The impact of a psychiatry clinical rotation on the attitude of South African final year medical students towards mental illness

De Witt, Caro ; Smit, Inge ; Jordaan, Esme ; Koen, Liezl ; Niehaus, Dana J. H. ; Botha, Ulla (2019-04-25)

CITATION: De Witt, C. 2019. The impact of a psychiatry clinical rotation on the attitude of South African final year medical students towards mental illness. BMC Medical Education, 19:114, doi:10.1186/s12909-019-1543-9.

The original publication is available at https://bmcmededuc.biomedcentral.com

Article

Background: Stigmatising attitudes of health care professionals towards mental illness can impede treatment provided for psychiatric patients. Many studies have reported undergraduate training to be a critical period for changing the attitudes of medical students, and one particularly valuable intervention strategy involves time spent in a clinical psychiatric rotation. In South Africa, medical students are exposed to a clinical rotation in psychiatry but there is no evidence to show whether this has an effect on attitudes toward mental illness. Methods: This prospective cohort study involved a convenience sample of 112 South African medical students in their 5th or 6th year of undergraduate training. This sample attended a 7-week psychiatry rotation. The Attitudes to Mental Illness Questionnaire (AMIQ) was used to assess students’ attitudes toward mental illness before and after the clinical rotation which includes exposure to a number of psychiatric sub-divisions and limited didactic inputs. Results: There was a significant improvement (p < 0.01, t-test) in the students’ attitude toward mental illness following the psychiatric rotation. Females displayed a more positive attitude towards mental illness at the end of the rotation compared to males. The participants’ attitude significantly deteriorated for the non-psychiatric vignette describing diabetes (< 0.01, t-test). Conclusions: Our findings suggest that clinical training and exposure to a psychiatric setting impacts positively on medical students’ attitude towards mental illness, even when this training does not include any focused, didactic anti-stigma input.

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