Psychiatry Course Research Articles

Undergraduate psychiatric education: current situation and way forward.

Undergraduate psychiatric education is essential for the training of medical students and for their recruitment into psychiatry. A significant shortage of graduates choosing a career in psychiatry has been recently documented, and this trend might have many causes. When medical students have positive experiences of teaching, elective placements and exposure to psychiatric patients, their attitudes towards psychiatry are significantly better. Therefore, there is a need to improve the quality of undergraduate training courses in psychiatry. Innovative teaching strategies are suggested, including the use of movies, virtual reality, simulated patients and multiprofessional training wards.

Decrease in Stigma Towards Mental Illness in Portuguese Medical Students After a Psychiatry Course.

Stigma towards mental illness is considered a key obstacle to the provision of medical care to psychiatric patients. This is not only present in the general population but also among healthcare professionals. Therefore, medical students could be a target population for stigma prevention measures. The aim of this study is to assess the evolution of the attitudes of medical students from the Faculty of Medicine of the University of Coimbra towards psychiatric patients, before and after attending Psychology and Psychiatric courses. Students from the third and fourth years of the integrated Master's degree in Medicine in the Faculty of Medicine of the University of Coimbra were asked to complete four questionnaires. The surveys were distributed before and after the attendance of the courses. There was a statistically significant decrease of the stigma scores (p = 0.025) between the two measurements (38.16 initially, 36.72 on the second moment). The baseline level of stigma was found to be negatively associated with empathy (rP = -0.477) and with the type of personality, with higher levels of openness to new experiences being associated with lower levels of initial stigma (rP = -0.357). Overall, the students' attitudes towards patients with mental illness were positive, with a decrease of the stigma value from the first to the second semester. This corroborates the hypothesis that education and contact with people with a mental condition could shape positive changes in attitudes and discrimination against those patients. Our results emphasise the importance of implementing programs inside medical schools in order to reduce stigma among future doctors.

The Assessment of Attitudes of Students at Medical Schools towards Psychiatry and Psychiatric Patients-A Cross-Sectional Online Survey.

The aim of the study was the assessment of the level of stigmatisation of psychiatric patients and psychiatry as a field of study by students at medical schools in Poland and the comparison of students’ attitudes over the years. The study was conducted based on a proprietary questionnaire assessing the stage of tertiary education, sociodemographic status, and MICA-2 psychometric tool that is used for assessing both the attitudes of students at medical schools towards psychiatry as a field of study and patients with mental health disorders. According to the MICA score, those who have higher scores have more negative attitudes towards psychiatry. The survey consisted of two rounds at an interval of 3 years. Results. The first-round survey, conducted in 2017, involved 480 students. The second-round survey, conducted in 2020, involved 573 students. In both cases, women constituted the vast majority of respondents. Women, as well as medical major students, achieved significantly lower scores than men p < 0.001. The said relationship was also observed for individual experience with mental illness. There was no correlation between the MICA-2 total score and the psychiatry course completion—p = 0.105. However, the levels of stigmatisation are still high. The implementation of educational methods to improve the perception of psychiatric patients by students at medical schools should be taken into consideration. An increase in direct student–patient contact, for example, by means of intensive elective classes, could be beneficial.

Pharmacy students’ attitude towards providing pharmaceutical care to patients with anxiety and their knowledge of psychotropic medicines in Jordan

To describe pharmacy students' attitude towards providing pharmaceutical care (PC) to patients with anxiety and their knowledge of psychotropic medicines (PM). A cross-sectional emailed survey was sent to all 200 pharmacy students (fourth and fifth year) in one Jordanian university. Statistical analysis included descriptive statistics and chi-square test. A total of 134 responses were received (response rate 67%). About two-thirds of students (87, 64.9%) would like to give enough time to patients with anxiety to discuss their medications. Only half of students knew correctly that alprazolam (53.7%) and diazepam (50.0%) are categorized as anxiolytics. Undertaking a course in psychiatry was significantly associated with better students' knowledge in PM (P < 0.05). Despite positive attitudes towards providing PC to patients with anxiety, policy makers should include courses on psychiatric pharmacotherapy in pharmacy curricula to improve pharmacy students' knowledge of PM.

Attitudes of medical students in Saudi Arabia towards mental illness and their beliefs regarding its causes and treatability.

The stigmatization of people with mental illness is a worldwide problem. The authors aimed to assess stigmatizing attitudes among medical students at a university in Saudi Arabia towards mental illness and to evaluate the association of psychiatric education and planned medical specialty with stigmatizing attitudes and beliefs concerning the treatability and etiology of mental illness. A cross-sectional survey of currently enrolled medical students at Sulaiman Al Rajhi University was conducted through convenience sampling using a 52-item questionnaire. Factor analysis identified four unique factors representing attitudes and beliefs towards mental illness. ANOVA and Chi-square tests were used to evaluate the differences in attitude among students at different levels and other variables associated with these factors. Altogether 245 students (46.7 %) responded to the survey. Completion of a classroom psychiatry course, but not a clinical clerkship, was associated with a stronger belief in the effectiveness of the treatment of both medical and mental illnesses (p = 0.031) as well as greater acceptance of the biopsychosocial model of the etiology of mental illness (p = 0.001). Students interested in pursuing a surgical career had weaker beliefs in the effectiveness of treatment of mental illnesses as compared to students interested in other minor specialties (p = 0.002). While attitudes towards socializing with people with mental illness did not differ significantly with different levels of psychiatric education, beliefs about treatability and biopsychosocial etiology seem to be strengthened after a classroom psychiatry course but not further reinforced after the clinical clerkship.

"It was great to break down the walls between patient and provider": liminality in a co-produced advisory course for psychiatry residents.

Although rhetoric abounds about the importance of patient-, person- and relationship-centered approaches to health care, little is known about how to address the problem of dehumanization through medical and health professions education. One promising but under-theorized strategy is to co-produce education in collaboration with health service users. To this end, we co-produced a longitudinal course in psychiatry that paired people with lived experience of mental health challenges as advisors to fourth-year psychiatry residents at the University of Toronto. The goal of this study was to examine this novel, relationship-based course in order to understand co-produced health professions education more broadly. Using qualitative interviews with residents and advisors after the first iteration of the course, we explored how participants made meaning of the course and of what learning, if any, occurred, for whom and how. We found that the anthropological theory of liminality allowed us to understand participants' complex experiences and illuminated how this type of pedagogy may work to achieve its effects. Liminality also helped us understand why some participants resisted the course, and how we could more carefully think about co-produced, humanistic education and transformative learning.

A Survey of Psychiatry Course Offerings for Fourth-Year Medical Students.

Fourth-year course offerings seem to vary widely among psychiatry departments with some offering a wide selection while others offer little or unspecified opportunity. The purpose of this study was to learn the distribution and diversity of fourth-year medical school psychiatry courses and identify unique course offerings that may inspire other departments. The authors compiled a list of US allopathic medical schools accredited by the Liaison Committee on Medical Education (LCME) using the LCME website. They accessed each school's website catalog and recorded all psychiatry electives available to fourth-year students listed in the catalog or the Visiting Student Application Service® (VSAS®) database. The authors calculated median published course offerings per department and categorized each course according to learning opportunity. The authors identified 142 fully accredited allopathic medical schools of which n = 126 listed fourth-year medical student courses on their website or through VSAS. The median number of fourth-year psychiatry course offerings per school was 6 (range, 1-22). The most frequently offered courses were inpatient psychiatry (n = 105 schools), child and adolescent psychiatry (n = 95), and consultation psychiatry (n = 84). The authors also identified unique enrichment courses in media, women's health, ethics, research, and cultural psychiatry. The fourth-year curriculum varies widely among institutions. Hypotheses to be tested are if prioritizing robust fourth-year rotations include improved resident readiness, improved retention of home students into the training program, improved recruitment of visiting students, increased faculty scholarly activity and career development, and improved recruitment into the subspecialties.

Electroconvulsive Therapy: a Video-Based Educational Resource Using Standardized Patients.

ObjectiveVideo-based depictions of electroconvulsive therapy (ECT) can be useful for educational purposes, but many of the readily available resources may worsen already stigmatized views of the procedure. Educators’ common reliance on such material highlights the paucity of equipoised depictions of modern ECT well suited for the training of health professionals. The authors developed and tested a new educational module enhanced by videotaped depictions of a simulated patient undergoing the consent, treatment, recovery, and follow-up phases of ECT.MethodsThe didactic intervention interspersed 7 short video clips (totaling 14 min) into a 55-min lecture on treatment-resistant depression. The session, part of an intensive course of preclinical psychiatry, was delivered online through synchronous videoconferencing with Zoom. The primary outcome measure was change in the Questionnaire on Attitudes and Knowledge of ECT (QuAKE).ResultsFifty-three out of 63 (87%) eligible second-year medical students completed assessments at baseline and after exposure to the didactic intervention. QuAKE scores improved between baseline and endpoint: the Attitudes composite increased from 49.4 ± 6.1 to 59.1 ± 5.7 (paired t 10.65, p < 0.001, Cohen’s d 0.69), and the Knowledge composite from 13.3 ± 1.2 to 13.9 ± 0.8 (paired t 3.97, p < 0.001, Cohen’s d 0.23).ConclusionsThese video-based educational materials proved easy to implement in the virtual classroom, were amenable to adaptation by end-use instructors, were well received by learners, and led to measurable changes in students’ knowledge of and attitudes toward ECT.

Addressing Electroconvulsive Therapy Knowledge Gaps and Stigmatized Views Among Nursing Students Through a Psychiatrist-APRN Didactic Partnership.

BACKGROUND: Knowledge gaps and stigmatized perceptions regarding electroconvulsive therapy (ECT) among patients and health providers contribute to the underutilization of an important therapeutic modality. The proactive education of future advanced practice registered nurses (APRNs) provides an opportunity to optimize the use of this evidence-based clinical practice. AIMS: As part of a general course in psychiatry during the first year of nursing school, we dedicated 1 hour to treatment-refractory depression, including ECT, and a second hour to a summary discussion of mood disorders. We evaluated the efficacy of this didactic offering, which was co-taught by a psychiatrist and a psychiatric APRN. METHOD: At baseline, consenting students (n = 94) provided three words they associated with ECT and then completed three validated instruments: (a) Questionnaire on Attitudes and Knowledge of ECT, (b) Opening Minds Stigma Scale for Health Care Providers, and (c) Self-Stigma of Seeking Help. Among the 67 students who repeated the assessment at endpoint, 39 attended the ECT didactic (Intervention group, 58%) and 28 did not (Control, 42%). RESULTS: After completion of the 3-month course, students showed improvement across all measures (p < .001). The only outcomes that improved differentially between the Intervention and Control groups were the Questionnaire on Attitudes and Knowledge of ECT Attitudes and Knowledge scales (p = .01). Word choice valence associated with ECT shifted favorably by endpoint (p < .001). CONCLUSIONS: An educational intervention co-led by a psychiatric-mental health APRN had a significant impact on nursing students' knowledge and perceptions of ECT. This approach can be readily implemented at other institutions. Future refinements will include the videotaped depiction of a simulated patient undergoing the consent, treatment, and recovery phases of ECT.

Effects of contact-based, short-term anti-stigma training for medical students : Results from arandomized controlled trial.

Mental health stigma (MHS) places aburden on those affected that far exceeds psychosocial harms. Contact-based anti-stigma work has been found effective for several target groups. For medical students however, its efficacy remains unclear. The purpose of this study was to examine the efficacy of contact-based, trialogic anti-stigma training for medical students. Arandomized controlled trial (RCT) was conducted, controlling for standard clinical placement in psychiatry. External validity was maximized by including all students (n = 204) who started their 6‑week obligatory psychiatry course during the study period between March and July 2018. Assessments were conducted at the beginning of each of the two covered terms and immediately postintervention. Students who received the anti-stigma training displayed significantly less stigmatizing attitudes after the intervention, measured using the MICA (Mental Illness-Clinicians' Attitudes) scale as primary outcome. Analogous findings were noted for social distance and stereotypes, whereas these could not be observed for emotional reactions. All significant changes were independent of gender and age. The positive results underpin the research in this field and point towards the inclusion of comparable interventions in regular student curricula. Given the limitation of amissing late follow-up, however, further research regarding the persistence of stigma reduction is needed.

Attitudes to psychiatry and to mental illness among nursing students: Adaptation and use of two validated instruments in preclinical education.

Stigma towards psychiatry and people with serious mental illness (SMI) is prevalent among healthcare providers and can adversely affect patient care. Internalized stigma among nurses can affect personal self-care and limit help-seeking behaviours. Stigma around mental health nursing can adversely affect recruitment into this already underserved field. This is the first report on the adaptation and use in a nursing student sample of two widely used stigma-related instruments that have been normed among medical students. The attitudes to psychiatry (ATP-30) and the attitudes to mental illness (AMI) instruments proved sensitive to change and can be useful in tracking specific anti-stigma curricular interventions. Interactive and participatory student activities in courses such as ours (that include simulation with standardized patients, clinical placements and patient interaction) need to be complemented by exposure to individuals with lived experience with mental illness in order to address stigmatized views of SMI. Nursing educators and fellow nurses willing to share their own experiences with mental illness-including diagnosis, health-seeking, treatment and recovery-may prove especially powerful and germane during nursing school. Even a strong academic curriculum is not sufficient to change stigmatized perceptions about mental illness, psychiatric care and mental health nursing as a profession. Comparison and potential synergy between ATP-30, AMI and OMS-HC (Opening Minds Scale for Health Care Providers) could prove fruitful in identifying a more comprehensive approach to stigma assessment over time. The addition of validated instruments, such as the Self-Compassion Scale-Short Form (SCS-SF) and the Self-Stigma of Seeking Help (SSOSH), which tap into internalized stigma and into health-seeking behaviours and intervening barriers could prove particularly useful in evaluating innovative interventions for stigma-decreasing initiatives in nursing education. Interactive and participatory didactic offerings need to be complemented by exposure to individuals with lived experience with mental illness and ideally to nursing educators and practicing nurses willing to share their histories of diagnosis, help-seeking, treatment and recovery. Introduction Stigma towards psychiatry and to people with serious mental illness (SMI) is prevalent among healthcare providers and can adversely affect patient care. Such stigmatized views can adversely affect recruitment into the already underserved field of mental health nursing. Aim/question We adapted two stigma-related instruments in a sample of nursing students and examined change in scores after participation in an eight-week preclinical psychiatry curriculum. Our goal was to identify stigma-malleable opportunities that would inform refinements in future iterations of a preclinical psychiatry curriculum in nursing. Method We made minor adaptations to the attitudes to psychiatry (ATP-30) and the attitudes to mental illness (AMI) instruments. We invited first-year nursing students to complete assessments at two time points: before and after completion of an eight-week core course in preclinical psychiatry. Results Seventy-one students completed the assessment at both time points. ATP-30 and three of its eight subscale scores improved by course's endpoint. By contrast, AMI scores did not change. Compared with medical student published norms, nursing students in our sample had higher (less stigmatized) average scores. Discussion The ATP-30 and the AMI can be easily adapted to a nursing student population and may prove useful in tracking specific anti-stigma educational interventions. Implications for practice A general psychiatry course during nursing school is, it and of itself, unlikely to change biased views about SMI and should be enhanced with exposure to, and interaction with individuals with lived experiences of mental illness, ideally by nurse educators and practicing nurses.

The Mental Status Exam Through Video Clips of Simulated Psychiatric Patients: an Online Educational Resource.

The Mental status exam (MSE) is a core component of psychiatric education. Innovative ways of teaching the MSE by making it "come alive" may prove useful in a wide range of curricular initiatives. The authors developed a publicly available online repository of sixteen video-based depictions by simulated psychiatric patients (SPPs) of ten common forms of psychopathology. They tested the practical feasibility and didactic efficacy of including the video clips through an education trial embedded into two pre-clinical psychiatry courses. One hundred fifty-three students participated in the study (75 medical, 78 nursing). Students in the intervention group (n = 73) performed better on an objective MSE standardized instrument's overall score than did those in the control group (n = 80; F2,150 = 4.817, p = 0.009), with a main effect for intervention over control (beta = 2.69; 95% CI = 0.56, 4.82; p = 0.014), but no effect for discipline. Among medical students, those in the intervention group improved on MSE knowledge and competence subjective self-ratings, compared with those in the control group (p ≤ 0.001). Video clips of SPPs depicting psychopathology are an effective complement to teach the MSE and enhance students' sign and symptom recognition on objective and subjective measures. This publicly available online video repository can help psychiatric educators enhance their teaching efforts to different types of learners.

The journey towards the best quality of MCQs test, a success story in a medical school

Multiple choice question (MCQ) test is the most popular assessment tool that used in medical schools, faculty training on construction of multiple choice questions and peer review are the main factors that contributing to have a good quality MCQ test. This study aimed to evaluate the effect of these two factors on the quality of MCQ test. An extensive training program was conducted for the staff members who were participated in teaching and assessment of undergraduate medical students of clinical biochemistry and psychiatric courses. Post-test item analysis was used to compare pre-training with post-training item analysis parameters. Chi-square test was applied, level of significance was 5%. Regarding difficulty index, it showed great improvement in number of questions which lie in acceptable range of difficulty from 16%, 25% before the training program to 61%,42% after the training program for psychiatry and clinical biochemistry courses respectively and this is significantly different (P0.05). In psychiatry course the number of questions with negatively discrimination power had been decreased from 36% before training program to 10% after it (P value 0.05). No significant improvement noticed in biochemistry course regarding this aspect. Both courses were showed improvement in the function of distracters, the percentage of test items where all distracters were functioning was increased from 11% to 41% in psychiatry course (P value=0.0002), and from 12% to 46%, in biochemistry course (P value=0.0001). The two courses which included in the study showed increased reliability after the training program and peer review processes, but this improvement is not statistically significant. A dramatic improvement was observed in the quality of MCQs after peer review and training program. We recommend adopting training program on construction of MCQs to be as teaching license for all medical school staff members in Saudi Arabia.

An evaluation of the effect of examination reform on the teaching of Psychiatry

Objective To determine the impact of new methods in teaching and examination on students' learning of psychiatry by increasing the proportion of objective questions in the final exam papers through examination reform, so as to help students adapt to the Practitioner Examination. Methods A total of 483 students from grade 2011 & 2012 were selected as research subjects. Through the comparative study of the test scores under different teaching methods before and after the examination reform, the SPSS 22.0 statistical software was used to analyze the structure, reliability, difficulty and level of differentiation of the examine papers via t tests. Results Examination papers after the reform showed an increase in difficulty in all question types; some question types also had higher levels of differentiation. Students receiving PBL-based education had higher scores compared to those under traditional teaching methods. The difference was statistically significant. Conclusion PBL teaching mode is more conducive to the mastering of knowledge points and helps students improve grades in objective questions. Medical schools should increase the use of PBL teaching reform in psychiatry courses and conduct examination reform, so as to improve the teaching effect and the passing rate of Practitioners Examination. Key words: Psychiatry; Test question types; Teaching methods; Examination reform

Teaching psychiatry to large groups in society

BackgroundThere is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.MethodThe program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36 years old lacked any healthcare education. The participants’ backgrounds, perceptions, participation in the education program, and costs are presented.ResultsBetween 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n = 2111; online course, n = 4480; advanced courses, n = 2322; highly specialized programs, n = 46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3 years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.ConclusionsPersonnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.

DIALÉTICA DA MEDICINA COMO POLITICA E DA POLÍTICA COMO MEDICINA: Sintonias bioéticas em passagens de Fanon

Após a conclusão do curso de medicina psiquiátrica em Lyon, em 1951 (Geismar, 1972, p.59), Fanon (1925-1961) foi acolhido no hospital Saint Alban, para um aprofundamento dos estudos psiquiátricos, tendo ali, trabalhado e pesquisado sob a supervisão do psiquiatra espanhol Francesc Tosquelles (1912-1994), onde praticou os fundamentos da psicoterapia institucional, desenvolvida por Tosquelles e seus colaboradores naquele hospital. Mais tarde, na Argélia, Fanon atuou no hospital de Blida-Joinvile (entre outubro de 1953 e 1956) e, posteriormente, na Tunísia, introduzindo reformas, à luz da psicoterapia institucional. A concepção de ser humano que cultivava e a compreensão de que a sociedade doente produz pessoas doentes, levaram-no a um profundo conflito, à medida em que foi tomando consciência da violência do colonialismo francês contra o povo argelino, conforme relatou na carta de demissão que enviou ao Ministro Residente, Robert Lacoste, em 1956 (FANON, 1980). Após o pedido de demissão, adentrou o movimento de libertação da Argélia. Escreveu livros e artigos combatendo o colonialismo e difundindo os ideais revolucionários. Van Renssalaer Potter (1914-1994), por longo tempo atuou como biólogo e bioquímico no MacArdle Laboratory for Cancer Research, na Universidade de Winsconsin, na cidade de Madison, onde doentes de câncer eram tratados. Na década de 1970, publicou um livro seminal, Bioética, ponte para o futuro. Anos depois, publicou estudos de Bioética Global. Mais tarde, articulou conceitos de Bioética Profunda. Preocupado com a sobrevivência humana neste planeta, atacado pela irresponsabilidade humana, Potter conclamou a humanidade à tomada de consciência e mudança de condutas. Comparando-se os dois autores, observa-se que os escritos de Fanon foram produzidos na década de 1950, sendo que seu último livro, Os Condenados da Terra, foi escrito em 1961. Potter, por sua vez, escreveu os primeiros estudos de bioética na década de 1970, cerca de uma década após o falecimento de Fanon. Respeitados os limites cronológicos, este estudo se pergunta: A dialética da medicina como política e da política como medicina, na práxis de Fanon, teria sintonias bioéticas? Para enfrentar este problema, o trabalho contextualiza a formação de Fanon, identificando os princípios da práxis médico-psiquiátrica dele. Em seguida, demonstra-se as contradições do colonialismo, identificando uma dialética da medicina como política e da política como medicina. Adiante, informa-se a contribuição de Van Rensselaer Potter, na proposição da bioética. Finalmente, argumenta-se a favor das sintonias bioéticas presentes nas passagens selecionadas. O procedimento metodológico é a pesquisa bibliográfica, analítico-dedutiva.&#x0D; Palavras-chave: Colonialismo. Consciência. Medicina. Política. Sintonias bioéticas.

Healthcare curriculum influences on stigma towards mental illness: Core psychiatry course impact on pharmacy, nursing and social work student attitudes

Background and purposeAttitudes towards disclosure of a psychiatric diagnosis and directed at persons with mental illness have represented negativity and stigma. The purpose of this study was to identify stigma towards mental illness among health profession students in pharmacy, nursing, and social work programs, and identify if primary psychiatric coursework in each curriculum has an impact on students’ perceptions. Educational activity and settingPharmacy, nursing and social work students were surveyed pre- and post-primary didactic psychiatry coursework (pre-course = 154 total; 95 pharmacy, 47 nursing, 12 social work; post-course = 128 total; 79 pharmacy, 38 nursing, and 11 social work) using the Opening Minds Scale for Health Care Providers (OMS-HC). The OMS-HC contains 12-questions evaluated on a five-point Likert scale ranging from 12 to 60 points, with lower scores indicating less stigma towards mental illness. Student results were compared to the large sample of healthcare student and provider responses used in validating the OMS-HC survey tool. FindingsStudents’ pre-course mean score on the OMS-HC was 30.6 ± 5.47 (pharmacy = 30.9, nursing = 31, social work = 26.3) and post-course mean score was 31.05 ± 6.82 (pharmacy = 32.24, nursing = 29.89, social work = 26.55). These scores illustrate negative stigma among students and also are similar to existing research identifying a disparity among the healthcare professions. Coursework did not appear to improve stigma toward mental illness. SummaryThe current education of healthcare providers does not appear to change students’ stigma, suggesting educational gaps requiring attention.

Workshops: an important element in medical education

SUMMARYWorkshops are used in many psychiatric teaching and learning contexts, from undergraduate to continuing professional development. Most psychiatrists have at some time attended a workshop. However, the terms workshop, tutorial and small-group teaching are used indiscriminately. It is therefore important to reflect on what characterises a workshop, the learning theories behind their development and what learning needs workshops best meet. We give an outline of the evidence for workshops in medical education and review the principles governing how to conduct workshops and the use of technology to enhance their delivery. Data collected from an undergraduate psychiatry course delivered in an Irish university are used to illustrate how applying these principles contributes to optimising the use of workshops from both the learners’ and facilitators’ perspective.LEARNING OBJECTIVES•Understand what an educational workshop is•Be able to relate workshops to current approaches in medical education•Appreciate the use of an effective educational workshopDECLARATION OF INTERESTNone.

Medical students’ attitude towards Psychiatry and Mental Disorders

Introduction: It is always difficult to attract medical students’ interest in Psychiatry as a career choice. Most of the students have negative views of Psychiatry even before entering medical school such as 1) stigma on patients and psychiatrists. 2) Unscientific specialty with less prestige. 3) Derogatory remarks by other specialty physicians. 4) Less financial return. This study was done to evaluate and analyze medical students’ attitude towards psychiatry at their different levels of medical career.Material and Method: Medical students from three different years were surveyed to assess their perception and attitude on psychiatry and related matters. First year students were surveyed when they joined within 2 weeks in medical college. Third year were given questionnaire at the first day of Psychiatry clerkship and 4th year students were also given on the first day of posting.Results: 280 students from 1st year (61 out of 100), 3rd year (79 out of 104) and 4th year (70 out of 76) studying MBBS were surveyed. Majority of students from different levels preferred medicine, surgery, pediatric when they first joined medical college and their current preference choice of specialization. Fifteen out of 61 first year students planned to join Psychiatry when they entered medical college which changed to 11 while they were enquired about current planning.Conclusion: Medical colleges need comprehensive course in Psychiatry that involves inpatient and outpatient to create interest in Psychiatry and we need strong advocacy to decrease stigma of “Psychiatry as a career choice” among medical students.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.18-23

'They Keep it All Hid': The Ghettoization of Mental Disability Law and its Implications for Legal Education

The Supreme Court has, since 1972, decided more than fifty cases involving persons with disabilities, a docket spanning virtually every aspect of constitutional and criminal procedure. These cases have dealt with the substantive and procedural limitations on the commitment power, the conditions of confinement in psychiatric institutions, the application of the Americans with Disabilities Act to persons institutionalized because of illness, the substantive and procedural aspects of the criminal incompetency inquiry and the insanity defense, the relationship between disability and sexually violent predator laws, and aspects of the death penalty. Thousands of cases have been decided in every state in the nation dealing with similar issues. In fact, in the Supreme Court’s first modern disability case – finding that the due process clause is implicated in decisions related to both the nature and duration of the commitment process – it expressed surprise that there were not more disability cases brought to its attention.However, a study of constitutional law, criminal procedure, civil rights and/or federal courts casebooks reveal virtually no disability cases. Policies and practices of exclusion are not unique. By way of example, more than a decade ago, Toni Massaro pointed out that constitutional criminal procedure has been treated as a subject separate from basic constitutional materials and courses. Mental disability has been ghettoized in the same way that criminal procedure has been ghettoized. It is a ghettoization that in some ways is far more troubling than the criminal procedure ghettoization, since schools offer courses in basic criminal procedure, and these courses are regularly well-subscribed. On the other hand, there are courses in mental disability law offered only at about half of American schools, and, at many schools, those courses are offered infrequently and only by adjuncts (who often have no legal training). This ghettoization reflects a hard truth that has passed under the radar of most civil rights teachers and civil rights students. Mental disability is simply not a topic taken seriously as a civil rights topic (or as a constitutional topic or as a federal courts topic). And this failure of inclusion goes directly to the heart of the challenge of teaching disability law. It is hidden (nearly totally hidden) from the traditional school curriculum. It is not in the curriculum at many schools. It is largely invisible to students and professors alike.I believe this ghettoization is a reflection of the invidious sanism that permeates the legal academy in the same way it permeates the rest of society. Law teachers are not immune to sanism – an irrational prejudice of the same quality and character of other irrational prejudices that cause (and are reflected in) prevailing social attitudes of racism, sexism, homophobia, and ethnic bigotry.In this essay, I reconsider this ghettoization from four overlapping vantage points. First, I consider how mental disability law became a part of the school curriculum, growing out of and largely supplanting courses in psychiatry and the law (and why this title change is not just a question of phraseology). Second, I discuss the significance of the notion that mental disability law can be cabined in one 2- or 3-credit course (implying that all disability can be surveyed in that period of time, in a way that school faculty would never think all tax or real estate or securities could be so taught), and the significance of the reality that so many schools offer no course or only one course sporadically (often, without any involvement of a full-time faculty member). Third, I examine the Online Mental Disability Law program at New York Law School (where I teach) from four different perspectives: (a) the pedagogy, (b) the range of subject matters taught, (c) the interdisciplinarity of the students and the faculty, and (d) the internationality of the students and intersectionality of our course offerings. Finally, and most importantly, I explain why it is absolutely essential for any disability course (or sequence of courses) to consider the concepts of sanism and pretextuality, the significance of ordinary common sense (OCS) and heuristic reasoning, and the impact of therapeutic jurisprudence.