Singh S P, Baxter H, Standen P, Duggan C
Department of Psychiatry, University of Nottingham, UK.
Med Educ. 1998 Mar;32(2):115-20. doi: 10.1046/j.1365-2923.1998.00162.x.
The General Medical Council's document 'Tomorrow's Doctors' (1993, GMC, London) recommended major changes in the undergraduate curricula of UK medical schools. In Nottingham, the fourth-year psychiatric attachment became shorter in duration, and interactive, problem-oriented, workshop-based learning replaced lectures. We compared the efficacy of this new teaching style in changing medical students' attitudes towards psychiatry and mental illness with that of old-style, didactic, lecture-based teaching. On the first and last days of their psychiatric attachment, 110 fourth-year-medical students (45 old curriculum; 65 new curriculum) completed two self-administered attitudinal measures: the Attitude to Psychiatry Questionnaire (ATP-30) and the Attitude to Mental Illness Questionnaire (AMI). We found that students had favorable attitudes towards psychiatry and mental illness before the attachment. These attitudes became more positive after the attachment in students from both curricula, with no significant difference between the groups and no gender difference. Students found patient contact rewarding, become more accepting of community care, and had greater appreciation of the therapeutic potential of psychiatric interventions. The interactive, student-centred, problem-oriented teaching of the shortened new curriculum appeared as effective in changing medical student' attitudes as a longer attachment with traditional teaching.
英国医学总会的文件《明日之医》（1993年，英国医学总会，伦敦）建议对英国医学院校的本科课程进行重大改革。在诺丁汉，四年级学生的精神科实习时间缩短，互动式、以问题为导向、基于工作坊的学习取代了讲座。我们将这种新教学方式在改变医学生对精神病学和精神疾病态度方面的效果与传统的、说教式的、基于讲座的教学方式进行了比较。在精神科实习的第一天和最后一天，110名四年级医学生（45名旧课程学生；65名新课程学生）完成了两项自我评估的态度量表：《对精神病学的态度问卷》（ATP - 30）和《对精神疾病的态度问卷》（AMI）。我们发现，学生在实习前对精神病学和精神疾病就持有积极态度。实习后，两组学生的这些态度都变得更加积极，两组之间没有显著差异，也没有性别差异。学生们发现与患者接触很有意义，对社区护理的接受度更高，对精神科干预的治疗潜力有了更深刻的认识。缩短后的新课程中以学生为中心的互动式、问题导向教学，在改变医学生态度方面似乎与传统教学中更长时间的实习一样有效。
