Curriculum documentation
Module 1 crosswalk: objectives → assessment → Milestones
Module 1, “Legal Statuses in the NY ED,” mapped end to end: what each of the 8 lessons teaches, which pre-test and post-test items assess it, and which ACGME Psychiatry Milestones subcompetencies the content feeds. Built for program directors and Clinical Competency Committees deciding what a resident’s Module 1 scores are evidence of.
How to read the scores
The dashboard reports a pre-test score, a post-test score, and the change between them. The two tests are blueprint-matched — same objectives, same 17-question totals, new scenarios — so the change is a descriptive score change, not a growth measure for any single skill. This page shows which lessons the 34 items sample. The faculty sign-off, unlocked after the post-test, is the observed-practice evidence that sits alongside the scores.
Module objectives (as published)
- Name each NY admission status and the section that creates it.
- Match the arrival route (police, court, DCS, ER physician) to the correct paper.
- State what each status changes: can the patient leave, who decides, what clock is ticking.
- Explain treatment-over-objection and capacity-vs-commitment in plain language.
Lesson objectives below are stated from each lesson’s own teaching content. Each lesson also carries two formative items — an opener scenario and a check question — that teach inside the lesson and are not scored in the dashboard.
The crosswalk
Lesson 1 — What “legal status” means and why it matters in the ED
- Define legal status as a legal category created by MHL Article 9 — not a diagnosis.
- State the three questions every status answers: can the patient leave, who decides, what clock is ticking.
- Recognize that a status can change, and that admitting, discharging, holding, disclosing, and documenting all depend on it.
Assessed by: Pre Q1, Q3 · Post Q1.
Milestones: PROF1 Professional Behavior and Ethical Principles SBP2 System Navigation for Patient-Centered Care
Lesson 2 — How patients arrive: the door powers (9.41 / 9.43 / 9.45 / 9.57)
- Match each arrival route to its authority: police (§9.41), DCS (§9.45), courts (§9.43), ER physician (§9.57).
- State the shared “likely to result in serious harm” standard in three prongs — self, others, and (2025) inability to meet essential needs.
- Distinguish transport from admission: a door paper alone retains no one.
- State the door duties: immediate DCS notification on temporary detention; EMS transport request for third-prong removals (2025).
Assessed by: Pre Q7, Q8, Q10 · Post Q3, Q5.
Milestones: SBP2 System Navigation for Patient-Centered Care PC1 Psychiatric Evaluation PROF1 Professional Behavior and Ethical Principles
Lesson 3 — Voluntary and informal admission (9.13 / 9.15), and conversion (9.23)
- Distinguish voluntary (§9.13, written application) from informal (§9.15, oral request; free to leave at any time).
- State the age rules: under 16 only on a parent/guardian/next-of-kin application; 16–18 on the minor’s own or the family’s.
- Describe conversion both ways: §9.13(b) retention (72 hours, two physicians examine and report separately, director releases or applies to court) and §9.23 (director’s duty to convert; MHLS notified).
Assessed by: Pre Q6, Q13 · Post Q4, Q6, Q13.
Milestones: PROF1 Professional Behavior and Ethical Principles ICS1 Patient- and Family-Centered Communication SBP2 System Navigation for Patient-Centered Care
Lesson 4 — Emergency admission: 9.39
- State who may sign: one staff physician — a resident may sign; attending co-signature is policy, not statute.
- Apply the three-element “reasonable cause” standard together: mental illness + immediate hospital care appropriate + likely serious harm.
- State the clocks: psychiatric-staff confirmation within 48 hours or the paper lapses; 15-day ceiling.
- State §9.39(a) notice: patient at admission, simultaneously MHLS and up to 3 designees — no nearest-relative provision.
Assessed by: Pre Q1 (48-hour confirmation), Pre Q3 (§9.39(a) notice vs. §9.29) · Post Q1 (all three elements — “clinic tomorrow” fails immediacy).
Milestones: PC1 Psychiatric Evaluation PC3 Treatment Planning and Management PROF1 Professional Behavior and Ethical Principles
Lesson 5 — Involuntary admission on medical certification: 9.27, plus rights, hearings, retention
- Reconstruct the §9.27 sequence: application + two examining physicians’ certificates (one may be a psychiatric NP, 2025; examinations may happen anywhere), then forthwith confirmation by a third, psychiatric-staff physician at the hospital.
- Apply the §9.05 disqualifications: relative of the patient or applicant, financial interest in the hospital, proprietary-facility staff. Residents are not barred.
- State the protection package: §9.29 notices, §9.31 hearing right, §9.33 court retention, §9.07 rights notice for all patients.
Assessed by: Pre Q2, Q4 · Post Q2, Q7.
Milestones: PROF1 Professional Behavior and Ethical Principles ICS3 Communication within Health Care Systems SBP3 Physician Role in Health Care Systems
Lesson 6 — Involuntary admission on DCS certificate: 9.37
- Reconstruct the §9.37 sequence: DCS application → staff physician confirms before admission → second, psychiatric-staff certificate within 72 hours (excluding Sundays/holidays) if retained involuntarily.
- Keep the DCS papers straight: §9.45 transports; §9.37 admits — and §9.37(d) carries its own custody/transport authority.
- Explain why resident eligibility for the 72-hour certificate is a medical-staff-bylaws question, not answered by the statute’s text.
Assessed by: Pre Q5 · Post Q12.
Milestones: SBP2 System Navigation for Patient-Centered Care PROF1 Professional Behavior and Ethical Principles PC3 Treatment Planning and Management
Lesson 7 — What each status changes
- For each status (9.13, 9.39, 9.27, 9.37): can the patient leave, who decides, what clock is ticking.
- Answer “I’m leaving” by status — including the §9.13(b) response when a voluntary patient now meets involuntary criteria, and the involuntary patient’s remedies (§9.07 notice, §9.31 hearing).
- State the transfer rules: status and clocks travel — no restart (§9.39(b)); involuntary transfer requires MHLS notice (§9.27(f)), not a court order.
Assessed by: Pre Q9 · Post Q9.
Milestones: SBP2 System Navigation for Patient-Centered Care ICS1 Patient- and Family-Centered Communication PC3 Treatment Planning and Management
Lesson 8 — The hard edges: refusal, capacity, handoffs, restraints, reporting, AOT, minors
- Explain the Rivers doctrine: involuntary status is not forced medication; overriding refusal requires a court order (imminent-danger emergency exception).
- Separate capacity (decision-specific) from commitment (status) in both directions.
- State restraint/seclusion principles: physician’s order, time limits, documentation — exact limits are hospital policy.
- State the SAFE Act duty at a high level (§9.46 reporting to the DCS) and recognize an AOT order (§9.60); recap the minors rules.
Assessed by: Pre Q12, Q14–Q17 · Post Q8, Q10, Q14–Q17.
Milestones: PROF1 Professional Behavior and Ethical Principles SBP1 Patient Safety and Quality Improvement PC1 Psychiatric Evaluation ICS1 Patient- and Family-Centered Communication
Item trace — all 34 graded items
| Item | Lesson | Content sampled |
|---|---|---|
| Pre 1 | 4 | §9.39 48-hour psychiatric-staff confirmation |
| Pre 2 | 5 | §9.29 notice scheme for §9.27 admissions |
| Pre 3 | 4 | §9.39(a) notice — no nearest-relative provision |
| Pre 4 | 5 | §9.05 disqualification (financial interest); resident may certify |
| Pre 5 | 6 | §9.37 second certificate — staff membership is a bylaws question |
| Pre 6 | 3 | §9.23 conversion, involuntary → voluntary |
| Pre 7 | 2 | §9.45 paper alone retains no one |
| Pre 8 | 2 | Three-prong standard — essential-needs prong (2025) |
| Pre 9 | 7 | Transfer — status and clock travel (§9.39(b)) |
| Pre 10 | 2 | §9.57 — ER physician; removal, not admission |
| Pre 11 | 1 | Framework — status, not diagnosis, determines who may leave |
| Pre 12 | 8 | Rivers baseline — detention is not medication authority |
| Pre 13 | 3 | Minors — under-16 voluntary application must come from parent/guardian/next of kin |
| Pre 14 | 8 | Restraint/seclusion principles — physician’s order, time-limited, documented, last resort |
| Pre 15 | 8 | AOT (§9.60) — court-ordered community treatment, not an admission status |
| Pre 16 | 8 | SAFE Act §9.46 — serious harm to self or others; report to the DCS |
| Pre 17 | 8 | Capacity is decision-specific (voluntary patient) |
| Post 1 | 4 | §9.39 three-element standard — immediacy element |
| Post 2 | 5 | §9.05 disqualification (relative); resident may certify |
| Post 3 | 2 | §9.43 court route — the order does not admit |
| Post 4 | 3 | §9.13(b) retention process — two examiners, director, court |
| Post 5 | 2 | §9.41 third-prong EMS transport request (2025) |
| Post 6 | 3 | §9.15 informal vs. §9.13 voluntary — written notice |
| Post 7 | 5 | §9.27 sequence — third-physician confirmation at the hospital |
| Post 8 | 8 | Rivers doctrine + decision-specific capacity |
| Post 9 | 7 | Involuntary transfer — MHLS notice (§9.27(f)) |
| Post 10 | 8 | SAFE Act §9.46 reporting duty |
| Post 11 | 1 | Framework applied — §9.23 conversion changes legal position, not illness |
| Post 12 | 6 | §9.37 sequence — pre-admission confirmation, then 72-hour staff certificate |
| Post 13 | 3 | Minors — at 16–18 the minor may apply on her own |
| Post 14 | 8 | Restraint/seclusion documentation — indication, alternatives tried, monitoring, re-evaluation |
| Post 15 | 8 | AOT — the order alone authorizes no detention |
| Post 16 | 8 | Capacity is decision-specific (committed patient’s consent) |
| Post 17 | 8 | Restraint orders are time-limited — re-evaluation and a new order |
Both tests total 17 items, so the two scores are comparable as totals; their difference is a descriptive score change between two different forms, not an equated measure.
Honest limits
- The quizzes measure knowledge and scenario judgment on paper. They cannot show that a resident gives a §9.29 notice correctly at 2 a.m. or certifies only when the criteria are met. Observed practice comes from the faculty sign-off and your own workplace assessments.
- Pre- and post-tests are blueprint-matched, not item-parallel; read the change at the module level, not per item.
- The legal content is New York Mental Hygiene Law, Article 9. The Milestones are national; this module and crosswalk are for NY programs.
Content version: October 2026 (tests: m1-content-v31). Milestones framework: ACGME Psychiatry Milestones, Version 2.1 (implementation July 1, 2021); subcompetency names verified against the ACGME Report Worksheet, October 2026.