The views of medical students about psychiatry clerkship education

Abstract

Objectives: Psychiatry education in medical schools seems to be given little attention and has not been fully integrated into curriculum. In this study our purpose was to get feedback about all phases of psychiatry clerkship from medical students, who completed psychiatry clerkship. Methods: A 31 item questionnaire investigating the views of medical students about psychiatry clerkship and a socio-demographic survey were given to the medical students, who completed psychiatry clerkship and signed informed consent prior to study procedures. Results: A total of 208 students agreed and signed consent to participate in the study. The number of female and male students were 114 & 94, respectively and mean age was 22.7±1.02. Most of the students (89%) expected from the lecturers “to teach how to manage aggressive patients.” Seventy six percent of students specified the requirement of consultation liasion education because “psychiatric symptoms could be seen in general medical conditions.” Seventy percent of students reported that they wanted to watch and discuss standart patient video records. Fifty three percent of the students emphasized that “Psychiatry examination was only assessing knowledge, but not the skills.” Seventy eight percent of students reported that “they wished to follow up the patients along a resident’’ and 64% “with an attending.” Also, 54% of students supported to participate in a research project or seminar related to psychiatry (e.g. neuroimmunology, neuroanatomy, psychoendocrinology) in previous years. Conclusion: The efforts to increase interest and improve outcome and effectiveness in psychiatry clerkship education have become more important. This is the first study on this topic in our country. To improve outcome and effectiveness in psychiatry clerkship education, the educators should find the balance between the views of medical students and experienced faculty members about the topics to be taught during the rotation.

Keywords

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Psikiyatri Stajını Tamamlamış Tıp Fakültesi Öğrencilerinin Staj Eğitimi Hakkındaki Görüşleri

Öz

Amaç: Tıp fakültelerinde psikiyatri eğitimine az önem verilmiş ve müfredata çok iyi entegre edilmemiş gibidir. Bu çalışmada psikiyatri stajını bitirmiş öğrencilerin stajın hemen bütün safhaları hakkında düşüncelerini geri bildirimle bize aktarmalarını amaçladık. Yöntem: Bu çalışmaya fakültemizde okuyan, psikiyatri stajını bitiren ve çalışmaya katılmayı kabul eden tıp öğrencilerin bilgilendirilmiş onamı alındıktan sonra, sosyo-demografik özellik anketinin ardından, ekibimizin hazırladığı 31 sorudan oluşan, psikiyatri stajına öğrencilerin bakışını araştıran bir anket verildi. Bulgular: Çalışmaya 208 öğrenci katılmayı kabul etmiştir. Bu öğrencilerin 114’ü kadın iken 94’ü erkekti ve ortalama yaşları 22.7±1.02 idi. Öğrenciler, en yüksek oranda eğitimcilerden saldırgan hasta karşısında neler yapabileceğinin öğretilmesini beklemekteydi (%89). Yüzde 76 öğrenci psikiyatrik belirtilerin genel tıbbi durumlarda da görülebileceğine inandığı için eğitimde konsültasyon ve liyezona ağırlık verilmesi gerektiğini belirtmişti. Yüzde 70 öğrenci standart hasta video kayıtlarını izlemek ve tartışmak istediklerini bildirmişti. Yüzde 53 öğrenci psikiyatri sınavının yalnızca bilgiyi ölçtüğüne ve beceriyi ölçmediğine vurgu yapmıştı. Öğrencilerin %78’i araştırma görevlisi ile ve %64’ü bir hocayla hasta takip etmek istediğini söylemişti. Ayrıca, %54 öğrenci daha önceki sınıflarda iken psikiyatri ile ilgili (nöroimmünoloji, nöroanatomi, psikoendokrinoloji gibi) seminer/araştırma projelerine katılmayı doğru bulmuştu. Sonuç: Psikiyatri stajyer eğitiminde ilgiyi ve verimi artırma çabaları giderek önem kazanmaktadır. Bu çalışma ülkemizde bu amaçla yapılan ilk çalışma olması nedeniyle önemlidir. Ancak eğiticiler eğitimde verim almak için öğrencilerin görüşünü göz önünde bulundururuken, deneyimli bir klinisyen olarak da öğretilmesi gerekenler arasında dengeyi gözetmelidir.

Anahtar Kelimeler

• psikiyatri, teorik stajyer eğitimi, müfredat, klinik uygulama

Kaynakça

1. McIlwrick J, Nair B, Montgomery G. “How Am I Doing?”: Many Problems But Few Solutions Related to Feedback Delivery in Undergraduate Psychiatry Education. Acad Psychiatry 2006; 30: 130-135.
2. Brodkey AC, Sierles FS, Woodard JL. Use of Clerkship Learning Objectives by Members of the Association of Directors of Medical Student Education in Psychiatry. Acad Psychiatry 2006; 30: 150- 157.
3. Kohn L, Corrigan J, Donaldson M: (Committee on Quality of Health Care in America of the Institute of Medicine of the National Academy of Sciences, Eds). To Err is Human: Building a Safer Health System. Washington, DC, National Academy Press, 2000.
4. Kassebaum D, Eaglen R. Shortcomings in the evaluation of students’ clinical skills and behaviors in medical school. Acad Med 1999; 74: 842-849.
5. Colletti LM. Difficulty with negative feedback: face-to-face evaluations of junior medical student clinical performance results in grade inflation. J Surg Res 2000; 90: 82-87.
6. Alpert JE, Schlozman S, Badaracco MA, Burke J, Borus JF. Getting Our Own House in Order: Improving Psychiatry Education to Medical Students as a Prelude to Medical School Education Reform. Acad Psychiatry 2006; 30: 170-173.
7. Roberts LW, Coverdale J, Louie A. Committing to Medical Student Education. Acad Psychiatry 2006; 30: 93-94.
8. Burke MJ, Brodkey AC. Trends in Undergraduate Medical Education: Clinical Clerkship Learning Objectives. Acad Psychiatry 2006; 30: 158-165.

9. Cıngı Başterzi AD, Tükel R, Uluşahin A, Coşkun B, Alkın T, Murat Demet M, Konuk N, Taşdelen B. Türkiye’de Mezuniyet Öncesi Psikiyatri Eğitiminin Bugünü. Türk Psikiyatri Derg 2010; 21: 195- 202.
10. Waddell AE, Katz MR, Lofchy J, Bradley J. A Pilot Survey of Patient- Initiated Assaults on Medical Students During Clinical Clerkship. Acad Psychiatry 2005; 29: 350-353.
11. Yassi A. Assault and abuse of health care workers in a large teaching hospital. Can Med Assoc J 1994; 151: 1273-1279.
12. Pane GA, Winiarski AM, Salness KA. Aggression directed toward emergency department staff at a university teaching hospital. Ann Emerg Med 1991; 20: 283-286.
13. Kornfeld DS. Consultation-liaison psychiatry: contributions to medical practice. Am J Psychiatry 2002; 159: 1964-1972.
14. Ghatavi K, Waisman Z. Teaching Medical Students About Personality Disorders and Psychotherapeutic Principles: A Resident Pilot Initiative Acad Psychiatry 2006; 30: 178-179.
15. Pessar LF, Levine RE, Bernstein CA., Cabaniss DS, Dickstein LJ, Graff SV, Hales DJ, Nadelson C, Robinowitz CB, Scheiber SC, Jones PM, Silberman EK. Recruiting and Rewarding Faculty for Medical Student Teaching. Acad Psychiatry 2006; 30: 126-129.
16. Niedermier JA, Bornstein R, Brandemihl A. The Junior Medical Student Psychiatry Clerkship: Curriculum, Attitudes, and Test Performance. Acad Psychiatry 2006; 30: 136-143.
17. The Membership and the Executive Council of the Association of Directors of Medical Student Education in Psychiatry. The Psychiatry Clerkship: A Position Statement on the length of the Psychiatry Clerkship. Acad Psychiatry 2006; 30: 103-103.
18. Briscoe GW, Carlson DL, Arcand LF, Levine RE, Cohen MJ. Clinical Grading in Psychiatric Clerkships. Acad Psychiatry 2006; 30: 104- 109.
19. Manley M, Heiss G. Timing Bias in the Psychiatry Subject Examination of the National Board of Medical Examiners Acad Psychiatry 2006; 30: 116-119.
20. Park RS, Chibnall JT, Morrow A. Relationship of rotation timing to pattern of clerkship performance in psychiatry. Acad Psychiatry 2005; 29:267-273.
21. Balon R, Heninger G, Belitsky R. Medical School Research Pipeline: Medical Student Research Experience in Psychiatry. Acad Psychiatry 2006; 30: 16-22.