title: An approach to evaluating competence in assessing and managing violence risk.
abstract: OBJECTIVE
  The authors developed and evaluated a tool for assessing competency in violence risk assessment and management.
  
  
  METHODS
  The Competency Assessment Instrument for Violence Risk (CAI-V) was based on the literature on violence risk assessment, which was complemented by feedback from faculty focus groups. In an objective structured clinical examination, 31 faculty observers used the CAI-V to rate the performance of 31 learners' (26 psychiatry residents and five psychology interns) risk assessments of standardized (simulated) patients. In an interrater reliability study, six faculty members rated video-recorded risk assessments.
  
  
  RESULTS
  The CAI-V had good internal consistency reliability (α=.93). Senior learners performed better on the CAI-V than junior learners, supporting the instrument's concurrent validity. Interrater reliability was good (intraclass correlation coefficient=.93). Participants reported that the CAI-V provided a helpful structure for feedback and supervision.
  
  
  CONCLUSIONS
  The results supported the potential of this new approach for appraising competency in violence risk assessment and management.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 401 Parnassus, San Francisco, CA 94143, USA. dalem@lppi.ucsf.edu
authors.forename: Dale E
authors.initials: DE
authors.lastname: McNiel
authors.forename: Erick K
authors.initials: EK
authors.lastname: Hung
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cramer
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Hall
authors.forename: Renee L
authors.initials: RL
authors.lastname: Binder
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004521:Educational Measurement; D005555:Forensic Psychiatry / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D001523:Mental Disorders / Q000175:diagnosis*; D015588:Observer Variation; D016544:Patient Simulation; D011586:Psychology, Clinical / Q000193:education; D015203:Reproducibility of Results; D018570:Risk Assessment; D012495:San Francisco; D014754:Violence / Q000517:prevention & control*; D000092864:Suicide Prevention