UCSF Departments of Psychiatry and Anesthesia. The Electro-Convulsive Therapy and Anesthesia Exercise (ECTAE) is a collaborative, self-directed, learning.

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Presentation transcript:

UCSF Departments of Psychiatry and Anesthesia. The Electro-Convulsive Therapy and Anesthesia Exercise (ECTAE) is a collaborative, self-directed, learning exercise, with online pre- and post-exercise assessments designed for students participating in a year-long, multi-disciplinary clerkship. The development of interdisciplinary learning is a high priority in medical student education. ECTAE is a joint learning experience in psychiatry and anesthesiology. Broad Objectives Utilize multiple modalities (self assessment, readings, video, hands-on clinical) to create an efficient learning activity. Eight (8) students participated in Mean score increased from 14.4 to 17.8 (max score = 20) with p-value of.002 After ECTAE, 50% of students stated that they were “a lot more comfortable” about referring a patient with treatment-refractory depression for ECT The third-year medical student is assigned a psychiatry inpatient scheduled for ECT Online pre-ECTAE assessment of knowledge about ECT and anesthesia 3. 3.Learn about ECT through psychiatry and anesthesia reference readings and viewing the DVD “Shock.” 4. 4.Interview ECT patient and administer a brief cognitive battery Participate in the ECT treatment assisting with anesthesia Reassess the patient (several days after ECT) 7. 7.Online post-ECTAE assessment with additional questions on attitudes Debrief experience with their psychiatry preceptor.   ECTAE succeeded in teaching cross-disciplinary learning objectives through self- directed exercises, online assessments, and actual clinical experience of ECT.   ECTAE is an effective activity for third-year medical students to learn core material in both psychiatry and anesthesia.   ECTAE decreased stigma of ECT. Curricular Development Goals Interdisciplinary learning (psychiatry and anesthesiology) Incorporation of information technology (online, pre- and post- exercise assessments) Self-directed module for medical students Specific Learner Objectives Assessment of mental status using structured interviewing methods (psychiatry), Basic airway management (anesthesia), Informed consent and interdisciplinary communication (both). Reduce the stigma of ECT(both) RATIONALE PURPOSE METHODS – Learning Activities CONCLUSIONS The Electro-Convulsive Therapy – Anesthesia Exercise (ECTAE): A New Learning Activity for Medical Students D. LI; M. ROLLINS; S. HALL; L. TONG. University of California San Francisco School of Medicine This study was supported by the UCSF Department of Psychiatry Faculty Fellowship in Educational Scholarship. We gratefully acknowledge the assistance of Leah S. Karliner, M.D., and Beverly McGehee. Psychiatry References Lisanby S. Electroconvulsive Therapy for Depression. NEJM 2007;357; Shock (2007), DVD, with Kitty Dukakis, directed by Bard Osbourne. Website on ECT from the Mayo Clinic: Anesthesia References Ding Z et al. Anesthesia for Electroconvulsive Therapy. Anesth Analg 2002;94:1351–64. Folk J et al. Anesthesia for Electroconvulsive Therapy: A Review. The Journal of ECT 2000;16(2):157–170. RESULTS METHODS – References METHODS – Structured Clinical Interviewing Methods Patient Health Questionnaire-9 depression subscale (PHQ-9) Mini Mental State Exam (MMSE) Semantic Fluency test (animal naming) Phonemic Fluency test (Controlled oral word association test) Example Assessment Questions Percent correct pre-ECTAE (N=8) Percent correct post-ECTAE (N=6) Systolic BP> 160mmHg is an absolute contraindication for ECT. * (correct answer: False) 50%100% ECT performed with unilateral lead placement is associated with greater severity of cognitive impairment than ECT performed with bilateral lead placement. * (correct answer: False) 50%100% I now rate my level of competency for mask ventilating a patient as: _____ ‘a lot more comfortable’ ‘a little more comfortable’ ‘no change’ % 50% 17%