Skip to main content

Advertisement

SpringerLink
Log in

Experiences of French medical students during their clerkship in adolescent psychiatry: a qualitative study

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

This article has been updated

Abstract

The epidemiology of adolescent psychiatric disorders and the relational complexity of their management make exposure to adolescent psychiatry essential during medical school. However, some clinical particularities can complicate the students’ learning experiences. Our work aimed to explore the experience of being a medical student during clerkships in adolescent psychiatry. Following the Interpretative Phenomenological Analysis qualitative approach, 20 semi-structured face-to-face interviews were conducted with medical students at the end of their clerkship in adolescent psychiatry. Three super-ordered themes emerged to describe their experience: in-depth self-exploration calling on emotions, thoughts and experiences; changes in the view of adolescent mental health; better understanding of the role and meaning of adolescent psychiatric care and how to approach it. Identification between students and patients could result from time-related factors (the end of adolescent brain remodeling, long, demanding studies, and financial and material dependence). In addition, the predominant use of non-analytical clinical reasoning processes—less valued in the rest of the graduate curriculum—poses a challenge for students. Indeed, for a student to find his or her place in adolescent psychiatry requires the student to reinvent him or herself, because the codes are different (no gown, less well-defined tasks, etc.). Finally, the excess prevalence of mental disorders among medical students requires increased vigilance on the part of tutors. For all these reasons, close, attentive tutoring seems essential to support students, while these clerkships afford a real opportunity for students to broaden their interpersonal skills.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and material

Data are available upon request.

Change history

  • 31 July 2023

    This article was revised due to update in author name.

Notes

  1. In France, subtle distinctions are made between the two forms for “you”: “tu” and “vous”, “tu” (the second person singular), suggesting a degree of familiarity—and “vous”—(the second person plural), signifying a more formal relationship.

  2. In France, a second competitive examination is organized at the end of undergraduate studies (6th year) among several thousand French medical students. Their ranking dictates their ability to choose the specialty they want and the city where they wish to complete their residency. Psychiatry is often associated with a low ranking.

References

  1. Kessler RC, Angermeyer M, Anthony JC et al (2007) Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 6:168–176

    PubMed  PubMed Central  Google Scholar 

  2. World Health Organization (2020) Adolescent mental health. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. Accessed 30 July 2021

  3. Kroenke K, Unutzer J (2017) Closing the false divide: sustainable approaches to integrating mental health services into primary care. J Gen Intern Med 32:404–410. https://doi.org/10.1007/s11606-016-3967-9

    Article  PubMed  PubMed Central  Google Scholar 

  4. Brenner AM (2009) Uses and limitations of simulated patients in psychiatric education. Acad Psychiatry 33:112–119. https://doi.org/10.1176/appi.ap.33.2.112

    Article  PubMed  Google Scholar 

  5. Jouquan J, Romanus C, Vierset V, et al (2013) Promoting active training as support of reflective pratice and in-depth learning. Thinking about training of health worker, an integrative perspective. [Promouvoir les pédagogies actives comme soutien à la pratique réflexive et à l’apprentissage en profondeur. Penser la formation des professionnels de la santé Une perspective intégrative] Bruxelles: De Boeck

  6. Lehr ST, Kaplan B (2013) A mental health simulation experience for baccalaureate student nurses. Clin Simul Nurs 9:e425–e431

    Article  Google Scholar 

  7. Robinson DJ (2009) A training and examination program to prepare psychiatric residents for. Acad Psychiatry 33:331–334. https://doi.org/10.1176/appi.ap.33.4.331

    Article  PubMed  Google Scholar 

  8. Stuart GW (2014) Principles and practice of psychiatric nursing-e-book. Elsevier Health Sciences, Amsterdam

    Google Scholar 

  9. Ogard-Repal A, De Presno AK, Fossum M (2018) Simulation with standardized patients to prepare undergraduate nursing students for mental health clinical practice: an integrative literature review. Nurse Educ Today 66:149–157. https://doi.org/10.1016/j.nedt.2018.04.018

    Article  PubMed  Google Scholar 

  10. Williams K (1998) Self-assessment of clinical competence by general practitioner trainees before and after a six-month psychiatric placement. Br J Gen Pract 48:1387–1390

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Mills KL, Lalonde F, Clasen LS et al (2014) Developmental changes in the structure of the social brain in late childhood and adolescence. Soc Cogn Affect Neurosci 9:123–131. https://doi.org/10.1093/scan/nss113

    Article  PubMed  Google Scholar 

  12. Tamnes CK, Herting MM, Goddings A-L et al (2017) Development of the Cerebral Cortex across adolescence: a multisample study of inter-related longitudinal changes in cortical volume, surface area, and thickness. J Neurosci 37:3402–3412. https://doi.org/10.1523/JNEUROSCI.3302-16.2017

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Deschamps P, Hebebrand J, Jacobs B et al (2020) Training for child and adolescent psychiatry in the twenty-first century. Eur Child Adolesc Psychiatry 29:3–9. https://doi.org/10.1007/s00787-019-01467-6

    Article  PubMed  PubMed Central  Google Scholar 

  14. Deschamps P, Jacobs B (2020) An international perspective on training in child and adolescent psychiatry. Eur Child Adolesc Psychiatry 29:1–2. https://doi.org/10.1007/s00787-020-01470-2

    Article  PubMed  Google Scholar 

  15. Frank R, Frank F (2010) Teaching child and adolescent psychiatry to undergraduate medical students—A survey in German-speaking countries. Child Adolesc Psychiatry Ment Health 4:21. https://doi.org/10.1186/1753-2000-4-21

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sawyer M, Giesen F (2007) Undergraduate teaching of child and adolescent psychiatry in Australia: survey of current practice. Aust N Z J Psychiatry 41:675–681. https://doi.org/10.1080/00048670701449153

    Article  PubMed  Google Scholar 

  17. Kaplan JS, Lake M (2008) Exposing medical students to child and adolescent psychiatry: a case-based seminar. Acad Psychiatry 32:362–365. https://doi.org/10.1176/appi.ap.32.5.362

    Article  PubMed  Google Scholar 

  18. Martin VL, Bennett DS, Pitale M (2005) Medical students’ perceptions of child psychiatry: pre- and post-psychiatry clerkship. Acad Psychiatry 29:362–367. https://doi.org/10.1176/appi.ap.29.4.362

    Article  PubMed  Google Scholar 

  19. Kalindjian N, Hourantier C, Ludot M et al (2020) Perceptions of medical students in encounter of adolescent patients inside pedopsychiatry unit: a qualitative study [Perceptions des externes en médecine lors de leur stage en pédopsychiatrie: étude qualitative]. Annales Médico-psychologiques, revue psychiatrique. Elsevier, Amsterdam, pp 820–826. https://doi.org/10.1016/j.amp.2019.10.003

    Chapter  Google Scholar 

  20. Smith DJA, Osborn M (2007) Pain as an assault on the self: an interpretative phenomenological analysis of the psychological impact of chronic benign low back pain. Psychol Health 22:517–534. https://doi.org/10.1080/14768320600941756

    Article  Google Scholar 

  21. Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357. https://doi.org/10.1093/intqhc/mzm042

    Article  PubMed  Google Scholar 

  22. Belghith F, Ferry O, Patros T, Tenret E (2017) National survey: life conditions of students—2016. Home students [Enquête nationale : Conditions de vie des étudiant-e-s 2016—Le logement étudiant]. Consultable sur www.ove-national.education.fr/medias/Fiche_logement_CdV_2016.pdf

  23. Danset A (2017) Mental health of medical students in University François Rabelais de Tours et Paris 7—Diderot, a descriptive, transversal and multicenter epidemiological study [La santé psychique des externes en médecine des Universités François Rabelais de Tours et Paris 7—Diderot, une étude épidémiologique transversale descriptive multicentrique]. Thèse d’exercice. Faculté de médecine de Tours

  24. Choquet M (2014) From pre-adolescence to adultwood [De la préadolescence à l’âge adulte]. La revue du praticien 221–223

  25. Cunningham H (2000) Why English young people leave their parent so early? [Pourquoi les jeunes anglais quittent-ils si tôt leurs parents ?] Revue de l’OFCE 72:207–215

  26. Galland O (2010) Introduction. A new year-class? [Introduction. Une nouvelle classe d’âge ?]. Ethnol Fr 40:5–10. https://doi.org/10.3917/ethn.101.0005

    Article  Google Scholar 

  27. Nendaz M, Charlin B, Leblanc V, Bordage G (2005) Clinical reasoning: data from research and implications for training. [Le raisonnement clinique: données issues de la recherche et implications pour l’enseignement]. Pédagogie médicale 6:235–254

    Article  Google Scholar 

  28. Pelaccia T, Tardif J, Triby E, Charlin B (2011) An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory. Med Educ Online. https://doi.org/10.3402/meo.v16i0.5890

    Article  PubMed  PubMed Central  Google Scholar 

  29. Richard C, Lussier M-T (2016) Professional communication in health care. [La communication professionnelle en santé]. Erpi

  30. Blakemore S-J (2019) Adolescence and mental health. Lancet 393:2030–2031. https://doi.org/10.1016/S0140-6736(19)31013-X

    Article  PubMed  Google Scholar 

  31. Rotenstein LS, Ramos MA, Torre M et al (2016) Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 316:2214–2236. https://doi.org/10.1001/jama.2016.17324

    Article  PubMed  PubMed Central  Google Scholar 

  32. Verger P, Guagliardo V, Gilbert F et al (2010) Psychiatric disorders in students in six French universities: 12-month prevalence, comorbidity, impairment and help-seeking. Soc Psychiatry Psychiatr Epidemiol 45:189–199. https://doi.org/10.1007/s00127-009-0055-z

    Article  PubMed  Google Scholar 

  33. Frenay M, Bédard D (2004) Academic training devices in the perspetive of situated learning and training to support building of knowledge and transfert. [Des dispositifs de formation universitaire s’inscrivant dans la perspective d’un apprentissage et d’un enseignement contextualisés pour favoriser la construction de connaissances et leur transfert]. Le transfert des apprentissages. Les Presses de l’Université Laval, Québec, pp 241–268

    Google Scholar 

  34. Piot M-A, Attoe C, Billon G et al (2021) Simulation training in psychiatry for medical education: a review. Front Psychiatry 12:658967. https://doi.org/10.3389/fpsyt.2021.658967

    Article  PubMed  PubMed Central  Google Scholar 

  35. Charon R (2008) Narrative medicine: honoring the stories of illness. Oxford University Press, Oxford

    Google Scholar 

  36. Wenger E (1999) Communities of practice: learning, meaning, and identity. Cambridge University Press, Cambridge

    Google Scholar 

  37. Bédard D, Frenay M, Turgeon J, Paquay L (2000) [Bases of educational programs aiming at promoting knowledge transfert: perspectives of learning and training in authentic environments ]. Res Academica, 18, 21–47. Bertrand, Y. (1993). Théories contemporaines de l’éducation. Chronique Sociale, Lyon

  38. Frenay M, Bédard D (2004) [Academic program in lign with contextetualized learning and training to promote building of knowledge and transfer.] 241–268. Dans A. Presseau & M. Frenay (dir.), Le transfert des apprentissages. Presses de l’Université Laval, Québec

  39. Vierset V, Frenay M, Bedard D, Giet D (2015) Necessity of combining theoretical and practial training. Présentation of an educational program promoting reflexivity in clerkship context. Pédagogie Médicale. https://doi.org/10.1051/pmed/2016009

    Article  Google Scholar 

  40. Vierset V, Frenay M, Bédard D (2015) [Which criteria to adress educational quality of medical clerkships?] Revue internationale de pédagogie de l’enseignement supérieur [Online], 31(2). http://journals.openedition.org/ripes/976. https://doi.org/10.4000/ripes.976. Accessed 13 Dec 2021

Download references

Acknowledgements

The authors would like to thank all the participants. The authors also thank Angela Verdier, Sarah Lesdom and Delphine Lees for the English translation, and Gregoire Billon for final language refinements within a Child and Adolescent Psychiatrist approach.

Funding

The authors received no funding for this project. Student recruitment followed rotation schedules.

Author information

Authors and Affiliations

  1. Institut Mutualiste Montsouris, Adolescent Mental Health Department, 42 Boulevard Jourdan, 75014, Paris, France

    Nina Kalindjian, Christelle Hourantier, Maurice Corcos & Marie-Aude Piot

  2. Université de Paris Cité- Health faculty, medical school, 15, rue de l’école de médecine, 75006, Paris, France

    Nina Kalindjian, Christelle Hourantier, Maude Ludot, Julie Gilles de la Londe, Maurice Corcos, Marie Rose Moro & Marie-Aude Piot

  3. Adolescent Mental Health Department, Hôpital Cochin, Maison de Solenn, 27, boulevard Port Royal, 75014, Paris, France

    Maude Ludot & Marie Rose Moro

  4. Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 16, avenue Paul Vaillant Couturier, 94800, Villejuif, France

    Maude Ludot, Marie Rose Moro, Jonathan Lachal & Marie-Aude Piot

  5. Department of General Practice, Sorbonne University, 75012, Paris, France

    Jean-Sebastien Cadwallader

  6. Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne University, 75012, Paris, France

    Jean-Sebastien Cadwallader

  7. Service de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France

    Jonathan Lachal

  8. Université Clermont Auvergne, 63000, Clermont-Ferrand, France

    Jonathan Lachal

Authors
  1. Nina Kalindjian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christelle Hourantier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maude Ludot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Julie Gilles de la Londe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maurice Corcos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-Sebastien Cadwallader
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marie Rose Moro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jonathan Lachal
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marie-Aude Piot
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NK, MAP and CH conceived the project and designed the study. NK and MAP obtained the Institutional Review Approval. NK and CH performed all the interviews, and coded all the interviews. NK and MAP wrote the first draft of the manuscript. NK and CH each coded interviews (blinded) and then assisted MAP in conducting analyses. MAP supervised the qualitative features by triangulation of the analysis discussion, thus ensuring the thoroughness of the analytical process and the qualitative features. MC, JL, JGDL, JSC, MR and ML participated in discussions on the relevance of the emerging themes and the strength of the theory constructed. All the authors participated in drafting the work and revising it critically for important intellectual content, approved the final version to be published, and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Marie-Aude Piot.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to report.

Ethics approval and consent

The research committee of West Paris University Hospital (Comité de la Recherche-Hôpitaux Universitaires Paris Ouest—CERHUPO) approved this study: N°2017-12-3. Before the sessions, we sent all students information by email, including the purpose of the study, emphasis on voluntary participation, confidentiality of interviews, and absence of consequences on their grades from their participation (or non-participation). Written consent was obtained from all participants.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kalindjian, N., Hourantier, C., Ludot, M. et al. Experiences of French medical students during their clerkship in adolescent psychiatry: a qualitative study. Eur Child Adolesc Psychiatry 32, 1443–1451 (2023). https://doi.org/10.1007/s00787-021-01940-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-021-01940-1

Keywords

Search

Navigation