Testing psychiatric knowledge with in-house examinations.

Formal assessment during psychiatric training is becoming more common, not only to evaluate trainees but also to meet demands for educational and fiscal accountability. National norm-referenced tests such as the new psychiatry in-training examination may not meet the needs of many residency programs. The authors describe an alternate approach: an in-house test of psychiatric knowledge. The importance of educational objectives, test specifications, piloting the test, and item analyses is emphasized. The process is time-consuming, and the authors examine the advantages of this approach in terms of its costs.