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From Information to Simulation: Improving Competency in ECT Training Using High-Fidelity Simulation

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Abstract

Objective

This study was intended to develop a new educational model that supplements ECT didactics with simulation-based procedural training and to evaluate the learning gains conferred by such a curriculum.

Methods

Two types of curricula were evaluated for educational efficacy in this prospective randomized controlled trial. Psychiatry residents (n = 35) completed surveys to ascertain their baseline experience, knowledge, and proficiency with the ECT procedure. They were then block-randomized to receive either a didactic ECT curriculum (non-SIM) or one augmented by simulation training (SIM). Three months post-completion of the two types of instruction, all residents were re-administered the surveys and a procedural post-assessment.

Results

The median number of ECTs performed prior to the study was similar between the two groups (SIM group = 3, non-SIM group = 4.) The SIM group showed significant improvement on pre- and post- survey theoretical knowledge scores: 51% (95% CI = 41 to 61%) and 69% (95% CI = 64 to 74%), respectively, p = .02; this difference was not significant in the non-SIM group, p = .2. Improvement between pre- and post- proficiency scores were seen in the SIM group: 22% (95% CI = 13 to 32%) and 51% (95% CI = 53 to 59%), p < .001 while the effect was less pronounced in the non-SIM group. Inter-rater agreement for the proficiency assessment was excellent: k, = .9.

Conclusions

Residents showed significant improvement in knowledge, comfort, and skills following ECT simulation training. With the proposed curriculum, residents would receive comprehensive education not only in the theory behind ECT but also in procedural skills. This curriculum can be modeled in other programs that do not have extensive ECT facilities.

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Authors and Affiliations

  1. Maimonides Medical Center, Brooklyn, NY, USA

    Anetta Raysin, Brian Gillett, Joseph Carmody, Nidhi Goel, Scot McAfee & Theresa Jacob

Authors
  1. Anetta Raysin
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  2. Brian Gillett
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  3. Joseph Carmody
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  4. Nidhi Goel
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  5. Scot McAfee
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  6. Theresa Jacob
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Corresponding author

Correspondence to Theresa Jacob.

Ethics declarations

This work was completed in compliance with federal, state, and institutional regulations as well as confidentiality standards.

Ethical Considerations

This study was approved by the Maimonides Institutional Review Board/Research Committee.

Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Raysin, A., Gillett, B., Carmody, J. et al. From Information to Simulation: Improving Competency in ECT Training Using High-Fidelity Simulation. Acad Psychiatry 42, 653–658 (2018). https://doi.org/10.1007/s40596-017-0859-1

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  • DOI: https://doi.org/10.1007/s40596-017-0859-1

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