LAUSR

The recently revised Association of Directors of Medical Student Education in Psychiatry (ADMSEP) milestones note that learners should be able to “conduct organized, comprehensive histories, including a thorough psychiatric and narrative history”, “apply the bio-psycho-social model in psychiatric assessments”, and “present patient encounters accurately and succinctly both verbally and in written communication” [1]. While clerkships teach these skills, it is a challenge to evaluate them reliably and objectively. Feedback on studentsubmitted histories and physicals is variable and often subjective [2]. Clerkships often use clinical staff evaluations for learner assessment, but these are prone to bias. In a study by Chibnall and Blaskiewicz in 2008, clinical staff scores advantaged learners with favorable personality traits and clinical staff ratings of “knowledge and skill” and “interpersonal behavior” did not correlate with National Board of Medical Examiners (NBME) examination or Objective Structured Clinical Examination (OSCE) scores [3]. Although multiplechoice examinations are efficient and standardized methods at evaluating knowledge, they rely on simplified patient presentations and are not able to assess communication skills. Standardized patient examinations and OSCEs do better at assessing communication in a standardized format, but are timeand resource-intensive, and accurate simulation of psychiatric patient presentations can prove technically challenging [4, 5]. Standardized grading rubrics specific to learner tasks may help decrease these discrepancies while also providing formative feedback [6]. To assess skills of eliciting, reporting, and interpreting a comprehensive psychiatric history, we developed an instrument to provide structured written feedback and objective assessment of psychiatric histories submitted by medical students. We report the results of a quality improvement activity demonstrating the reliability and validity of the instrument.