Objectives: Traditional training of electroconvulsive therapy (ECT) consists of a combination of didactic and hands-on demonstrations using ECT equipment. Our goal was to explore the potential of a high-fidelity patient simulator (HPS) to train these skills. To our knowledge, this is the first time an HPS has been used for skills training in psychiatry.
Methods: Nineteen psychiatry residents participated in this randomized controlled trial to compare traditional training (n = 9) versus training using an HPS (n = 10). Two blinded raters assessed performance using a newly developed checklist and global rating scale for this task (ECT-OSATS) (Objective Structured Assessment of Technical Skills). Residents also completed a pretest-posttest knowledge test and confidence survey.
Results: Residents in the HPS group performed significantly better in terms of ECT-OSATS when compared with the control group (P < 0.001). All 10 of the HPS group received a “pass” rating following training, whereas only 1 of the 9 control group received a “pass” rating. There were no significant group differences in posttest confidence (P = 0.21) or total knowledge gain scores from pretest to posttest (P = 0.36).
Conclusions: The level of clinical skill acquired by trainees in psychiatry for performing ECT is significantly superior using HPS- based training, in contrast to the domains of knowledge and confidence, which appear to be equally imparted using either training modality. The acquisition of skills in administering ECT seems to be an independent variable in relation to a clinician’s level of knowledge and confidence in performing ECT.
From the *Department of Psychiatry, University of Ottawa; †Department of Psychiatry, The Ottawa Hospital; ‡Royal Ottawa Mental Health Centre; §University of Ottawa Skills and Simulation Centre; ∥Departments of Medicine, Surgery, and Anesthesia, University of Ottawa; and ¶Academy for Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Received for publication December 13, 2012; accepted March 4, 2013.
Reprints: Kiran Rabheru, MD, CCFP, FRCPC, DABPN, Geriatric Psychiatry & ECT Service, The Ottawa Hospital, 501 Smyth St, Ottawa, Ontario, Canada K1H 8L6 (e-mail: firstname.lastname@example.org).
This work was awarded Best Oral Presentation at the Academy for Innovation in Medical Education annual research day, Ottawa, Ontario, Canada, March 23, 2012.
Dr Rabheru is on the advisory board for Astra Zeneca, Lundbeck, and Bristol Meyers and has received honoraria for speaking for those companies. Dr Hamstra has received honoraria for speaking for Laerdal. For the remaining authors, no conflicts of interest were declared.
Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ectjournal.com).