Competency by Design for Electroconvulsive Therapy in Psychiatry Postgraduate Training: Face and Content Validation Study

Psychiatry is in the process of shifting curricula in postgraduate training to a competency-by-design approach. One core aspect of postgraduate psychiatry training is the knowledge and practice of electroconvulsive therapy (ECT). The aim of this study was to develop and validate the corresponding set of competencies that need to be developed during postgraduate training in psychiatry.

This study involves the proposal of a set of competencies by an ECT curriculum committee from the University Department of Psychiatry, based on the competency-by-design principles, followed by a modified Delphi process, to reach expert consensus on the proposed, modified, and added competencies.

Six ECT experts meeting the preset criteria were recruited to the study from 6 academic centers across Canada and participated in the 2 Delphi rounds. Thirty-one competencies were proposed in the first round. Twenty-three proceeded to the second round by meeting 80% agreement on a score of ≥4 using a 5-point Likert scale. Three competencies required rewording based on qualitative feedback; accordingly, 10 new competencies were suggested. Thirty-five competencies were rated by experts and reached the threshold of agreement and rating. Cronbach α increased from 0.89 after the first round to 0.95 after the second iteration.

Consensus was generated on 35 competencies that need to be achieved during postgraduate training in psychiatry. These competencies can serve as the basis for developing ECT curricula in postgraduate psychiatry training. The method used is feasible and can be adopted for the development of other competencies and curricula in psychiatry and other medical fields.