Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, South Kargar Ave, Tehran, Iran.
BMC Med Educ. 2024 Oct 25;24(1):1216. doi: 10.1186/s12909-024-06189-1.
Stigma surrounding psychiatric disorders persists among medical students, who represent the future of healthcare provision. The reluctance of these students to engage with patients with psychiatric conditions poses challenges in delivering appropriate healthcare services. This study aimed to evaluate the effects of an educational package on reducing stigma and altering attitudes toward patients with mental illnesses among medical students.
This interventional and quasi-experimental study enrolled medical students who entered in a 4-week clinical post in psychiatry wards from September 2021 to February 2022. Each group of students was randomly assigned to the intervention or control group. All students in the two groups underwent practical training in psychiatry wards. An anti-stigma educational package was provided for the students in the intervention group. This package consisted of three components, including a one-hour virtual training session titled "Stigma, its importance, and coping strategies", watching three short documentary films on the experiences of successfully treated patients with mental illness, and writing a reflection after a face-to-face interview with a hospitalized patient. The Attitudes Toward Mental Illness (ATMI) questionnaire was used to evaluate the attitudes of all students at the end of the rotation. Additionally, content analysis was performed on the reflection writings of the intervention group.
The intervention group (n = 142) and control group (n = 92) showed slight changes in ATMI. The effect sizes were small. Both the intervention and control groups demonstrated significant improvements in attitudes toward the treatment of mental illness. Content analysis of reflection writings highlighted increased awareness, empathy, and medical students' need for more educational content on the significance of stigma and how to address it.
The educational intervention did not significantly impact medical students' attitudes toward patients with psychiatric disorders; however, the standard clinical training and exposure to psychiatric patients may be sufficient to enhance students' perspectives on the treatability of mental illness. Writing a reflection regarding face-to-face exposure with a patient with mental illness may increase awareness and empathy in medical students. Further investigation is needed to assess the long-term effects of reflection on medical students' behavior.
精神障碍相关污名在医学生中仍然存在，而医学生是未来医疗服务的提供者。这些学生不愿与精神疾病患者接触，这给提供适当的医疗保健服务带来了挑战。本研究旨在评估一个教育包对减少医学生对精神疾病患者的污名和改变态度的影响。
这是一项干预性和准实验研究，纳入了 2021 年 9 月至 2022 年 2 月在精神病病房进行为期 4 周临床实习的医学生。将每组学生随机分配到干预组或对照组。两组学生都在精神病病房接受实践培训。为干预组学生提供了一个反污名教育包。该教育包由三个部分组成，包括一个题为“污名、其重要性和应对策略”的一小时虚拟培训课程、观看三部关于成功治疗的精神疾病患者经历的短片纪录片，以及在与住院患者进行面对面访谈后写一篇反思。在轮转结束时，使用态度量表评估所有学生的态度。此外，对干预组的反思文章进行了内容分析。
干预组（n=142）和对照组（n=92）的 ATMI 略有变化。效应量较小。干预组和对照组在治疗精神疾病的态度方面都有显著改善。反思文章的内容分析强调了学生意识、同理心的提高，以及学生对污名相关内容和处理方法的更多教育内容的需求。
教育干预并没有显著影响医学生对精神障碍患者的态度；然而，标准的临床培训和接触精神病患者可能足以增强学生对精神疾病可治疗性的看法。关于与精神疾病患者面对面接触的反思写作可能会提高医学生的意识和同理心。需要进一步研究来评估反思对医学生行为的长期影响。
