Improving Medical Student Attitudes Toward Suicide Prevention Through a Patient Safety Planning Clerkship Initiative.

Abstract

This project aimed to understand medical students' attitudes toward suicide prevention and their experiences in an innovative clerkship training program that engaged students in patient safety planning. Medical students were invited to complete the Attitudes to Suicide Prevention (ASP) scale to explore student perceptions of suicide prevention and risk assessment. Seventy-five psychiatry clerkship students also completed a new safety planning training program with at-risk patients on psychiatry inpatient units. Each student observed a patient safety plan being completed, discussed this process with the resident or attending, completed a safety plan with another patient, and then debriefed with the observing physician. Participants completed the ASP before and after the rotation. The cross-sectional data (n=490) showed that student perceptions of suicide prevention were generally positive (M=27.8, SD=6.1) with variation among classes, but many students did not fully recognize the potential effectiveness of suicide risk reduction strategies. After the clerkship intervention, students were significantly more likely to report that working with suicidal patients was rewarding (p=0.035) and less likely to report discomfort assessing patients for suicide risk (p=0.001). Medical educators can reinforce the process and efficacy of suicide interventions by modeling the described initiative. Psychiatry clerkship training that intentionally engages students in safety planning with patients is generalizable, and these skills could be extended to the student burnout crisis. Longitudinal studies will help determine how individual perceptions change through medical school and whether students apply safety planning skills in psychiatry and other specialties to care for suicidal patients.