Attitude of medical students towards psychiatry

Findings are presented from a survey of all medical students at the College of Medicine, Abha, Saudi Arabia dealing with students' attitudes towards specialization in psychiatry. The health region of Asir in south-west rural Saudi Arabia, of about one million inhabitants, needs Saudi Nationals to specialize in psychiatry to provide planned future delivery of services. Medical students all over Saudi Arabia, however, have not been choosing psychiatry for their specialization after graduation. The Scientific Committee for Mental Health, convened at the Ministry of Health in Riyadh in February 1986, invited representatives of psychiatry from medical schools in the nation to discuss this priority topic. A year later, a new course called 'Introduction to Psychosomatic Medicine' was introduced as an elective for medical students with its practice at the general hospital. It tries to introduce students to 'voluntary and active as against passive learning ... and problem-solving rather than imposed memorizing' of medicalized forms of psychiatry, an innovation compared with the previous conventional method. A significant difference in attitude was demonstrated between students who had their exposure to psychiatry from this course and those who followed only the conventional methods of learning.     

Attitude change in a human sexuality course that de-emphasizes small group activities

The attitudes of second-year medical students were measured to determine if positive attitude changes could be obtained in a human sexuality course that de-emphasized small group activities. Students were given a semantic differential instrument and were asked to rate four concepts related to human sexuality: (a) my sexuality, (b) masturbation, (c) homosexuality, and (d) my role in understanding sexual problems.
Significant changes in student attitudes were reported at the 0.05 level for the concept, my sexuality; at the 0.01 level for the concept, my role in understanding sexual problems; and at the 0.001 level for the concepts, homosexuality and masturbation. Females had more positive attitudes ( P 0.001), pre and post, towards homosexuality than did males. No significant differences were found between married and single students.     

The ATP 30—a scale for measuring medical students' attitudes to psychiatry

The development and validation of a thirty item, Likert-type scale designed to measure medical students' attitudes to psychiatry—the ATP-30 (Attitudes Toward Psychiatry—30 items)—are described. We had hoped to demonstrate that 'attitude to psychiatry' was not a unitary matter but an amalgam of attitudes to a number of things to do with psychiatric practice. This hope was not fulfilled, as a unitary dimension was obtained. A positive change in the attitudes of students toward psychiatry was demonstrated in third and fourth medical year students in relation to exposure to psychiatry. Such a change was not demonstrable in two classes of occupational therapy students exposed to a course in psychiatry. The reasons for this difference between medical students and occupational therapy students are discussed—there possibly being important implications here for psychiatric curriculum planning in medical school. Lastly, we have demonstrated that the positive change in attitudes amongst medical students was transient rather than lasting—a matter which most studies of attitude change do not address. In spite of the apparent impermanence of the positive change in attitudes among medical students, there are a number of possible uses to a scale such as the ATP-30, and these are discussed.     

Medical students'' attitudes to old people and career preference: a comparison of two universities

Medical students' attitudes to old people were compared at broadly similar points in their education at two medical schools, one with a department of health care of the elderly (Nottingham), the other without such a university department (Leeds). The students were tested at both schools before their clinical training in care of the elderly, using a modified Rosencranz-McNevin semantic differential scale to measure general attitudes to old age, and a Likert scale to measure attitudes to medical care. Questions were also asked about career preferences. Both groups of students showed similar general attitudes to ageing. The Nottingham students showed more positive attitudes to care of old people, and this was reflected in career preferences.     

Teaching and learning about human sexuality in undergraduate medical education

BACKGROUND: Effective management of the doctor's role in relation to human sexuality requires sensitivity and tact, an ability to put patients at ease, use of appropriate language, and therapeutic, non-discriminatory attitudes. However, previous research suggests that medical students and doctors may hold negative attitudes towards homosexuality and some forms of sexual behaviour. Some educational programmes have started to help students develop communication skills for sexual health consultations, but little work has addressed the broader issue of attitudes and values which may underlie behaviour. It is vital that medical students begin early the process of reflection and recognition of how their attitudes and values might influence their care of patients. In this paper we report on a course designed to initiate this process at Leicester-Warwick Medical School (LWMS). COURSE DESCRIPTION: The course utilizes techniques of desensitization, problem-solving and reflection to enable the students to achieve the learning outcomes, which are primarily oriented towards reflection and self-development. It uses a variety of teaching and learning strategies, combining peer learning with self-directed learning, and small-group learning with whole class learning. COURSE EVALUATION: We report observations and a before-and-after questionnaire study of students' views and attitudes. This evaluation suggests that the course is successful in reducing students' anxieties about human sexuality and improving their confidence in developing appropriate skills. CONCLUSIONS: The LWMS course is one model which might be used to begin the process of encouraging medical students to develop ways of appropriately managing their responsibilities in relation to human sexuality.     

Preparing tomorrow's doctors: the impact of a special study module in medical informatics

BACKGROUND: In response to the call for more informatics teaching in the medical curriculum, an elective special study module has been offered to first-year students at Queen's University since 1997. OBJECTIVES: To assess the impact of a medical informatics course in terms of the use of skills acquired and attitudes held about information technology (IT) in medicine. METHODS: A postal structured questionnaire was sent to all 30 students who took the medical informatics special study module in 1997 and to all 29 students who took the module in 1998, plus an age and sex-matched group of controls in each year. Main outcome measures included attitudes to the role of IT in medicine and declared frequency of use of various software packages. RESULTS: Compared with the control group, those taking the module felt less confident initially with computers. There was a high level of positive attitude to computers in medicine following the course, in both study and control groups. There was a significantly greater use of word-processing (P=0.001) and presentation packages (P=0.0005) amongst third-year students compared with second-year students, but there was no significant difference in this regard between those taking the module and controls. CONCLUSIONS: Students' use of computer technology and IT skills, is more influenced by the demands of the overall curriculum than by undertaking a single module in medical informatics. A special study module may, however, provide valuable support by performing a 'remedial function'. The authors found the module a useful first step in the process of introducing medical informatics to the core curriculum.     

Research in human sexuality education

Since human sexuality courses are relatively recent additions to most U.S. medical school curricula, there are no established procedures for evaluating the courses. The purpose of this study was to test medical students' attitudes toward concepts in sexuality before and after a 5-day sexuality course using the semantic differential. The concepts students rated were 'my sexuality', 'masturbation', 'homosexuality' and 'my role in understanding sexual problems '. Post-test scores were subtracted from pre-test scores andan alysed by multivariate analysis of variance testing for significant difference from zero.
Ninety-six second-year medical students completed the pre- and post-semantic differential tests. The changes between the pre- and post-tests were significant at the 0.001 level for all four concepts with the concept, 'homosexuality' showing the greatest change. The study suggests the semantic differential may be an effective instrument in assessing attitude changes. It also suggests the teaching techniques used in human sexuality courses may be successfully applied to other areas of medical education.     

The evolution of a course in human sexuality University of Edinburgh, 1972–1978

A short undergraduate course in human sexuality has been developed over a period of 7 years. The objectives, initially concerned with cognitive learning, shifted to affective aspects of the topic, introduced through a format of sexually explicit films and small-group discussions. Continuing evaluation of successive courses by students has been particularly valuable in identifying helpful and unhelpful behaviour in group leaders, and has been used in their training. The evaluations also demonstrated that students saw a need to develop their interviewing skills. The course, therefore, now seeks to combine affective learning with other topics of direct relevance to clinical practice.     

An investigation of the attitudes of medical students to physically disabled people

A study was carried out to investigate the change in attitudes towards physically disabled people of a group of fifty-eight medical students during the first 3 years of their course. The students attended a newly established medical school which has developed a curriculum without the traditional division into preclinical and clinical years and where contact with patients occurs from the first year. Results demonstrated that, as expected, at the start of the course the attitudes of females towards disabled people were more positive than those of males. Also, a significant change in attitudes was found after 3 years, both males and females demonstrating more positive attitudes toward physical disability. The differences between males and females were maintained. The relationship between these students' attitudes and their behaviour was discussed and proposals for further research to investigate this are outlined.     

Doctors'' interest in psychiatry as a career

Fifty pre-registration housemen were interviewed to elicit their attitudes towards a career in psychiatry. The doctors were all those in one academic year who were recommended for honours on the basis of their performance during the psychiatry clerkship. Those who gained honours in other subjects as well as psychiatry were unlikely to choose a career in psychiatry. The study indicates that further improvements in the psychiatry clerkship will not improve recruitment. Factors outside psychiatry--the pull to general practice and other specialties and the negative attitudes towards psychiatry expressed by other doctors--are among the major deterrents for young doctors considering a career in psychiatry. Collaborative teaching between psychiatrist, physicians and surgeons during the pre-registration year should encourage recruitment and gradually improve the widely held negative attitudes towards psychiatry.     

The use of computerized Learning in intensive care: an evaluation of a new teaching program

A computer-assisted learning program in respiratory intensive care was introduced into the undergraduate curriculum at University College Hospital. Educational effectiveness was assessed. This method of learning was found to be highly acceptable to students. The improvement in students knowledge of the subject was up to three times greater in those who used the computer program, than a control group of students who received only teaching by conventional means, (P = 0 X 016). The results of a questionnaire designed to elicit students' attitudes to this learning experience are discussed.     

The development and evaluation of a method of teaching liaison psychiatry to medical students

A method is described of teaching medical students aspects of psychiatry related to their work with physically ill patients. The teaching requires few resources and focuses on a limited number of educational objectives centred on the acquisition of knowledge of psychiatry relevant to medical practice. The course comprised eight weekly one-hour seminars held during the first clinical year attachment to medical firms, prior to the students' psychiatry attachments. Clinically based, traditional 'bedside' teaching was used, involving patients known to the students. In a preliminary analysis of the effects of the teaching, students who had participated in the seminars scored significantly better on a test of liaison psychiatry knowledge than a matched group who had not experienced the course.     

Ownership of direct ophthalmoscopes by medical students

In September 1986 the Department of Education and Science withdrew the equipment grant for clinical medical students. This coincided with a reduction of 50% in the level of ownership of direct ophthalmoscopes amongst a group of 51 medical students who commenced their medical studies after September 1986 (no longer eligible for the equipment grant), when compared with a group of 63 students (in the same clinical year) who started the medical course before 1 September 1986 and who were hence still able to claim the equipment grant. The majority of non-owners gave lack of finance as the reason for non-ownership. Owners of ophthalmoscopes performed ophthalmoscopy more frequently than non-owners, but the difference did not reach statistical significance.     

General practice in the undergraduate curriculum: 20 interviews with Southampton final-year students

The Primary Medical Care Group at the University of Southampton contributes to the medical curriculum in the first, third and final years. A visiting lecturer from Sweden took the opportunity to interview a sample of 20 final-year students using a qualitative approach. Questioning centered on the impact of the primary care course both in relationship to medicine as a whole and to general practice. It was found that primary medical care was often not seen as a central or integral part of the curriculum but many students acknowledged its important contribution to seeing the patient as a whole and in integrating the various other parts of the curriculum, with significant opportunity for role modelling and informing career choice. A hidden curriculum emerged of attitudes which provided a conflict for some students. Improvements should include clearer dovetailing of primary medical care with other curricular components, limitation of aims with more specific and rigorous assessment and a wide strategy of staff development not confined to those directly involved in general practice attachments.     

Medical student assessment of videotape for teaching in diagnostic radiology

A series of six videotape recordings, prepared jointly by the Department of Radiodiagnosis and the Television Service, University of Leeds, described some aspects of the radiology of the chest, using only radiographs. A small group of final year medical students viewed these videotapes over the space of a few days. Their scores for factual questions immediately afterwards were compared with their attitudes to the learning experience, expressed anonymously without knowledge of these scores. Students who scored the highest marks were most consistently critical of the videotapes; those with lower marks tended to record favourable attitudes when they performed best and unfavourable attitudes at other times. Scales set up by the students themselves to evaluate the experience produced a wide range of detailed and constructive suggestions. In general, students commented very favourably on the capacity of videotape to present fine radiographic details and we conclude that it is an appropriate medium for this purpose.     

The effect of medical education on the attitudes of medical students towards disabled people

The negative attitudes of society towards disability and the resulting prejudicial behaviour affects the lives of disabled people. One of the declared aims of the Faculty of Medicine of the University of Southampton is to improve attitudes. Hence, an attempt has been made to assess differences in the attitudes held by first- and fourth-year medical students, senior house officers and members of the general public towards disabled people. The measurement instrument used was the 'Attitudes Towards Disabled Persons (ATDP) Scale'. The total number of subjects in the survey was 428, of whom 263 (61%) responded. No significant differences were found between the attitudes of the four groups studied. However, a subpopulation of subjects who agreed with the statement that 'Disabled people cause more problems to doctors than non-disabled people' had attitudes which were significantly more negative.     

Microfiches as an aid to teaching histology

A set of six colour microfiches and an atlas of black-and-white prints of the photomicrographs used in the microfiches have been prepared by the author and have been used for teaching an Histology course to medical students for 4 years. Student reaction to them and their use has been gauged by voluntary questionnaires. Of students who responded, 78% found the microfiches made the course easier for them; 76% like the microfiches because they can use them for home study; 77% find them useful for class discussion; 62% like them because of their colour reproduction. A small group of fifteen students, who failed the Histology course the year prior to the introduction of microfiches and subsequently repeated the course, felt they could revise better with the help of the microfiches. Also they felt the course was clearer. Comparison of the examination results of the students for the 4 years preceding the introduction of microfiches with those of the 4 years since, shows an improvement in mean percentage achieved together with a decrease in the standard deviation (s.d.).     

Voluntary active euthanasia and doctor-assisted suicide: knowledge and attitudes of Dutch medical students

The objective of the study was to gain insight into the knowledge of and attitudes towards voluntary active euthanasia and doctor-assisted suicide (EEDAS) of Dutch medical students, and to determine whether knowledge and attitudes change after a 1–day informative conference about EDAS. Data were collected by means of two self-administered questionnaires. Questionnaire 1 had to be completed before the start of the conference and questionnaire 2 after the conference. In both questionnaires, students were asked by means of two open-ended questions to define euthanasia and doctor-assisted suicide. They were also asked to indicate which of eight statements met with the requirements for prudent practice. Finally, the students were asked to what extent they agreed or disagreed with each of seven statements about attitudes towards EDAS. To determine if a selection occurred among students who returned both questionnaires, their background characteristics, and knowledge and attitudes towards EDAS were compared with those who returned only the first questionnaire. Forty-seven students returned only the first questionnaire, while both questionnaires were returned by 137 students. No differences were found between students who returned both questionnaires and those who returned only the first questionnaire with regard to age, religion, knowledge of and attitudes towards EDAS. Students' knowledge of the definitions of EDAS and the requirements for prudent practice improved significantly. Students' reactions to the statements on attitudes towards EDAS showed that a large majority had a fairly positive attitude towards EDAS. There was no significant difference before and after the conference. Male students and students with a religion were more opposed to EDAS than female students and students without a religion. The fact that the students' knowledge of EDAS improved after a 1–day conference does not imply sufficient understanding of the issue. Because EDAS is allowed only under strict conditions in the Netherlands, medical students require special training. Only then will they be equipped to deal with requests for EDAS during their future careers.     

Changes in students'' attitudes and values during medicine versus surgery clerkships

A prospective study of students' attitudes and values was conducted during medicine and surgery clerkships over the first clinical year. Students who finished the surgery clerkship first were more cynical and intolerant of ambiguity than the medicine students. Surgery students also felt they lacked self-confidence and had stronger feelings of being victimized. Cynicism and attitudes towards ambiguous situations improved during the medicine clerkship. Feeling victimized was strongly correlated with their problems with self-confidence, with cynicism, and a feeling of having to submit to authority figures. The findings of this study suggest that the clerkship order significantly affects the development of students' attitudes. Students also became more punitive and less confident as the first clinical year progressed. The implications of these changes in attitude on educational planning are discussed.     

Toward a clinical orientation in the basic medical biochemistry curriculum

A re-evaluation of biochemistry in medical school curricula is presented, with reference to designing more effective courses. Responses to a survey conducted among 103 medical students enrolled in two general biochemistry courses indicated that basic biochemistry would be considered more relevant to the medical curriculum if clinical applications were emphasized over basic principles. A majority of students (91%) expressed interest in applying bio-chemical principles to pathological conditions. They recommended that the biochemistry curriculum should include lectures on the significance of bio-chemistry in medical practice and its role in the life processes, laboratory comparisons of normal and pathological specimens, and course titles that reflect a more clinical orientation.