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. 2023 Aug;47(4):368-373.
doi: 10.1007/s40596-023-01762-0. Epub 2023 Mar 21.

A Direct Observation Form for Evaluation of the Psychiatric Interview: Pilot Testing During the Psychiatry Clerkship

Austin Butterfield  1 , Ashley Curry  2 , Joel Yager  2 , Joseph Sakai  2
Affiliations

A Direct Observation Form for Evaluation of the Psychiatric Interview: Pilot Testing During the Psychiatry Clerkship

Austin Butterfield et al. Acad Psychiatry. 2023 Aug.

Abstract

Objectives: The authors evaluated the validity of a structured direct observation form (DOF) to assess medical student performance on psychiatric interviews for use in the psychiatry clerkship.

Methods: One hundred and forty-eight third-year medical students were evaluated by two DOFs completed by a supervising resident, fellow, attending, or another team member. One DOF was completed early (time 1) and the other late (time 2) during a 4-week psychiatry clerkship.

Results: The DOF showed good internal consistency (Cronbach's alpha = 0.88-0.89). DOFs submitted at time 2 were positively associated with end-of-course clinical grades (p < 0.001); this association remained significant while controlling for time of academic year the course was completed, rater rank, complexity of the case, and difficulty of the interview (time 2 p < 0.001). Mean scores from the DOF were associated with the time of year students took the course with students assessed early in the academic year having lower average scores (p-values = 0.01 at time 1, 0.002 at time 2). Scores on time 1 DOFs were positively associated with rater rank (p = 0.005; residents gave higher scores than faculty). DOFs also correlated with an Entrustable Professional Activity (EPA) assessment of the interview (time 1 r = 0.76, p < 0.001; time 2 r = 0.79, p < 0.001), but not with shelf exam scores (time 1 r = 0.10, p = 0.24; time 2 r = 0.11, p = 0.21).

Conclusions: A brief structured form evaluating medical student performance on psychiatric interviews provided valid information about performance by third-year medical students during the psychiatry clerkship.

Keywords: Assessment; Clerkships; Direct observation; Interviewing; Medical students; Psychiatry.

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