The Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
University of Toronto, Toronto, ON, Canada.
BMC Med Educ. 2022 Mar 9;22(1):163. doi: 10.1186/s12909-022-03216-x.
Recruitment to psychiatry as a career has been challenging in Canada and abroad despite the known shortage and increasing burden of psychiatric issues globally. Deterrents to choosing psychiatry as a career include its negative stigma and paucity of knowledge about the field. The study goal was to evaluate the Ottawa Psychiatry Enrichment Program (OPEP), a one-week extracurricular program about psychiatry as a career for 1st and 2nd year medical students. We hypothesized OPEP would improve students' attitudes towards psychiatry, and positive changes would be sustained 2-3 years later following their residency match. We hypothesized there would be a high recruitment of OPEP attendees to psychiatry programs.
1st and 2nd year medical students from Canada applied to OPEP. Attendees completed the Attitudes Towards Psychiatry Questionnaire (ATP-30) at three times: before OPEP (PreOPEP), after OPEP (PostOPEP) and after their Canadian Residency Matching Service (CaRMs) match 2-3 years later. OPEP ATP-30 scores were compared to third-year student ATP-30 scores before and after their psychiatry rotation. Data were analysed using Friedman non-parametric ANOVA and post hoc testing by either Wilcoxon rank sum test, Wilcoxon matched pairs signed rank test, or parametric Welch independent t-test as appropriate. Effect sizes of group mean differences were calculated using Cohen's "d".
Between 2017-2018, 29/53 Canadian applicants were selected for OPEP. 100%, 93.1% and 75.8% of OPEP students completed the PreOPEP, PostOPEP, and CaRMs ATP-30 surveys respectively. 43% of OPEP attendees matched to psychiatry. PostOPEP ATP-30 scores (mean = 133, median = 137, SD = 10.6) were significantly higher than PreOPEP ATP-30 (mean score = 121, median = 122, SD = 9.3, p < 0.001) and CaRMS ATP-30 (mean = 126, median = 127, SD = 12.3, p < 0.02) scores. OPEP effect size on ATP-30 scores was large (d = 1.2) but decreased 2-3 years later (p = 0.078, d = 0.44). 97/202 students completed the ATP-30 before and after their psychiatry rotation (clerkship). Clerkship effect size on improvement in ATP-30 was moderate (d = 0.39). There was a non-significant difference between OPEP CaRMS ATP-30 and post clerkship ATP-30 scores (median 127 vs 121, p = 0.056).
OPEP ameliorated attitudes toward Psychiatry, but improvement deteriorated longitudinally. Strategies for program design, and innovations to boost/retain improvements during clerkship years are discussed.
尽管全球范围内精神病学问题的知晓率低且负担日益加重，但在加拿大和其他国家，精神病学作为职业的吸引力一直存在挑战。选择精神病学作为职业的障碍包括其负面形象和对该领域知识的匮乏。本研究旨在评估渥太华精神病学强化项目（Ottawa Psychiatry Enrichment Program，OPEP），这是一个针对医学生的为期一周的精神病学职业课外项目。我们假设 OPEP 将改善学生对精神病学的态度，并且在他们完成住院医师匹配后 2-3 年内，积极变化将持续存在。我们假设 OPEP 的参加者中有很大一部分会选择精神病学项目。
来自加拿大的医学生 1 年级和 2 年级学生申请参加 OPEP。参与者在三个时间点完成《精神病学态度问卷》（Attitudes Towards Psychiatry Questionnaire，ATP-30）：参加 OPEP 前（PreOPEP）、参加 OPEP 后（PostOPEP）和完成加拿大住院医师匹配服务（Canadian Residency Matching Service，CaRMs）匹配后 2-3 年。将 OPEP 的 ATP-30 得分与三年级学生在完成精神病学轮转前后的 ATP-30 得分进行比较。使用 Friedman 非参数 ANOVA 分析数据，并根据需要使用 Wilcoxon 秩和检验、Wilcoxon 配对符号秩检验或参数 Welch 独立 t 检验进行事后检验。使用 Cohen 的“d”计算组间均值差异的效应大小。
在 2017-2018 年期间，53 名加拿大申请人中有 29 人被选中参加 OPEP。分别有 100%、93.1%和 75.8%的 OPEP 学生完成了 PreOPEP、PostOPEP 和 CaRMs ATP-30 调查。43%的 OPEP 参与者匹配到了精神病学项目。PostOPEP 的 ATP-30 得分（均值=133，中位数=137，标准差=10.6）明显高于 PreOPEP 的 ATP-30 得分（均值=121，中位数=122，标准差=9.3，p<0.001）和 CaRMs 的 ATP-30 得分（均值=126，中位数=127，标准差=12.3，p<0.02）。OPEP 对 ATP-30 得分的影响较大（d=1.2），但 2-3 年后下降（p=0.078，d=0.44）。在完成精神病学轮转（实习）前后，有 202 名学生中的 97 名完成了 ATP-30 调查（n=97）。实习对 ATP-30 得分的改善有中度影响（d=0.39）。OPEP 和实习后 ATP-30 得分之间没有显著差异（中位数分别为 127 和 121，p=0.056）。
OPEP 改善了对精神病学的态度，但随着时间的推移，这种改善逐渐减弱。讨论了项目设计策略和创新措施，以提高/保持实习期间的改善。
