Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick , Coventry , UK.
Department of Psychiatry, University of Oxford, Warneford Hospital , Oxford , UK.
Med Teach. 2019 Aug;41(8):939-948. doi: 10.1080/0142159X.2019.1602253. Epub 2019 May 6.
Medical students with poor attitudes toward psychiatry are unlikely to choose it as a career, and current psychiatry recruitment is inadequate for future NHS needs. Amending medical school curricula has been suggested as one solution. We performed a unique naturalistic mixed-methods cross-sectional survey of two sequential cohorts in a UK medical school, before and after the restructuring of the entire MBChB curriculum. As well as increasing integration with other specialties, the emphasis placed on psychiatry increased throughout the course, but the final psychiatry block reduced from 8 to 6 weeks. Students experiencing the refreshed curriculum had better attitudes to psychiatry and psychiatric patients and were more positive about psychiatry as a career for themselves and others, compared to students on the old curriculum. This was demonstrated both quantitatively using validated rating scales (12/30 questions ATP-30 and 1/6 questions PEAK-6) and qualitatively using free-text responses. Restructuring undergraduate medical curricula to enhance integration may yield added value, including the potential to improve attitudes to specialties previously learned in silos, such as psychiatry. This may improve recruitment and the understanding of mental health for all future doctors.
医学生如果对精神病学持有不良态度，就不太可能选择这个专业作为职业，而目前的精神病学招聘人数不足以满足未来国民保健制度的需求。有人建议修改医学院的课程设置，以解决这个问题。我们在英国一所医学院的两个连续班级中进行了一项独特的自然主义混合方法横断面调查，分别在整个 MBChB 课程重组之前和之后进行。除了与其他专业更加融合之外，精神病学的重点在整个课程中逐渐增加，但最后的精神病学模块从 8 周减少到 6 周。与旧课程的学生相比，经历新课程的学生对精神病学和精神病患者的态度更好，对自己和他人从事精神病学的职业也更有积极性。这一点既通过使用经过验证的评分量表（ATP-30 的 12/30 个问题和 PEAK-6 的 1/6 个问题）进行了定量证明，也通过自由文本回复进行了定性证明。对本科医学课程进行结构调整以加强整合可能会带来额外的价值，包括改善对以前在孤立环境中学习的专业的态度的潜力，如精神病学。这可能会提高所有未来医生对精神卫生的理解和招聘。
