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Electroconvulsive Therapy Teaching in Canada: Cause for Concern

Patry, Simon MD, FRCPC*; Graf, Peter PhD; Delva, Nicholas John MD; Chan, Peter MD§; Enns, Murray MD; Gilron, Ian MD; Gosselin, Caroline MD§; Jewell, Mark BA, RPN#; Lawson, James Stuart PhD**; Martin, Barry MD††; Milev, Roumen MD‡‡

Journal of ECT:
doi: 10.1097/YCT.0b013e31827989b9
Original Studies
Abstract

Aim: The objective of this study was to present survey data on the teaching of electroconvulsive therapy (ECT) in health care centers across Canada.

Methods: Of 1273 centers identified, 175 were found to practice ECT. These centers were asked to complete a questionnaire, and 107 (61%) of them answered 5 questions dealing specifically with ECT teaching. These questions were as follows:

(1) Does your facility have an ECT teaching program for residents in psychiatry?

(2) How is ECT taught to residents in psychiatry?

(3) If direct supervision of the administration of ECT is a requirement of the psychiatry training program, is there a minimum number of supervised treatments or minimum duration of training period?

(4) Do residents provide unsupervised ECT at your center?

(5) Which other groups of learners, if any, are provided with orientation, teaching, or training in ECT?

Results: Sixty percent of respondents had no ECT teaching program for psychiatry residents. Pedagogical methods varied, ranging from direct observation of ECT treatments to directed readings. Few centers required a minimum number of supervised treatments. No resident-administered ECT is performed without direct supervision. Interestingly, various groups of health care professionals were often invited to participate in ECT training.

Conclusions: The situation regarding ECT teaching continues to be a cause for concern given the noted absence of organized, structured, and mandatory programs. No resident administering ECT, however, goes unsupervised, which is in keeping with good practice. Electroconvulsive therapy is taught in many different ways, and teaching is accessible to different groups of health care professionals. However, much remains to be done to standardize ECT teaching to render this therapy available to all those who need it and to overcome the stigma and bias associated with it.

Author Information

From the *Department of Psychiatry, Université Laval, Québec; †Department of Psychology, University of British Columbia, Vancouver, British Columbia; ‡Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; §Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; ∥Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba; ¶Department of Anesthesiology, Queen’s University, Kingston, Ontario; #Addiction and Mental Health Services, Edmonton, Alberta; **Department of Psychiatry, Queen’s University, Kingston; ††Department of Psychiatry, University of Toronto, Toronto; and ‡‡Departments of Psychiatry and Psychology, Queen’s University, Kingston, Ontario, Canada.

Received for publication August 22, 2012; accepted October 16, 2012.

Reprints: Simon Patry, MD, FRCPC, 2601 de la Canardière, J-1021, Québec, Canada G1J 2G3 (e-mail: simon.patry@institutsmq.qc.ca).

This study was made possible by an unrestricted grant from the Vancouver Coastal Health Authority.

The authors have no conflicts of interest or financial disclosures to report.

© 2013 by Lippincott Williams & Wilkins