Objective: To compare the effects of learning about electroconvulsive therapy (ECT) via live observation to learning via an instructional videotape. Method: During their psychiatry clerkship, 122 medical students were randomized using these two educational methods, and their ECT knowledge and attitudes were assessed during the first and last weeks of the 6-week clerkship. Results: For both the knowledge and attitudes measures, the clerkship (time) effect was statistically significant (i.e., posttest scores were higher than pretest scores). The interaction effect was significant for knowledge only (pretest scores for students in the live group were slightly lower at pretest than those for students in the videotape group and slightly higher at posttest). The effect size was very small, however, suggesting little meaningful educational difference between the two instructional methods. Conclusion: Both live demonstration and viewing a videotape appear to be effective methods for teaching medical students about ECT.