title: Comparison of traditional didactic seminar to high-fidelity simulation for teaching electroconvulsive therapy technique to psychiatry trainees.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Kiran
authors.initials: K
authors.lastname: Rabheru
authors.forename: Andrew
authors.initials: A
authors.lastname: Wiens
authors.forename: Bismil
authors.initials: B
authors.lastname: Ramprasad
authors.forename: Luc
authors.initials: L
authors.lastname: Bourgon
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Antochi
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D004565:Electroconvulsive Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D017145:Models, Educational; D011570:Psychiatry / Q000193:education*