title: Simulation-based ongoing professional practice evaluation in psychiatry: a novel tool for performance assessment.
abstract: BACKGROUND
  Ongoing professional practice evaluation (OPPE) activities consist of a quantitative, competency-based evaluation of clinical performance. Hospitals must design assessments that measure clinical competencies, are scalable, and minimize impact on the clinician's daily routines. A psychiatry department at a large academic medical center designed and implemented an interactive Web-based psychiatric simulation focusing on violence risk assessment as a tool for a departmentwide OPPE.
  
  
  METHODS
  Of 412 invited clinicians in a large psychiatry department, 410 completed an online simulation in April-May 2012. Participants received scheduled e-mail reminders with instructions describing how to access the simulation. Using the Computer Simulation Assessment Tool, participants viewed an introductory video and were then asked to conduct a risk assessment, acting as a clinician in the encounter by selecting actions from a series of drop-down menus. Each action was paired with a corresponding video segment of a clinical encounter with a standardized patient. Participants were scored on the basis of their actions within the simulation (Measure 1) and by their responses to the open-ended questions in which they were asked to integrate the information from the simulation in a summative manner (Measure 2).
  
  
  RESULTS
  Of the 410 clinicians, 381 (92.9%) passed Measure 1,359 (87.6%) passed Measure 2, and 5 (1.2%) failed both measures. Seventy-five (18.3%) participants were referred for focused professional practice evaluation (FPPE) after failing either Measure 1, Measure 2, or both.
  
  
  CONCLUSIONS
  Overall, Web-based simulation and e-mail engagement tools were a scalable and efficient way to assess a large number of clinicians in OPPE and to identify those who required FPPE.
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA. tristan.gorrindo@mgh.harvard.edu
authors.forename: Tristan
authors.initials: T
authors.lastname: Gorrindo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goldfarb
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Birnbaum
authors.forename: Lydia
authors.initials: L
authors.lastname: Chevalier
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meller
authors.forename: Jonathan
authors.initials: J
authors.lastname: Alpert
authors.forename: John
authors.initials: J
authors.lastname: Herman
authors.forename: Anthony
authors.initials: A
authors.lastname: Weiss
mesh_terms: D000046:Academic Medical Centers; D002983:Clinical Competence; D003198:Computer Simulation; D004650:Employee Performance Appraisal / Q000379:methods*; D006801:Humans; D020407:Internet; D008404:Massachusetts; D011570:Psychiatry; D018570:Risk Assessment / Q000379:methods; D014754:Violence