The Potential Effect of the Psychiatric Clerkship and Contact-Based Hypothesis on Explicit and Implicit Stigmatizing Attitudes of Canadian Medical Students Towards Mental Illness.

Abstract

The purpose of this study was to assess if having completed a psychiatric clerkship or having increased exposure to mental illness in general was associated with reduced explicit and implicit stigmatizing attitudes towards mental illness in undergraduate medical students. A secondary analysis of data specific to medical students from McMaster University was completed. Data were obtained through a cross-sectional survey administered electronically. It consisted of a demographic questionnaire, the Opening Minds Scale for Healthcare Providers (OMS-HC) 12-item survey, and an Implicit Association Test (IAT). The OMS-HC was used as a measure of explicit stigmatizing attitudes, whereas the IAT was used as a measure of implicit bias. All analyses were completed using Stata/IC 15 and were two-tailed with significance defined as p < 0.05. Individuals that self-reported either having had a mental illness or diagnosis by a health care professional had significantly lower levels of explicit stigma. Final-year medical students had significantly lower levels of implicit stigmatizing attitudes than first-year medical students. Neither having completed a psychiatric clerkship nor having a close relationship with someone experiencing a mental illness was significantly associated with the explicit or implicit stigmatizing attitudes of medical students. More years in medical school and self-identifying or receiving a diagnosis of mental illness are associated with reduced stigmatizing attitudes, whereas having completed the psychiatric clerkship and having a close relationship with an individual experiencing mental illness were not. This study suggests that the psychiatric clerkship may have limited impact on the stigmatizing attitudes of medical students.