Service Evaluation of Medical Undergraduate Psychiatry Placement

Abstract

AimsThere are no clear guidelines for the optimal organisation of psychiatry placements for medical undergraduates. Moreover, the UK needs to enrol more psychiatry trainees. This service evaluation aimed to show that an efficient psychiatry placement can improve attitudes of students towards psychiatry and increase their likelihood to choose psychiatry.MethodsWe evaluated the efficacy of a new strategy for the psychiatry placement of 24 fourth-year medical students from the University of East Anglia during the academic year 2021/2022. The strategy consisted of having a 4-week placement in one of 3 wards at the Norfolk and Suffolk Foundation Trust Woodlands Unit (PICU, acute male and female wards) with brief (one- to two-day) rotations across the wards, as well as the community team and individual areas of interest. This afforded students exposure to different settings, pathologies and levels of severity, with enough time in one service to allow integration into the team, participation in clinical and therapeutic activities and most important, observation of patient longitudinal improvement. Multidisciplinary teams were included by presenting the training as a win-win, and we relied on a good teaching culture at our Trust. We also offered a programmed induction day, a mid-placement meeting and an end-of-placement debrief. We evaluated the efficacy of the strategy using the Attitude Towards Psychiatry Questionnaire before and after the placement, as well as measuring overall satisfaction.ResultsThe overall satisfaction score on a 5 point Likert scale was very good (M = 4.58; SD = 0.58). Mean ATP total score significantly improved from 116.50 (SD 9.49) to 133.00 (SD 8.68) over a maximum attainable score of 150 (F(1;23) = 69.70, p < .001, ηp2= .75), with 23 out of the 30 items having significantly improved individually as well. The reliability of the scale was high with a Cronbach's alpha of .81 before and .84 after the psychiatry placement. The question “I would like to be a psychiatrist” improved significantly from 2.54 to 3.25 on the 5 point Likert scale (F(1, 23) = 16.33, p < .001, ηp2= .42) with an increase in students answering “agree” or “strongly agree” from 16.7% to 45.8%. This improvement was significantly positively correlated with the overall satisfaction score (R = .528, p < .01).ConclusionPsychiatry placement for medical undergraduates is a valuable opportunity to improve their attitudes towards psychiatry and their likelihood of choosing psychiatry as a specialty. We present our strategy as a model toward these goals.