title: Clinical Case Vignettes: A Promising Tool to Assess Competence in the Management of Agitation.
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.
authors.affiliation: Geisel School of Medicine at Dartmouth, Hanover, NH, USA. Gillian.l.sowden@dartmouth.edu.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Sowden
authors.affiliation: McLean Hospital, Belmont, MA, USA.
authors.forename: Heather S
authors.initials: HS
authors.lastname: Vestal
authors.affiliation: McLean Hospital, Belmont, MA, USA.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stoklosa
authors.affiliation: McLean Hospital, Belmont, MA, USA.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Valcourt
authors.affiliation: University of California School of Medicine, San Francisco, CA, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Peabody
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Keary
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Shamim H
authors.initials: SH
authors.lastname: Nejad
authors.affiliation: McLean Hospital, Belmont, MA, USA.
authors.forename: Argyro
authors.initials: A
authors.lastname: Caminis
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Huffman
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D008297:Male; D016544:Patient Simulation; D011570:Psychiatry / Q000193:education* / Q000592:standards; D011595:Psychomotor Agitation / Q000628:therapy*
keywords: Agitation; Assessment; Evaluation; Psychiatry; Residents