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.
J ECT. 2013 Dec;29(4):291-6. doi: 10.1097/YCT.0b013e318290f9fb.
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.
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.
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).
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.
传统的电痉挛疗法（ECT）培训包括使用 ECT 设备进行理论和实践演示的结合。我们的目标是探索高保真患者模拟器（HPS）在培训这些技能方面的潜力。据我们所知，这是首次在精神病学领域使用 HPS 进行技能培训。
19 名精神科住院医师参加了这项随机对照试验，以比较传统培训（n=9）与使用 HPS 进行的培训（n=10）。两名盲评者使用新开发的检查表和全球评定量表（ECT-OSATS）（客观结构化技术评估）对这项任务进行评估。住院医师还完成了预测试后知识测试和信心调查。
与对照组相比，HPS 组在 ECT-OSATS 方面的表现明显更好（P<0.001）。HPS 组的 10 名住院医师在培训后均获得“通过”评级，而对照组的 9 名住院医师中仅有 1 名获得“通过”评级。在测试后信心方面（P=0.21）或从预测试到后测试的总知识增益评分方面（P=0.36），两组之间没有显著差异。
与基于传统培训的方式相比，精神病学住院医师在进行 ECT 时所获得的临床技能水平使用 HPS 进行培训明显更高，而在知识和信心方面则似乎通过两种培训模式同等传授。在进行 ECT 方面的技能获取似乎是与临床医生进行 ECT 的知识和信心水平相关的独立变量。
