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In this book Simons and Rubinstein, two former students of the late William Console, give the reader the most unusual opportunity of observing a gifted teacher with a class of residents, as if through a one-way screen. The instructor is using videotapes of his initial interviews with five different patients. This method provides a pedagogical challenge and a clinical conference of the highest order. A delightful feature that permeates the book is the total lack of self-consciousness at being observed on the part of the participants.
In each session Console showed part of a tape and then discussed the material with the residents before proceeding to the next episode. As presented in the book, the method has the appeal of a suspense story: from the beginning of the interview to its conclusion, the reader attends to clues—the patient's slips of the tongue, hesitations, pauses, etc.—and is drawn unwittingly into trying to solve the diagnostic mystery.
Console maintained that it is best for the psychiatrist and the patient to be seen together on a single video screen in order to portray how an experienced therapist reacts during an interview. If separate screens were used, some subtle exchanges between the patient and the psychiatrist could be missed or neglected, or an occasional embarrassing moment for the teacher could even be erased from the tape, reducing the students' credence. Console insisted that this technique of using unedited tapes is of particular importance for the teaching of psychiatric residents.
After thirty years of teaching residents and medical students, Console offered the opinion that psychiatric residents are the least confident and the least equipped of all resident physicians. In other branches of medicine, students have the opportunity to observe a senior physician examine a patient, go through a differential diagnosis, and prescribe therapy. But the psychiatrist examines and treats a patient in privacy. The resident hears only a report