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Effect of Contact-Based Education on Medical Student Barriers to Treating Severe Mental Illness: a Non-randomized, Controlled Trial

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Abstract

Objective

Emerging evidence suggests that contact-based education—learning via structured social interactions designed around intergroup contact theory—could be an important educational adjunct in improving attitudes, beliefs, and behaviors of medical students toward patients with severe mental illness (SMI). However, existing literature in the area lacks structured curriculum, control group designs, or longitudinal analyses. The authors conducted a longitudinal, non-randomized, controlled trial of the National Alliance on Mental Illness (NAMI) Provider Education Program—a 15-h contact-based adjunctive curriculum—on the attitudes, beliefs, and behavior of third-year medical students (MS3) at a single institution.

Methods

Two-hundred and thirty-one students were invited to participate. Forty-one students elected to complete the curriculum and eighty served as the control group (response rate = 52%). Participants in both conditions completed questionnaires assessing aspects of caring for patients with SMI at pre-test, 1-week post-curriculum, and at 3-month follow-up.

Results

Results indicated that participants in the curriculum reported improved attitudes, beliefs, and behavior in working with SMI as compared with their cohort-matched peers. The majority of these outcomes were maintained at 3-months post-intervention, with effect sizes in the medium to large range. The largest improvement was in behavioral responses to a vignette describing an acute psychiatric emergency.

Conclusions

The present study provides evidence that a contact-based curriculum leads to improvements in the attitudes, beliefs, and behaviors of MS3 students when offered as an adjunctive program following their first year of clinical rotations.

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References

  1. Lyons Z, Janca A. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice. BMC Med Educ. 2015;15(1):1–10. https://doi.org/10.1186/s12909-015-0307-4.

    Article  CAS  Google Scholar 

  2. Petkari E, et al. The influence of clerkship on students’ stigma towards mental illness: a meta-analysis. Med Educ. 2018;52(7):694–704. https://doi.org/10.1111/medu.13548.

    Article  PubMed  Google Scholar 

  3. Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, et al. The devil is in the third year: a longitudinal study of Erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91. https://doi.org/10.1097/ACM.0b013e3181b17e55.

    Article  PubMed  Google Scholar 

  4. Totic S, Stojiljković D, Pavlovic Z, Zaric N, Zarkovic B, Malic L, et al. Stigmatization of “psychiatric label” by medical and non-medical students. Int J Soc Psychiatry. 2012;58(5):455–62. https://doi.org/10.1177/0020764011408542.

    Article  PubMed  Google Scholar 

  5. Cutler JL, Harding KJ, Mozian SA, Wright LL, Pica AG, Masters SR, et al. Discrediting the notion “working with ‘crazies’ will make you ‘crazy’”: addressing stigma and enhancing empathy in medical student education. Adv Health Sci Educ Theory Pract. 2009;14(4):487–502. https://doi.org/10.1007/s10459-008-9132-4.

    Article  PubMed  Google Scholar 

  6. Pettigrew TF, Tropp LR. A meta-analytic test of intergroup contact theory. J Pers Soc Psychol. 2006;90(5):751–83. https://doi.org/10.1037/0022-3514.90.5.751.

    Article  PubMed  Google Scholar 

  7. Roberts LW, Bandstra BS. Addressing stigma to strengthen psychiatric education. Acad Psychiatry. 2012;36(5):347–50. https://doi.org/10.1176/appi.ap.12060118.

    Article  PubMed  Google Scholar 

  8. Aggarwal AK, Thompson M, Falik R, Shaw A, O’Sullivan P, Lowenstein DH. Mental illness among us: a new curriculum to reduce mental illness stigma among medical students. Acad Psychiatry. 2013;37(6):385–91. https://doi.org/10.1176/appi.ap.13040063.

    Article  PubMed  Google Scholar 

  9. Schmetzer AD, Lafuze JE, Jack ME. Overcoming stigma: involving families in medical student and psychiatric residency education. [Erratum appears in Acad Psychiatry. 2008 May-Jun;32(3):265 Note: Jack, Maren E [added]]. Acad Psychiatry. 2008;32(April):127–31. https://doi.org/10.1176/appi.ap.32.2.127.

    Article  PubMed  Google Scholar 

  10. Pettigrew TF. Intergroup contact theory. Annu Rev Psychol. 1998;49(1):65–85. https://doi.org/10.1146/annurev.psych.49.1.65.

    Article  CAS  PubMed  Google Scholar 

  11. Mahoney JS, Mulder C, Hardesty S, Madan A. Integrating caring into patient-centered care through interprofessional education and ethics: the caring project. Bull Menn Clin. 2017;81(3):233–46.

    Article  Google Scholar 

  12. Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63(10):963–73. https://doi.org/10.1176/appi.ps.201100529.

    Article  PubMed  Google Scholar 

  13. Gadomski AM, Wolff D, Tripp M, Lewis C, Short LM. Changes in health care providers’ knowledge, attitudes, beliefs and behaviors regarding domestic violence, following a multifaceted intervention.pdf. Acad Med. 2001;76(10):1045–52.

    Article  CAS  Google Scholar 

  14. Day E, Edgren K, Eshleman A. Measuring stigma toward mental illness: development and application of the mental illness stigma scale. J Appl Soc Psychol. 2007;37(10):2191–219.

    Article  Google Scholar 

  15. Schulze B, Richter-Werling M, Matschinger H, Angermeyer MC. Crazy? So what! Effects of a school project on students’ attitudes towards people with schizophrenia. Acta Psychiatr Scand. 2003;107(2):142–50. https://doi.org/10.1034/j.1600-0447.2003.02444.x.

    Article  CAS  PubMed  Google Scholar 

  16. Williams B, Brown T, Boyle MWV. The Medical Condition Regard Scale (MCRS): an examination of its factor structure using paramedic students. Nurse Educ Today. 2013;33(9):938–43.

    Article  Google Scholar 

  17. Cohen J, Struening E. Opinions about mental illness in the personnel of two large mental hospitals. J Abnorm Soc Psychol. 1962;64(5):349–60.

    Article  CAS  Google Scholar 

  18. Burra P, Kalin R, Leichner P, et al. The ATP 30 scale for measuring medical students’ attitudes to psychiatry. Med Educ. 1982;16(1):31–8. https://doi.org/10.1111/j.1365-2923.1982.tb01216.x.

    Article  CAS  PubMed  Google Scholar 

  19. Thombs BD, Adeponle AB, Kirmayer LJ, Morgan JF. A brief scale to assess hospital doctors’ attitudes toward collaborative care for mental health. Can J Psychiatr. 2010;55(4):264–7.

    Article  Google Scholar 

  20. Cohen M, Woodward CA, Ferrier B, Williams AP. Interest in different types of patients: what factors influence new-to-practice family physicians? Can Fam Physician. 1996;42(Nov):2170–8.

    CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors would like to thank Sue Huppert, Chief External and Government Affairs Officer, and Jennifer Latterell, DO at Des Moines University for their tireless support of this work. We would also like to thank Nicholas Huth and Stephanie Zobel (DO 2022) whose review and contributions greatly improved the quality of the manuscript.

Funding

This project was made possible by generous grants from the Iowa Department of Public Health (#5889MHW01) and the Mid-Iowa Health Foundation (#115-3226). Non-financial support, including facilitators and teaching materials, was provided by the NAMI.

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Correspondence to Jeritt R. Tucker.

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This study was reviewed by the Des Moines University Institutional Review Board and determined to be exempt.

Conflict of Interest

Teri Brister is Director of Information and Support at the National Alliance on Mental Illness. On behalf of all other authors, the corresponding author states that there are no conflicts of interest.

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Tucker, J.R., Seidman, A.J., Van Liew, J.R. et al. Effect of Contact-Based Education on Medical Student Barriers to Treating Severe Mental Illness: a Non-randomized, Controlled Trial. Acad Psychiatry 44, 566–571 (2020). https://doi.org/10.1007/s40596-020-01290-1

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  • DOI: https://doi.org/10.1007/s40596-020-01290-1

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