Evaluation of Clinical Competence in Psychiatry by the Royal College Examination

Abstract

One hundred and seven psychiatric residents, postgraduate program directors and Royal College Examiners returned questionnaires which inquired into the areas of training programs, interim performance checks and the Certification Examination. There was relatively little dissatisfaction expressed with the written examination. However, most residents, program directors and examiners felt there were better ways to evaluate clinical competence than by means of the oral examination which was considered to lack validity and reliability. Respondents were very constructive in the suggestions they offered which focused on two main areas: the need to provide examiners with a larger work sample of a candidate's performance (for example, through a sample of the candidate's treatment audio-visual tapes), and the desirability of explicit performance criteria from the Royal College as to their expectations in the areas of knowledge, skill, judgment and ethics, so that the examination could be the final step in a shaping process rather than a high risk, single trial, pass/fail situation.