This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

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Standardized clinical vignettes may be a simple, time-efficient, and valid tool for assessing residents' competence in the management of agitation.

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In this study, simulation-based training appeared to be more effective at teaching knowledge and skills necessary for the management of acutely agitated patients, as compared to didactic-based instruction alone. Subjective evaluations of confidence in these skills did not improve significantly compared to controls, corroborating the need for using objective outcome measures when assessing simulation-based training.

The field of psychiatry is rapidly evolving, and residency didactic curricula must also evolve in order to remain up-to-date and relevant to the learner. However, ensuring continuous revision of educational content can be a significant challenge for residency programs. Curriculum revision is a complex process that requires input from faculty for planning, implementation, and monitoring, as well as feedback from learners themselves [1]. It can be difficult to obtain consistent and meaningful feedback about each didactic and to interpret the feedback to inform curriculum changes. Administrative resources for gathering and interpreting feedback are scarce, resident comments may be overly reactionary in the immediate post-didactic period, and faculty may be resistant to suggested changes. In the absence of specific constructive feedback, didactic instructors may deliver the same session year after year. Though the importance of ongoing curricular revision has been emphasized [2, 3], to our knowledge, there are no models described in the literature to guide residency programs in systematically reviewing and revising a psychiatry didactic curriculum on an ongoing basis to ensure high-quality teaching and up-to-date content. At the Massachusetts General Hospital (MGH)/McLean Hospital Adult Psychiatry Residency, a large program with two primary teaching campuses, the entire didactic curriculum (defined as any formal scheduled teaching, discussion-based lessons, or experiential learning-based seminars) was systematically revised in 2012 [4]. Following the launch of the new curriculum, program leadership developed a process for ongoing review and improvement of the didactic content and teaching methodologies in the curriculum. This educational case report provides a description of a novel continuous quality improvement (CQI) process for residency didactic curricula that engages residents as key participants in the process. CQI processes are systematic approaches to improving quality, often using the plan-do-study-act cycle, by identifying quality improvement opportunities (plan), implementing change (do), collecting feedback (study), and monitoring ongoing revision of

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