Psychiatry teaching amongst medical undergraduates: stories that matter and mediators of better learning outcome

ABSTRACT

Objectives

Psychotic disorders can exact a toll on both patients and caregivers. Whilst the desired teaching goals include gaining an understanding of the manifestations, neurobiology and treatment of these conditions, such concepts may appear abstract to medical undergraduates new to psychiatry before their clinical rotation. This study aimed to examine the use of patient narratives in teaching. Based on self-determination and Kolb’s learning theories, it was hypothesized that intermediate processes (such as engagement, motivation, reflection) mediate narratives’ effectiveness as a pedagogical tool.

Methods

Narratives in the form of stories of prominent individuals with psychotic disorders (such as John Nash) were incorporated in undergraduate teaching. Overall, 1014 out of 1500 (67.6%) medical undergraduates provided feedback over 2014–2018 through an anonymized questionnaire after the teaching session. Relationships between the use of narratives, intermediate processes, and overall effectiveness of session were assessed using correlation, regression, and structural equation modeling analyses.

Results

Most learners (97.2%) found that use of narratives helped them better appreciate the topic. Use of narratives correlated with better engagement, motivation, feeling equipped, reflection about the topic, and effectiveness as a pedagogical medium. The use of narratives was significantly predictive of ratings on these intermediate processes (all p < 0.001), which in turn mediated the relationship between narratives and overall session ratings.

Conclusion

Consistent with adult learning theories, the use of narratives can improve appreciation of psychotic spectrum disorders via better engagement, motivation, and reflection within learners. Appropriate narratives can be incorporated into other topics to enhance undergraduate psychiatry education.

KEYWORDS:

• Narratives
• pedagogy
• psychiatry
• medical education
• psychosis

Compliance with ethical standards

The study was approved as an exempt study by the Institutional Review Board of the National Healthcare Group, Singapore (NHG DSRB Ref: 2014/00422)

Declaration of interest

The authors report no conflicts of interest.

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication.

Author contributions

KS & QHC – Conception of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article, final approval of the version to be published.

Additional information

Funding

This paper was not funded.