The goal of this prospective, open-label non-inferiority randomized controlled trial is to investigate if Virtual Reality (VR) based simulation are an effective training tool for novice medical trainees. The main questions it aims to answer are:
* Is the VR-based electroconvulsive therapy (ECT) training program non-inferior to traditional, mannequin-based ECT training programs in fostering ECT skill acquisition? * What are the changes in confidence in administering ECT, as well as number of training repetitions completed in the VR and mannequin training groups? * What is the ease of use of the VR-based ECT training program? Researchers will compare the VR-based ECT training program to a mannequin-based ECT training program to see if the VR-based ECT training program is comparable to traditional methods at training for ECT.
Participants will:
* Complete an ECT skills assessment at the beginning and end of the study session. * Watch a 30-minute didactic ECT lecture video. * Be randomized to either the VR ECT simulation group or the mannequin ECT simulation group and be given 30 minutes to practice ECT administration with their assigned education tool.
Is a medical student at the University of Toronto
Has not received formal ECT training before
Visual or hearing impairment that does not allow the participant to use VR.
History of significant motion sickness.
Parallel
Virtual Reality electroconvulsive therapy simulator
Other interventionA virtual reality (VR)-based simulator for electroconvulsive therapy (ECT) practice. Users will go through tutorials on how to use the VR equipment and be guided through an ECT tutorial, then they can practice ECT with no guidance at 3 distinct difficulty levels. Level 1 of the simulator will contain ECT scenarios with very few patient conditions that need additional consideration. Level 2 will contain more patient conditions that need additional consideration, as well as a chance for adverse events to occur during treatment. Level 3 will contain many patient conditions that require the user to consider when deciding how to provide ECT, as well as a high chance of adverse events occurring. Users will be shown how well they did after completing a run of a scenario.
Mannequin Simulator
Other interventionA mannequin that users can use to practice electroconvulsive therapy (ECT) administration on. Users will be provided a mannequin and ECT equipment, as well as a scenario check-list to go through.
Electroconvulsive Therapy Objective Structured Assessment of Technical Skills (ECT-OSATS)
A comprehensive ECT proficiency assessment tool including a technical skills checklist and a global performance rating scale. The technical skills checklist includes specific tasks during ECT administration that need to be completed to ensure a successful ECT delivery. Scores for each task can range from 1 - "Not Done" to 3 - "Done Correctly". Higher scores indicate better performance. The global performance rating scale includes items such as "Efficiency", "Knowledge", "Communication", and "Overall Impression of Performance" of the participant's ECT administration session as a whole. Scores can range from 1 - 5, with higher scores indicating a more positive outcome. The rating scale culminates with a "Global Impression of Pass or Fail", with options of "Fail" - the participant cannot perform ECT independently, or "Pass" - the participant can perform ECT independently. The ECT-OSATS was adapted from Rabheru et al. (2013).
VR System Usability Scale (SUS)
A questionnaire asking about the user's experience in their use of virtual reality technology. It is a 8-item questionnaire rated on a 5-point Likert scale with options of "Strongly Agree", "Somewhat Agree", "Neutral", "Somewhat Disagree", and "Strongly Disagree". Each choice is also associated with a numbered score, from "Strongly Agree" at 1 to "Strongly Disagree" at 5. Depending on the question, higher scores could indicate a more positive or a more negative outcome. E.g., for the question "I thought the VR system was easy to use", a higher score would indicate a more negative outcome. Conversely, for the question "I found the VR system unnecessarily complex", a higher score would indicate a more positive outcome. Scores will be adjusted depending on if the question rates higher scores as a positive or negative outcome. Adjusted scores will be summed, then multiplied by 2.5 and divided by 80 to yield a final system usability score out of 100. Adapted from Brooke, John (1995).
Rate of Learning Questionnaire
A 3-item questionnaire examining the participant's confidence in performing ECT at baseline and at end of study, as well as the number of practice repetitions the participant completed during the education intervention session. Confidence in performing ECT is assessed on a 3-point scale ranging from "Not At All" to "Very confident", with "Very Confident" being a more positive outcome. Practice repetitions are defined as the number of times the participant completed ECT training scenarios during their education intervention session.
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