title: A method for evaluating competency in assessment and management of suicide risk.
abstract: OBJECTIVE
  Although health professionals increasingly are expected to be able to assess and manage patients' risk for suicide, few methods are available to evaluate this competency. This report describes development of a competency-assessment instrument for suicide risk-assessment (CAI-S), and evaluates its use in an objective structured clinical examination (OSCE).
  
  
  METHODS
  The authors developed the CAI-S on the basis of the literature on suicide risk-assessment and management, and consultation with faculty focus groups from three sites in a large academic psychiatry department. The CAI-S structures faculty ratings regarding interviewing and data collection, case formulation and presentation, treatment-planning, and documentation. To evaluate the CAI-S, 31 faculty members used it to rate the performance of 31 learners (26 psychiatric residents and 5 clinical psychology interns) who participated in an OSCE. After interviewing a standardized patient, learners presented their risk-assessment findings and treatment plans. Faculty used the CAI-S to structure feedback to the learners. In a subsidiary study of interrater reliability, six faculty members rated video-recorded suicide risk-assessments.
  
  
  RESULTS
  The CAI-S showed good internal consistency, reliability, and interrater reliability. Concurrent validity was supported by the finding that CAI-S ratings were higher for senior learners than junior learners, and were higher for learners with more clinical experience with suicidal patients than learners with less clinical experience. Faculty and learners rated the method as helpful for structuring feedback and supervision.
  
  
  CONCLUSIONS
  The findings support the usefulness of the CAI-S for evaluating competency in suicide risk-assessment and management.
authors.affiliation: Dept. of Psychiatry, Univ. of California San Francisco, USA.
authors.forename: Erick K
authors.initials: EK
authors.lastname: Hung
authors.forename: Renée L
authors.initials: RL
authors.lastname: Binder
authors.forename: Samantha R
authors.initials: SR
authors.lastname: Fordwood
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Hall
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cramer
authors.forename: Dale E
authors.initials: DE
authors.lastname: McNiel
mesh_terms: D002983:Clinical Competence; D019468:Disease Management; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011570:Psychiatry / Q000592:standards*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D000092864:Suicide Prevention