Clinical Case Vignettes: A Promising Tool to Assess Competence in the Management of Agitation

Acad Psychiatry. 2017 Jun;41(3):364-368. doi: 10.1007/s40596-016-0604-1. Epub 2016 Aug 16.

Abstract

Objective: While standardized patients (SPs) remain the gold standard for assessing clinical competence in a standardized setting, clinical case vignettes that allow free-text, open-ended written responses are more resource- and time-efficient assessment tools. It remains unknown, however, whether this is a valid method for assessing competence in the management of agitation.

Methods: Twenty-six psychiatry residents partook in a randomized controlled study evaluating a simulation-based teaching intervention on the management of agitated patients. Competence in the management of agitation was assessed using three separate modalities: simulation with SPs, open-ended clinical vignettes, and self-report questionnaires.

Results: Performance on clinical vignettes correlated significantly with SP-based assessments (r = 0.59, p = 0.002); self-report questionnaires that assessed one's own ability to manage agitation did not correlate with SP-based assessments (r = -0.06, p = 0.77).

Conclusions: Standardized clinical vignettes may be a simple, time-efficient, and valid tool for assessing residents' competence in the management of agitation.

Keywords: Agitation; Assessment; Evaluation; Psychiatry; Residents.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Clinical Competence* / standards
  • Female
  • Humans
  • Internship and Residency / methods*
  • Internship and Residency / standards
  • Male
  • Patient Simulation*
  • Psychiatry / education*
  • Psychiatry / standards
  • Psychomotor Agitation / therapy*