Hopkins Competency Assessment Test (HCAT)

Introduction

A brief instrument for evaluating the competency of patients to give informed consent or write advance directives. It consists of reading a short essay while hearing it read aloud & a questionnaire for determining the patient's understanding of the essay. At least 3 different essays are used depending upon the patient's level of education (6th grade, 8th grade, 13th grade). All of the essays are 4 paragraphs in length. The essay(s) discuss medical procedures, informed consent, advance directives & durable power of attorney. Score on the questionnaire ranges from 0-10.

A score of 4 or below is 100% sensitive & specific for cognitive impairment (relative to assessment by forensic psychiatry.

The test takes 10 minutes to administer. It can be administered by a non-clinician.