Development and Implementation of a Virtual Clinical Skills Examination in General Psychiatry

During the COVID-19 pandemic, psychiatry programs have administered the Clinical Skills Evaluation (CSE) through videoconferencing. The authors evaluated the feasibility and appropriateness of administering virtual CSEs.

Virtual CSEs were administered to 11 general psychiatry residents on March 16, 2021. Teleconference software was used to connect faculty at work sites, residents at a simulation center, and volunteer patients at home. Before and after the CSE, residents and faculty were surveyed with Likert scale questions to evaluate their perceptions and experience.

All virtual CSEs were completed successfully. Nine residents (82%) and 12 faculty (92%) responded to both surveys. Most participants (range, 67-83%) indicated that the virtual CSE was appropriate for assessing patient health and resident skills. Most participants (range, 56-100%) reported that the opening and closing of the interview, informational and affective cues, and rapport were adequately assessed. All participants agreed that suicidal and homicidal risks could be adequately assessed. Most faculty and residents (76%) believed that unique skills were required for telehealth interviews. Before the CSE, more faculty than residents believed that they received adequate training for the virtual CSE (P=.02); afterward, most participants thought that training was adequate (P=.46). More faculty than residents reported increased convenience with virtual assessments (both surveys, P<.01).

Virtual CSEs were deemed feasible and appropriate. Further research is needed to identify the specific skills required to perform a virtual CSE and to clarify the potential limitations and benefits of this format.