What can the medical education do for eliminating stigma and discrimination associated with mental illness among future doctors? Effect of clerkship training on Chinese students' attitudes

摘要

Objective: The study was to examine the changes in attitudes towards psychiatry and mental illness among Chinese medical students during their psychiatry clerkship training. Methods: The Attitudes Towards Mental Illness (AMI) and the Attitudes Towards Psychiatry-30 (ATP-30) questionnaires were administered to 325 fourth-year Chinese medical students before and after they completed an 8-week psychiatry clerkship training. Results: After the clerkship training, there was a significant improvement in attitudes towards psychiatry and mental health as reflected by the total scores on ATP-30 (103.4 ± 8.6 versus 111.8 ± 9.6, p < 0.001) and AMI (58.9 ± 6.3 versus 64.1 ± 6.6, p < 0.001). The proportions of students who showed positive attitudes to psychiatry and mental illness were significantly increased on most of the items on ATP-30 and AMI after rotation (p's = 0.027). Although there was a significant change after training, the percentage of the students who would consider psychiatry as their future medical specialty was still on a low level (6.5% versus 11.4%, before versus after rotation, p = 0.028). Conclusions: The results of our study suggested that psychiatry clerkship training may improve medical students' attitudes towards psychiatry and mental illness, but its influence on medical students' consideration to choose psychiatry as a future medical career is limited. The students who did not consider psychiatry as a future career held less positive attitudes to psychiatrists, psychiatric patients and the treatment.