Preparing for Patient Care: A Pre-clerkship Curricular Thread to Improve Learners' Knowledge, Attitudes, and Confidence Treating Patients at Risk for Suicide.

Suicide is a leading cause of death. Unfortunately, stigma still surrounds depression and mental health treatment. Many health care providers are uncomfortable broaching the topic with patients. There is an urgent need to better equip future physicians to compassionately identify and treat patients at risk for suicide. To address this problem, we created a novel suicide prevention spiral curricular thread for advanced pre-clerkship medical students. Mixed methods surveys were administered before and after the curriculum. Following completion of the curriculum, learners' confidence identifying and treating patients at risk of suicide significantly increased. Attitudes including professional confidence, therapeutic optimism, and generalist perspective measured by the Revised Depression Attitudes Questionnaire also increased, indicating reduced stigmatizing attitudes and increased knowledge and confidence. Participants reported that engaging in the standardized patient encounter was the most impactful event, although the prior events provided necessary foundational training. This study demonstrates the feasibility and effectiveness of a curricular thread approach during the pre-clerkship phase for training medical students in suicide prevention to prepare them for patient care. Other medical schools can use this framework to design and integrate suicide prevention training into their own curricula.