Psychiatry For Medical Students Research Articles

Patients as educators in medical student education in forensic psychiatry: a scoping review of the barriers and facilitators

ABSTRACT Patient educator programmes have become a fundamental part of medical student education, delivering rich and transformative learning. However, little is known about the barriers and facilitators to implementing patient educator programmes for medical students in psychiatry and specifically forensic psychiatry. A systematic search of three databases with no date parameters was undertaken in November 2022, using keywords related to medical education, coproduction, patient involvement, and psychiatry. Five papers on patient educator programmes in psychiatry were located. No literature related to patient educator programmes in forensic psychiatry was identified. Facilitators include a robust policy infrastructure and transparent arrangements for safe educational practices alongside a commitment to coproduction and relational working. Barriers include epistemic injustice, the skills of professional facilitators, and a lack of supporting educational theory. There appears to be scope to deliver high-quality medical student education in forensic psychiatry through patient educator programmes with reciprocal benefits for educators such as rehabilitation, skills development, and possibly therapeutic benefits. The educational and therapeutic value of patient as educator programmes in forensic psychiatry are under-researched. Patient as educator programmes in forensic psychiatry require careful consideration regarding risk, while patients’ prior involvement with the criminal justice system may increase stigma and discrimination. The complexity and risks have seldom been considered. It appears a priority to address the knowledge gap identified by this review.

Acceptance and commitment training for reducing burnout in medical students during a clinical clerkship in psychiatry and palliative care: A pilot study

Physicians are likely to experience burnout early in their medical education, and it only accelerates as their clinical and academic responsibilities expand and they begin clinical practice. However, effective burnout interventions for clinical-year medical students are lacking. Avoidance of unpleasant internal experiences and decreased engagement in value-based behaviors are associated with burnout. This study, an open-label pilot research with a single-center, before-and-after comparative study design and without a control group, aimed to examine the feasibility and effectiveness of brief acceptance and commitment training (ACT) in reducing burnout during psychiatric clinical clerkships at a medical school. The feasibility proved to be good, with all the participants (n = 56) completing the training. There were no significant differences in the emotional exhaustion (EE) and depersonalization (DP) scores of burnout as measured by the Maslach Burnout Inventory (MBI) at the end of the ACT and two months following the intervention. A comparison was made with scores recorded before the intervention, and significant differences were observed. A subsample of medical students with moderate or greater burnout at T0 manifested significant burnout score reductions. The same subsample revealed a significant increase in psychological flexibility as indicated by the progress factor score on the Valuing Questionnaire (VQ) at T1 compared to T0 and a significant reduction in reaction latency to negative words as indicated by the DIRAP score of the Implicit Relational Assessment Procedure (IRAP) for anxiety. We argue that short-term ACT during clinical clerkships of medical students in psychiatry and palliative care is feasible and potentially effective, and a multi-site comparative study using more direct behavioral measures is warranted to further investigate its effectiveness.

Evaluation of US Medical Student Bias Toward Mental Health Before and After First-Year Pre-clinical Psychiatry Education.

Much of mental health care is provided by non-psychiatric providers, and unfortunately, bias toward patients with mental health conditions leads to worsened outcomes. The authors endeavored to determine if pre-clinical medical student psychiatry education had an impact on these perceptions. All 366 first-year medical students at Indiana University were invited to participate in a survey that consisted of the Mental Illness: Clinician's Attitudes version 2 (MICA-2) and six supplemental questions, pre- and post-course. One hundred seventeen students completed both surveys. The pre- and post-course means were 36.6 and 33.6, a change of - 2.9 (paired t-test p-value < 0.001), indicating a reduction in bias. These results suggest that pre-clinical education can lead to a measurable decrease in bias in medical students early in training. Unfortunately, individual question results and free responses continue to highlight significant bias in US medical students against mental illness and the field of psychiatry. Health care educators should be aware of these biases and their potential impact on patient outcomes so that these harmful perceptions can be targeted.

Association of Attitude Towards Mental Illness with Exposure to Psychiatry in Medical Students

Background: Society's attitude towards patients with mental illness has been evolving over the past century and the speed of this evolution has particularly accelerated since the advent of modern ways of communication and media. As with other areas of development, attitude change may be expected to be slow-paced in our country but local evidence is lacking in this regard. Objective: To measure the level of stigma towards mental illness in medical students along with its association with their prior exposure to Psychiatry. Method: This is across-sectional study conducted between May to August 2019 at a private medical college. Consecutive sampling was used to include a total of 247 (71% female and 29% male) students of the fourth and final year MBBS after written informed consent. A specially designed form was used to collect relevant socio-demographic details along with data regarding exposure to Psychiatry. The scores from self-reported Mental Illness: Clinicians' Attitudes scale (MICA)were also recorded. Chi-Square test was used to assess the association of exposure to psychiatry to stigmatizing attitudes. Data were analyzed using SPSS20. Results: Prior exposure to mental illness in family or friend was reported by 60.5% of the students, 70% described an exposure through media and only 32% had undergone a clinical psychiatry rotation. Average stigma scores on MICA were found in 41% of our sample, while 32% had above-average scores and 27% had lower than average stigma. Pearson' schisquare test showed that the previous exposure to mental illness via media sources was found to be significantly associated with lower levels of stigma in medical students (p=

Junior Doctor Mentors: Enhancing Medical Student Psychiatry Training

AimsIncreased clinical contact during undergraduate psychiatry placements has been shown to both increase the likelihood of students considering a career in psychiatry and reduce mental-health related stigma. It can be challenging to provide medical students with a valuable clinical experience, a problem which has been further exacerbated by the coronavirus pandemic. We aimed to develop a junior doctor mentoring scheme to increase clinical exposure and teaching for students.MethodsWithin NHS Lanarkshire, groups of 4–6 University of Glasgow medical students are accommodated for their five-week clinical psychiatry blocks, during which they have a varied structured timetable, providing an overview of different psychiatric specialties. As such, students meet a wide range of clinicians, which can unfortunately mean there is little continuity in their training throughout the block.We developed a mentoring scheme to help address this issue. Enthusiastic trainee doctors – including foundation year two doctors, GP trainees and psychiatry core trainees – were invited to participate. Medical students are paired with a mentor for the duration of their block, during which they meet informally on a weekly basis. Mentors provide students with ward shadowing opportunities and bedside teaching, as well as completing work-place based assessments (WPBAs), discussing case reports and providing an additional perspective for end-of-block reports.ResultsThe mentoring scheme has been running successfully for every five-week student placement since October 2020. Student feedback has been collected via an anonymous electronic questionnaire. Students were asked what they enjoyed the most about their placement, with students frequently highlighting the support from their mentor.Examples from free-text comments included, “having an assigned mentor was really useful as someone to touch base with and go through clinical cases” and, “having a mentor was invaluable – it is crucial to have a friendly face on the wards and a contact to complete WPBAs”.Informal feedback from mentors has also been positive with trainees enjoying the opportunity to develop their teaching skills and support student training. Mentors also highlighted the role's benefit for their portfolios and specialty applications.ConclusionThis simple and cost-free intervention has had resoundingly positive feedback from medical students and trainees. Medical students enjoy having consistent informal teaching, support and feedback. Our mentoring scheme will continue for all medical students in NHS Lanarkshire and we would encourage other areas to consider a similar project. By increasing clinical exposure we hope to further reduce mental health stigma amongst students and inspire the psychiatrists of tomorrow.

Incorporating Racial Equity Discussion in Medical Student Psychiatry Curriculum.

Incorporating Racial Equity Discussion in Medical Student Psychiatry Curriculum.

Teaching Justice in Health Care

Back to table of contents Previous article Next article Ethics CornerFull AccessTeaching Justice in Health CareCharles C. Dike, M.D., M.P.H.Charles C. DikeSearch for more papers by this author, M.D., M.P.H.Published Online:29 Mar 2022https://doi.org/10.1176/appi.pn.2022.04.4.34“I will keep them [the sick] from harm and injustice. … Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. …” —Hippocratic Oath, 400 B.C.This well-known pledge, the foundation of medical ethics, is repeated in one form or another by graduating medical students as they take on the sacred privilege of caring for others. Out of it flows the ethical injunctions of beneficence, nonmaleficence, and justice. As a graduating physician, I did not fully comprehend the sophistication of this age-old oath. It was easy enough to understand that the goal of treatment was to make patients better and cause no harm. But what exactly is “justice” in the field of medicine? Some have understood it to mean equitable distribution of available resources while providing care for our patients. Or being just or fair in the treatment of patients.Physicians are quick to state that their actions in therapeutic contexts are in the best interest of their patients, and they try their best to avoid harm. Physicians cannot, however, lay the same claim to justice. African Americans and other people of color have often borne the brunt of unjust physician practices. The COVID-19 pandemic exposed what has historically been the experience of people of color—that is, White patients are prioritized over Black patients. There were reports that Black patients did not have widespread access to COVID tests and were passed over for being placed on a ventilator or an EMCO despite having similar clinical presentations. In psychiatry, Black patients are more likely to be diagnosed with a psychotic illness even when the symptoms suggest otherwise, given intramuscular antipsychotic medications, and mechanically restrained, to mention only a few inequities, than their White peers.The public and gruesome killing of George Floyd and subsequent global protests led to a long-delayed awakening. Suddenly physician groups began to profess an awareness of the inherent injustice of the U.S. health care system and of their historical maltreatment of their non-White physician colleagues. Dr. Jeffrey Geller, former president of APA, convened the Task Force on Structural Racism Throughout Psychiatry to study the issue in depth, educate the public, and make amends. The APA Ethics Committee gave an opinion thus: “To provide competent care, a psychiatrist should cultivate an awareness of the adverse effects on mental health that result from racism and ethnoracial discrimination. … A treating psychiatrist should be mindful of the impact that racism and ethnoracial and other kinds of discrimination may have in the lives of patients and their families, in clinical encounters, and in the development of mental health services. ...”Despite the apparent awakening, psychiatry residents’ training on social (health care) justice remains sorely lacking. Concerned by this reality in their residency programs, several APA/APAF fellows took on the challenge and, under the auspices of the task force’s Workgroup on Fellow Projects and Leadership, created “A Primer of Online Resources on Structural Racism in Psychiatry for Medical Students & Trainees in Psychiatry.”The effort to educate our residents will flounder without sustained attention at developing a formal and structured educational process in residency programs. Equal attention should be placed on training faculty, not just faculty of color, to teach this material. Combating injustice in our health care system requires all hands to be on deck. Future physicians and psychiatrists—and their patients—deserve no less. We should hold ourselves accountable to all the elements of our code of ethics: beneficence, nonmaleficence, autonomy (respect for persons), and, yes, justice. ■APA’s ethics opinions related to COVID-19 is posted here.“A Primer of Online Resources on Structural Racism in Psychiatry for Medical Students & Trainees in Psychiatry” is posted here.Charles C. Dike, M.D., M.P.H., is chair of the APA Ethics Committee and former chair of the Ethics Committee of the American Academy of Psychiatry and the Law. He is also an associate professor of psychiatry and co-director of the Law and Psychiatry Division at the Yale University School of Medicine. ISSUES NewArchived

Addressing Disparities in Geropsychiatry Education: Lessons Learned from 2020

With the onset of the Covid-19 pandemic in 2020, numerous disparities in both geriatric mental health care and geriatric mental health education emerged as challenges for medical educators. Many of these disparities were known prior to the onset of pandemic, including unequal access to geriatric psychiatry educators and clinical experts across the country, as well as limited opportunities for clinical experiences in geriatric psychiatry for medical students and residents. Indeed, the Institute of Medicine Report of 2012, “In Whose Hands: The Mental Health and Substance Use Workforce for Older Adults”, had identified the current and projected gaps in geriatric mental health training to meet the needs of an aging population. Since 2020, additional gaps and disparities have been recognized that adversely affect the ability to adequately develop and train the next generation of geriatric psychiatrists, as well as geriatrics-informed general psychiatrists and primary care physicians. The year 2020 also brought to the fore, issues of racism and ageism, both of which may not have been adequately addressed before in geropsychiatry education. Yet, racism and ageism are both now more clearly understood as key factors affecting the lives of elders and adding to disparities in geriatric mental health care. At the same time, the challenges of the pandemic led to new innovations in both the delivery of geropsychiatry education and the content of the education strategies that will help to mitigate disparities for patients and trainees. This symposium will address 3 key areas related to disparities in geropsychiatric education and will share important insights that should inform future approaches to geropsychiatry education.Dr. Susan W. Lehmann will present on: “’In Whose Hands?’: Where are we today?” In her talk, Dr. Lehmann will discuss the 2012 Institute of Medicine Report that described the deficiencies and disparities in geriatric mental health education identified in 2012, and she will provide an update 10 years later about what has changed since the report, and what remains to be done. She will specifically talk about geographic disparities in opportunities for training and the impact of these disparities on the mental health care of older adults. Dr. Lehmann will discuss the need for professional organizations to focus on national approaches to advocacy and change.Dr. Kirsten Wilkins will present on: “Challenges and Opportunities: Preparing the Next Generation of Geropsychiatry Trainees”. In her talk, Dr. Wilkins will discuss disparities in health care that were exposed by the Covid-19 pandemic and which negatively impact geropsychiatry education. She will address the clinical care training challenges presented by unequal access to telemedicine for elders, as well as the challenges of incorporating virtual care into the geropsychiatry curriculum for trainees. Dr. Wilkins will also address the national reckoning on race and racism that emerged during 2020 and its impact on older adults and the learning environment for geropsychiatry trainees. She will discuss the implications for geropsychiatry educators in preparing trainees to be leaders in eliminating the deleterious effects of racism and ageism for older adults.Dr. Michelle Conroy will present on: “Innovations and opportunities within geriatric psychiatry education: lessons learned from the COVID-19” pandemic. She will discuss innovations in geropsychiatry education that were developed during the Covid-19 pandemic in response to identified disparities, and lessons learned for educators that should continue into the future. In particular, she will describe a number of successful new outreach programs, didactics, and educational products developed by geropsychiatry educators in AAGP.

Evaluando habilidades en psiquiatría. Implementación y experiencia del ECOE para pregrado de Medicina

IntroductionMedical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE's introduction in 2015. MethodsAn explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described. ResultsThe mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0-5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups. ConclusionsThe OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process.

Impact of clinical posting in psychiatry on the attitude towards mental illness in undergraduate final year medical students.

The stigma in psychiatry is pervasive, it is more serious obstacle for treatment initiation. Stigmatization among health professional themselves can result in compromised patient care. The aim of this study is to see the impact of psychiatry clinical posting on the attitude of medical students towards, psychiatry and mental illness. A total of 30 final year medical students participated to this study. The attitude towards psychiatry (ATP) and the attitude towards mental illness (AMI) questionnaire were administered before and after 15 days clinical posting in psychiatry. Medical students had favorable attitude towards psychiatry and mental illness with in a mean score of 108.34 on ATP and on 68.24AMI. There was a significant increase in the mean score of both scales after the psychiatry clinical posting. AMI and ATP for female and for male (AMI - ATP). A 15 days clinical posting of final year medical students in psychiatry was associated with an increase in positive attitude towards mental illness and psychiatry among female students but not among male students and posting reduces the stigma among the students also.

Final-year medical student Psychiatry and Addiction Medicine synchronous summative tele-assessments during a COVID-19 Delta-variant stay-at-home lockdown.

ObjectiveWe describe the planning, process and evaluation of final-year Psychiatry and Addiction Medicine summative assessments in a four-year graduate medical degree program, during a COVID-19 Delta-variant public health stay-at-home lockdown.ConclusionsWe conducted separate written and clinical synchronous (real-time simultaneous) tele-assessments. We used online assessment technology with students, examiners and simulated patients, all in different physical locations. Medical students’ examination performance showed a good range. This was comparable to other discipline stations, and performance in previous years. There was no differential performance of students through the day of the assessments.

Symposium

Clinical Research Centre for Neuromodulation in Psychiatry(Multicentric Project under India Alliance at NIMHANS, Bengaluru, CIP, Ranchi and KMC, Manipal)Proposal for Symposium at Annual National Conference of Indian Psychiatric Society, 2022Transcranial Electrical Stimulation (tES) in psychiatry: Scope and Emerging evidencesDuration: 60 minutesNon-invasive brain stimulation (NIBS) techniques are increasingly being used to treat symptoms that are resistant to psychotropic treatments. Transcranial Direct Current Stimulation (tDCS) is one such emerging focal stimulation technique showing promising leads in treatment resistant psychiatric conditions and getting popular due its lower-cost and ease of administration. Emerging mechanistic and clinical efficacy studies are showing promising results of tDCS for psychiatric practice. Its relative safety has implications for its utility in special populations including extremes of age, pregnancy, and comorbid conditions. Advancing technologies are leading tDCS towards personalised therapeutic options.In addition, novel transcranial electrical stimulations (tES) with different waveforms are being evaluated in neuroscience. Alternating current (tACS), oscillatory current (tOCS), pulse current (tPCS) and random noise (tRNS) stimulations are modulating neural oscillations in various clinically translatable fronts. Rich knowledge in neural oscillations in psychiatric conditions from Electrophysiological/magnetoencephalographic studies over many decades are now beginning to bear fruits for translational research.First presentation will cover theoretical basis and translational aspects of tDCS. Second presentation will discuss on safety and clinical utility of tDCS with special focus on its utility in special clinicalPage 1 of 2population. Third presentation will provide an overview on neural oscillation, and its importance in psychiatric disorders. Fourth presentation will review the novel waveforms of tES and how they can modulate neural oscillations to bring about therapeutic changes in psychiatric disorders.Structure of the SymposiumRelevance of Psychiatry in (NExT) National Exit TestThe medical colleges in India are likely to increase as per the Govt of India’s plan to have one medical college in every district to enhance the availability of medical doctors to the population needs. India already has more than 80000 medical students graduating as doctors every year. Unfortunately, the training medical students in psychiatry has been poor with no psychiatry skill mandatory for licencing to graduate as a doctor. This is in contrast to the needs of India, which has more than 200 million people with psychiatric disorders as per the WHO ICMR Global burden study. The 2019 Competency- based medical curriculum implemented in India to ensure Indian Medical Graduate (IMG) have required skills failed to incorporate psychiatry as mandatory in the examination process. The National Medical Commission (NMC) has proposed the National Exit Test at the end of the MBBS course as a single examination for postgraduation courses. It is important that Psychiatry as a subject is given required weightage in NExT to enhance the knowledge of upcoming doctors to cater the needs of the people with psychiatric disorders in the community.Dr Ravi Gupta : Why is the NExT important for Undergraduate psychiatry education ?Dr Henal Shah : What is relevance of Psychiatry in the NExT for postgraduates, irrespective of speciality ? Dr Kishor M : Why is NExT important for Psychiatry teachers?Dr Sujit Sarkhel : The Role of Indian Psychiatric Society and its preparedness for upcoming NExTSpeakerTopicDuration discussion (including)Dr. Samir Kumar Praharaj Prof. of Psychiatry, KMC, ManipalApplication of tDCS: Bench to Bedside15 minutesDr. Sonia Shenoy Assoc. Prof. of Psychiatry, KMC, ManipalScope of tDCS in Special Population15 minutesDr. Umesh S Assoc. Prof. of Psychiatry, CIP, RanchiNeural oscillations: Implications for psychiatry15 minutesDr. Sreeraj VS Assist. Prof. of Psychiatry, NIMHANS, BengaluruNovel tES waveforms: Potentials application for psychiatric15 minutes

COVID-19 pandemic and assessments of final year medical students in psychiatry: an innovative Sri Lankan experience

The Sri Lanka Journal of Psychiatry (SLJP) is a peer-reviewed, open access journal published bi annually by the Sri Lanka College of Psychiatrists.The Journal publishes original papers, brief reports including case reports and commentaries relevant to psychiatry and allied sciences. The Sri Lanka Journal of Psychiatry is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.Cover“Perseverance”. These tenacious fishermen in Mannar continue their livelihood despite numerous difficulties. L. N. P. Samarasinghe, Acting Consultant Psychiatrist, Base Hospital Nikaweratiya, Sri Lanka.

Evaluating the effectiveness of a single-day simulation-based program in psychiatry for medical students: a controlled study

BackgroundTraining in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment.MethodsThis was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses.ResultsTwenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation.ConclusionsAdding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.

The impact of psychiatry school on attitudes towards psychiatry in medical students and junior doctors in Pakistan

AimsTo assess the impact of Psychiatry School on the attitudes towards psychiatry in Pakistani medical students (MS) and junior doctors (JD).MethodInspired by the Royal College of Psychiatrists’ ‘Choose Psychiatry’ campaign, an online event by the name of ‘Psychiatry Autumn School Pakistan’ was held on the 1st of November 2020. The event was promoted through social media and medical students and junior doctors from across Pakistan were invited to attend. Moreover, a panel of British and Pakistani psychiatrists belonging to different sub-specialties was invited to deliver talks. The attendees were provided an insight into psychiatry as a viable career option and were introduced to the training pathways, research opportunities, and the various sub-specialties present within the field.Participants were requested to complete the 'Attitudes Towards Psychiatry' (ATP-30) questionnaires before and immediately after the event. Individual scores on the questionnaire can range from 30 to 150 and a high score indicates a positive attitude. Statistical analysis was performed using a paired t-test.Result41 attendees (MS = 30, JD = 11) completed the pre-and post-school survey. The respondents were majorly female (76%) and from public sector universities (76%), with an average age of 23 years. The mean ATP score before the course was 119 (MS = 117, JD = 121) which increased by 9 points to 128 (MS = 126, JD = 131) after the event. When the two samples were compared using a paired t-test, the difference was statistically significant p &lt; 0.005.ConclusionWe conclude that a psychiatry school can positively influence attitudes towards psychiatry in medical students and junior doctors and our findings are consistent with similar studies done in other countries.In Pakistan, unfortunately, only 2–4% of undergraduate students opt for a career in psychiatry owing to insufficient knowledge and awareness about the available treatment modalities and advancement in the field. Hence, such an intervention can greatly enhance recruitment within the profession as it makes psychiatry more accessible and visible as a career choice, generates awareness about the effectiveness and evolution of psychotherapeutic practices, and eradicates misconceptions about the field that prevail among young doctors.This was the first psychiatry school held in Pakistan and the findings of the study as well the feedback received from the participants and the speakers motivate us to continue campaigning for ‘Choose Psychiatry.’

Medical Student Engagement in a Virtual Learning Environment Positively Correlates with Course Performance and Satisfaction in Psychiatry

IntroductionThere has been a move to a “flipped classroom” (FC) in medical education. The FC promotes active learning and utilizes independent preparation prior to in-class sessions. Few studies have evaluated the effectiveness of the FC approach in medical education, specifically via virtual learning. The purpose of this study evaluates student and faculty perceptions of the FC approach and relationships between student engagement and performance.MethodThe first-year medical student psychiatry curriculum was redesigned with an FC approach and subsequently altered by COVID-19 to a virtual learning environment. A mixed-method approach was used to examine both qualitative assessment and quantitative performance data. Students and facilitators were invited to participate in surveys regarding the curriculum changes. Student performance data was collected via quizzes and examinations. Engagement was evaluated by student participation in National Board of Medical Examiners–style multiple-choice questions delivered via Top Hat®. Correlational analyses were used to evaluate associations between engagement and performance. T-tests were used to compare student satisfaction across 2019 and 2020.ResultsPerformance on in-class questions was positively associated with class rank and performance (p < 0.005). More students were either satisfied or strongly satisfied (91.5%) in 2020 compared to 85.7% in 2019 (two-tailed t-test, p = 0.04). Most students (81.3%) preferred in-class questions to lectures. In 2020, 62.6% of student comments were positive regarding the psychiatry curriculum vs 33.3% in 2019. Over 61.5% of facilitators felt positive towards the changes.ConclusionOur results demonstrate a positive relationship between engagement and class performance. Students and facilitators positively perceived the approach, with students preferring in-class questions compared to lectures. Future research should evaluate overall performance on standardized tests, third-year clerkships, and number of students matching into psychiatry.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-021-01287-x.

Attitudes of Medical Students Towards Psychiatry in Venezuela: a 6-Year Longitudinal Study.

The authors evaluated changes in attitude towards psychiatry of medical students in one medical school in Venezuela. Balon's modified questionnaire was administered to first and sixth-year medical students to analyze their attitude towards psychiatry. The answers were compared with McNemar's test. The students' negative perception of psychiatry increased by the end of medical school with 45% of sixth-year students reportedly feeling uncomfortable when working with patients with psychiatric illness compared to only 8.3% of first-year medical students. Interest in specializing in psychiatry decreased from 2.6% in first-year medical students to 0% in sixth-year medical students (p=0.001). Different factors may lead to the loss of interest in psychiatry of medical students in Venezuela, such as little time spent with patients, being in contact only with patients with psychosis, stigma about psychiatry among medical doctors and friends, feeling more comfortable with other specialties, and other specialties having a higher perceived status and being better paid.

Prospective study on a fast-track training in psychiatry for medical students: the psychiatric hat game

BackgroundWhile medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months.MethodsThis gamified fast-track training consists of two teams and each team has to guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples.ResultsOne hundred and sixty-six students were proposed to take part in the study. Among them 129 completed the whole program (response rate = 77.7%). Mean scores measured at the three points in time were significantly different (p < 0.001, N = 129). Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained 3 months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training.ConclusionsThe Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.

Simulation in psychiatry for medical doctors: A systematic review and meta-analysis.

Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. From 46571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n=69), simulated patients (n=72), virtual reality (n=22), manikin (n=5) and voice simulation (n=2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD]=0.52, 95% confidence interval [CI] 0.31-0.73 [I2 =0.0%] and SMD=0.28, 95% CI 0.04-0.53 [I2 =52.0%], respectively), skills (SMD=1.37, 95% CI 0.56-2.18 [I2 =93.0%] and SMD=1.49, 95% CI 0.39-2.58 [I2 =93.0%], respectively), knowledge (SMD=1.22, 95% CI 0.57-1.88 [I2 =0.0%] and SMD=0.72, 95% CI 0.14-1.30 [I2 =80.0%], respectively), and behaviours (SMD=1.07, 95% CI 0.49-1.65 [I2 =68.0%] and SMD=0.45, 95% CI 0.11-0.79 [I2 =41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.

Psychological effects of war: A role play

The practice of psychiatry, perhaps more than any other specialty, is largely affected by culture. The medical student psychiatry curriculum often fails to incorporate this reality. In the Middle East currently, because of the endemic violence and warfare, the topic of the Psychological Effects of War should be an integral part of the psychiatry curriculum. Unfortunately, this topic is often neglected or poorly addressed in most psychiatric textbooks or curricula. A group of three students at WCM-Q in Doha took matter in their own hands to fill this gap. They used role play to illustrate three different conditions that are associated with the psychological effects of war in three different scenarios: anxiety, depression and PTSD. They made a video of the scenes with other fellow students participating in the discussion. This innovative approach is a good example of peer-to-peer education to cover an important topic that is frequently missing in standard curricula.