The impact of reflective practices on medical students' attitudes towards mental illness

Amaç: Çalışmada, reflektif uygulamaların tıp öğrencilerinin ruhsal bozukluklara yönelik tutumları üzerine etkisi ve tutum değişiminde bazı değişkenlerin etkisinin araştırılması amaçlanmıştır. Yöntem: Türkiye'de iki tıp fakültesinde yürütülen yarı-deneysel bir çalışmadır. Eğitimsel müdahale, müdahale grubundaki öğrencilerin psikiyatri stajında hastalarla görüşme deneyimine yönelik yazılı ve sözlü refleksiyon uygulamalarından oluşmaktadır. Müdahalenin etkisi, psikiyatri stajı öncesinde ve sonrasında müdahale ve kontrol gruplarına uygulanan Mental Hastalığa Yönelik İnançlar Ölçeği (MHİÖ) verileri ile değerlendirilmiştir. Bulgular: Çalışmaya müdahale (%51.6) ve kontrol (%48.4) gruplarında toplam 190 öğrenci katılmıştır. Ortalama MHİÖ puanı her iki grupta müdahale sonrasında anlamlı olarak düşük bulunmuş, ancak gruplar arasında anlamlı farklılık gözlenmemiştir. Empati ve temel kişilik özelliklerinin ikişer alt boyutu ile ruhsal bozukluğu kişisel olarak deneyimlemenin tutum değişimine etkisi anlamlılık göstermiştir. Bu değişkenler için düzeltme yapıldığında, zaman (psikiyatri eğitimi) etkisi anlamlı bulunmamıştır. Öğrenciler, sözel refleksiyon oturumunun yazılı refleksiyondan daha yararlı olduğunu düşünmektedir. Tartışma: Psikiyatri staj eğitimi öğrencilerin ruhsal bozukluklara yönelik tutumlarının değişiminde küçük ve anlamlı etki yaratırken, reflektif uygulamalar anlamlı etki göstermemiştir. Bulgular ışığında, empati, temel kişilik özellikleri ve ruhsal bozukluğu kişisel deneyimleme, damgalama ile ilişkili faktörler olarak öğrencilerin ruhsal bozukluklara yönelik tutumlarının geliştirilmesinde dikkate alınabilir.

Reflektif uygulamaların tıp öğrencilerinin ruhsal bozukluklara karşı tutumları üzerine etkisi

Objective: This study aimed to examine the impact of reflective practices on the attitudes of the medical students towards mental illnesses and to determine the impact of some variables on the attitude change. Methods: A quasiexperimental study was carried out in two medical schools in Turkey. Educational intervention, included written and verbal reflection practices for student experience in interview with patients during psychiatry clerkship, was applied in intervention groups. The impact was evaluated by collecting data at before and after psychiatry clerkship using Beliefs towards Mental Illness Inventory (BMI) in intervention and control groups. Results: Total 190 students were included in the intervention (51.6%) and (48.4%) control groups. Mean score of total BMI was found to be signifycantly lower after intervention in both groups, however, no statistical difference was observed between the two groups. The impact of two subscales of the empathy and basic personal traits of the students and self-experience of mental illness on attitude change were found to be statistically significant. After correction was done for these variables, time affect (psychiatry training) could not be found statistically significant. Verbal reflective practice was found to be more beneficial than written one. Discussion: Psychiatry clerkship training created a small and meaningful impact, but reflective practices did not show a significant impact on attitude change of students towards mental illness. Empathy, basic personal traits and self-experience of mental illnesses can be taken into consideration as factors related with stigma in improving attitudes of students.

Kaynakça

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