Cluain Mhuire Community Mental Health Service, Dublin, Ireland.
Psychiatr Rehabil J. 2013 Mar;36(1):35-41. doi: 10.1037/h0094745.
Community mental health services are evolving toward more holistic, patient-centered, recovery-based practices. This change necessitates an attitudinal shift from mental health workers, and training in recovery principles is helpful in achieving this change. Medical students often have narrow, doctor-centered concepts of mental health care. Traditional clinical placements in psychiatry do little to address this. We evaluated a recovery-focused teaching program for medical students in psychiatry.
Medical students' knowledge of recovery from mental illness was assessed before and after either a 6-week traditional or recovery-focused clinical placement in psychiatry, using the Recovery Knowledge Inventory. A validated questionnaire was used to assess attitudes toward mental illness before and after the placements. Focus groups were conducted before and after the recovery teaching.
One hundred nineteen medical students participated; 23 experienced the recovery teaching program while 96 had a traditional placement (23 in the same center as the recovery teaching program and 73 in other centers). There were no significant differences between groups at baseline. After recovery teaching, medical students significantly increased their recovery knowledge and had more positive attitudes toward mental illness and psychiatry when compared with those who had a traditional placement. The focus groups revealed greater optimism and more holistic concepts of recovery from mental illness.
The recovery teaching program was associated with increased knowledge of recovery principles and more positive attitudes toward mental illness. Psychiatric clinical placements for medical students should include an explicit recovery focus.
社区心理健康服务正朝着更加整体化、以患者为中心、基于康复的实践方向发展。这种转变需要心理健康工作者转变态度,而康复原则的培训有助于实现这种转变。医学生通常对心理健康护理有狭隘的、以医生为中心的概念。传统的精神病学临床实习并不能很好地解决这个问题。我们评估了一项针对精神病学医学生的以康复为重点的教学计划。
使用康复知识量表(Recovery Knowledge Inventory),在精神病学传统临床实习或康复为重点的临床实习 6 周前后,评估医学生对精神疾病康复的了解程度。在实习前后使用经过验证的问卷评估对精神疾病的态度。在康复教学前后进行焦点小组讨论。
共有 119 名医学生参与,其中 23 人参加了康复教学计划,96 人参加了传统实习(23 人在与康复教学计划相同的中心,73 人在其他中心)。基线时两组之间没有显著差异。与传统实习组相比,接受康复教学后,医学生的康复知识显著增加,对精神疾病和精神病学的态度更加积极。焦点小组揭示了对精神疾病康复的更大乐观和更全面的概念。
康复教学计划与康复原则知识的增加和对精神疾病的态度更加积极有关。医学生的精神病学临床实习应包括明确的康复重点。