other professionals (as well as clients/patients themselves) may think to themselves, "heck, I can just download the app and test myself for brain damage."

 

[Iwillheal]

It astounds me how true it is that we're technology-phobic, but we are. I've run into a few psychologists along the way that are so phobic, it's honestly hard for me to not outright laugh at them, because I dont think they know anything of my background, while they go on and on about how our clinic calendar cant be online because of "hackers"...

I want to use this hook to address the fact that there are legitimate concerns about technology and I think they should be taken seriously. That I think computerization of assessment is inevitable is not equal to me thinking it's necessarily a good thing. Though it can lead to more efficient and cheaper testing, easier scoring, and better use of a psychologist's abilities and times, there are potential negative aspects of this as well.

Confidentiality is of paramount importance in a therapeutic relationship and the possibility of someone hacking into a computer and stealing private info, however remote, is a serious concern. But there are other concerns too, like whether the testing is going to be as valid, if modified and administered by a computer. And what about the worry the possibility of us losing jobs because of yet another process becoming computerized? Or us having to have to pay and to take classes to learn how to use the computerized assessments, etc? And let's not even discuss the general philosophical issue of human isolation that results from these various technological "advances". The other day I spent my whole day not really needing to talk to a single person face to face despite the fact that I spent a couple of hours exchanging information, feelings, and opinions (on email, internet forums), shopped at the local supermarket (self-checkout), got money (ATM), got books from the library, etc. I'm glad I'm not registered in an online grad program. I probably would not end up talking face to face to another person for days, if that were the case...

 

[bmedclinic]

iwillheal-
certainly there are legitimate concerns, and I didnt mean to dismiss those. I take confidentiality most seriously. You should know that in the calendar scenario I was referencing two important things existed: 1) the incredibly incompetent clinic director has absolutely no grasp of technology, yet insists on lecturing about it and 2) the clinic schedule we were discussing would say something like MP w/ CP (clinicians initials and client's initials). That's enough information to serve it's purpose in that scenario so that clinicians can log in from somewhere and schedule appointments instead of walking 15 minutes across campus or making a seperate trip in to write essentially the same thing in a book.

I share the concern about elimination of jobs, and I think that as electronically administred psychometric assessments progress (especially into areas such as IQ, but not limited there) studies need to be done (like with CALM) that show that using a computer is both effective and not stigmatizing in itself.

I'm a huge fan of efficiency, but what we do as a profession goes beyond simple efficiency.

 

[JeyRo]

"Computers in the future may weigh no more than 1.5 tons."

lol