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Psychiatr Serv. 2011 Jan;62(1):90-2. doi: 10.1176/

An approach to evaluating competence in assessing and managing violence risk.

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  • 1Department of Psychiatry, University of California, San Francisco, 401 Parnassus, San Francisco, CA 94143, USA.



The authors developed and evaluated a tool for assessing competency in violence risk assessment and management.


The Competency Assessment Instrument for Violence Risk (CAI-V) was based on the literature on violence risk assessment, which was complemented by feedback from faculty focus groups. In an objective structured clinical examination, 31 faculty observers used the CAI-V to rate the performance of 31 learners' (26 psychiatry residents and five psychology interns) risk assessments of standardized (simulated) patients. In an interrater reliability study, six faculty members rated video-recorded risk assessments.


The CAI-V had good internal consistency reliability (α=.93). Senior learners performed better on the CAI-V than junior learners, supporting the instrument's concurrent validity. Interrater reliability was good (intraclass correlation coefficient=.93). Participants reported that the CAI-V provided a helpful structure for feedback and supervision.


The results supported the potential of this new approach for appraising competency in violence risk assessment and management.

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