Clinical documentation is a core competency in medical education, yet little is known about how it is taught during psychiatry clerkships. This study examined student and supervisor perceptions of documentation preparedness, supervision, educational value, and difficulty within an academic consultation-liaison (CL) psychiatry service. An anonymous survey study was conducted among medical students, psychiatry residents, and attending physicians on an adult CL psychiatry service between February 2022 and August 2023. Students rated documentation comfort, supervision, and educational experiences; supervisors rated student preparedness, teaching practices, and perceived utility of student notes. Quantitative and qualitative analyses were performed. Twenty-seven medical students and 36 supervisors completed surveys. Supervisors rated students as somewhat unprepared at the clerkship start but reported significant improvement by its conclusion (p < 0.001), although some deficiencies persisted. Students reported the greatest comfort documenting the history of present illness and the least with capacity assessments. Supervisors most frequently identified challenges with the assessment and plan and the mental status examination. Nearly all students valued documentation training, and supervisors described substantial time reviewing, editing, and teaching documentation. Residents provided significantly more documentation supervision than attendings (p < 0.001). Psychiatry clerkship documentation skills improve during training but remain an area of ongoing development. Differences between student self-assessment and supervisor perceptions suggest that documentation competence may extend beyond learner confidence. Structured, domain-specific curricula and resident-supported teaching models may enhance preparedness and align educational and clinical goals.
