Effectiveness of Entrustable Professional Activity-Based Clinical Psychiatry Training for Indian Medical Interns: A Preliminary Study.

ObjectiveEntrustable Professional Activities (EPA) are discretely measurable specific professional tasks that integrate multiple competencies to define and provide varying levels of faculty support per trainee needs. Methods: We developed an EPA-based psychiatry curriculum for medical interns. Fifty-four interns completed the OSCE stations, Multiple Choice Questions, and Attitude questionnaires to assess EPAs, knowledge and attitudes towards the relevance and utility of clinical psychiatry in general practice. Results: Two weeks of EPA-based psychiatry training resulted in improvement in median scores on attitude questions (p < 0.05), clinical skills measured using EPA levels. Conclusions: EPA-based curriculum can improve clinical skills, knowledge, and attitudes towards clinical psychiatry in interns.

Electroconvulsive therapy in South Asia: Past, present, and future.

The practice of electroconvulsive therapy (ECT) varies both between and within countries. We aimed to review historical and current trends in ECT practices, perceptions, and legislations in South Asia, a region with a high burden of mental illness and suicide. We searched MEDLINE (PubMed) and Google Scholar databases for relevant literature on ECT from each country. Additionally, a team of country-specific investigators performed supplemental searches and contacted key country contacts for relevant information. Relevant data were abstracted under the following headings: ECT practices, perceptions, and legislations. Knowledge gaps and research priorities were synthesized. Modified bitemporal ECT, delivered using brief pulse devices, was most commonly offered across institutions. Schizophrenia, not affective illness, was the most common indication. Electroencephalographic monitoring of seizures was rarely practiced. Thiopentone or propofol was preferred for anesthetic induction, while the favored muscle relaxant was succinylcholine. In India and Sri Lanka, perceptions about ECT were largely favorable; not so in Pakistan and Nepal. Only India and Pakistan had laws that governed any aspect of ECT practice; ECT practice guidelines were available only in India. There is a lack of research on efficacy, ECT in special populations, continuation ECT practices, and interventions to improve ECT-related perceptions. Most regional institutions offered modified brief-pulse ECT, and schizophrenia was the most common indication. Knowledge of and attitude towards ECT varied between countries. There is a need to develop a regional ECT consortium to facilitate uniform training, advocacy efforts, and the development of regional practice guidelines.