title: Competency of psychiatric residents in the treatment of people with severe mental illness before and after a community psychiatry rotation.
abstract: OBJECTIVE
  psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness.
  
  
  METHODS
  the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation.
  
  
  RESULTS
  a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents.
  
  
  CONCLUSIONS
  a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.
authors.affiliation: Brien Center for Mental Health and Substance Abuse Services and Berkshire Medical Center, Pittsfield, Massachusetts 01201, USA. mrand@briencenter.org
authors.forename: Melinda
authors.initials: M
authors.lastname: Randall
authors.forename: Mauricio
authors.initials: M
authors.lastname: Romero-Gonzalez
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gonzalez
authors.forename: Anne
authors.initials: A
authors.lastname: Klee
authors.forename: Paul
authors.initials: P
authors.lastname: Kirwin
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003156:Community Mental Health Services; D004493:Education; D004503:Education, Medical, Graduate / Q000458:organization & administration / Q000592:standards; D055317:Evidence-Based Practice / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D010347:Patient Care Planning / Q000592:standards; D015397:Program Evaluation; D011570:Psychiatry / Q000193:education*; D012047:Rehabilitation Centers; D012720:Severity of Illness Index