Evaluating training and competency assessment in public and community psychiatry: a narrative review

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BACKGROUND: Public and Community Psychiatry training prepares residents to care for underserved populations, including people with severe mental illness (SMI), people with substance use disorder (SUD), sexual and gender minorities, and those experiencing homelessness. While Public and Community Psychiatry training primarily occurs in psychiatry rotations, core competencies, such as addressing stigma and providing care for marginalized communities, are also essential in other medical specialties. Assessment methods vary widely, making competency evaluation challenging. This review aimed to examine educational assessments in Public and Community Psychiatry training and evaluate their effectiveness in measuring resident competencies. METHODS: We conducted a narrative review assessing knowledge, behaviors, and competencies in Public and Community Psychiatry training. A search was performed across PubMed, ERIC, and PsycINFO in August 2024. Studies using validated tools or custom surveys were included. Abstracts, reviews, and non-English publications were excluded. RESULTS: Forty-one studies were categorized into five focus areas: general Public and Community Psychiatry assessment, SMI and mental health stigma, SUD, other marginalized populations, and specialized training. Validated tools such as the Community Attitudes Toward the Mentally Ill Scale (CAMI), Drug and Drug Problems Perceptions Questionnaire (DDPPQ), Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI), Genderism and Transphobia Scale (GTS), and Competency Assessment Instrument for Violence Risk (CAI-V) demonstrated reliability. However, many studies relied on non-validated tools and assessed only short-term changes, limiting generalizability. CONCLUSIONS: While validated tools show promise, the lack of standardized, longitudinal assessments limits competency assessment. Integrating validated tools into structured frameworks with long-term assessments could improve training evaluation and better prepare residents across different specialties to provide care for underserved populations.

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