Influencing attitudes of medical students towards substance misusers
DOI:
https://doi.org/10.11157/fohpe.v25i2.617Keywords:
substance use disorder, empathy, changing attitudes, medical education, narrative, stigmaAbstract
Introduction: Substance use disorder is a stigmatised medical condition that is commonly associated with negative attitudes from clinicians, which results in a barrier to best practice treatment. Medical schools need to help develop professional behaviours in students, including compassion, empathy and respect.
Methods: We designed and implemented a brief experiential teaching activity that allowed students to hear multiple patient narratives of their addiction. The effects of this activity on the students’ attitudes were investigated using an attitudinal questionnaire before and after the session. Differences in agreement with the attitudinal statements before and after the seminar are described.
Results: 118 second-year MD students participated in this study, with 102 completing both the pre- and post-seminar questionnaire. In most domains covered by the questionnaire, the proportion of student agreement with statements demonstrated a significant positive change in their attitude towards working with substance misusers.
Conclusion: Student knowledge, sense of responsibility and role legitimacy were high before the seminar, suggesting students accepted that they would have a duty to understand and treat addiction. By contrast, their initial responses to the “I don’t like” and “I feel uncomfortable” questions suggested that they did not feel comfortable or confident with that role or anticipate that it would be rewarding or that the people would be likeable. Student responses to these questions all showed a significant positive change after the seminar. This suggests that listening to narratives of people in recovery from substance use disorders can positively influence attitudes of medical students.
References
Anderson, P., & Clement, S. U. E. (1987). The AAPPQ revisited: The measurement of general practitioners' attitudes to alcohol problems. British Journal of Addiction, 82(7), 753–759. https://doi.org/10.1111/j.1360-0443.1987.tb01542.x
Australian Medical Council (AMC). (2024). Standards for assessment and accreditation of primary medical programs. https://www.amc.org.au/accredited-organisations/accreditation-standards-and-procedures/
Barney, L. J., Griffiths, K. M., Christensen, H., & Jorm, A. F. (2009). Exploring the nature of stigmatising beliefs about depression and help-seeking: Implications for reducing stigma. BMC Public Health, 9, Article 61. https://doi.org/10.1186/1471-2458-9-61
Batson, C. D., Chang, J., Orr, R., & Rowland, J. (2002). Empathy, attitudes, and action: Can feeling for a member of a stigmatized group motivate one to help the group? Personality and Social Psychology Bulletin, 28(12), 1656–1666. https://doi.org/10.1177/014616702237647
Birden, H., Glass, N., Wilson, I., Harrison, M., Usherwood, T., & Nass, D. (2013). Teaching professionalism in medical education: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Medical Teacher, 35(7), e1252–e1266. https://doi.org/10.3109/0142159x.2013.789132
Charon, R. (2001). Narrative medicine: A model for empathy, reflection, profession, and trust. Jama, 286(15), 1897–1902. https://doi.org/10.1001/jama.286.15.1897
Corrigan, P., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162–179. https://doi.org/10.2307/1519806
Crapanzano, K. A., Hammarlund, R., Ahmad, B., Hunsinger, N., & Kullar, R. (2018). The association between perceived stigma and substance use disorder treatment outcomes: A review. Substance Abuse and Rehabilitation, 27(10), 1–12. https://doi.org/10.2147/sar.s183252
Dwamena, F., Holmes‐Rovner, M., Gaulden, C. M., Jorgenson, S., Sadigh, G., Sikorskii, A., Lewin, S., Smith, R. C., Coffey, J., & Olomu, A. (2012). Interventions for providers to promote a patient‐centred approach in clinical consultations. Cochrane Database of Systematic Reviews, 12, Article CD003267. https://doi.org/10.1002/14651858.cd003267.pub2
Hoggatt, K. J., Frayne, S. M., Saechao, F. S., Yano, E. M., & Washington, D. L. (2019). Substance use disorder-related disparities in patient experiences of primary care. Health Equity, 3(1), 193–197. https://doi.org/10.1089/heq.2018.0069
Kagawa, Y., Ishikawa, H., Son, D., Okuhara, T., Okada, H., Ueno, H., Goto, E., Tsunezumi, A., & Kiuchi, T. (2023). Using patient storytelling to improve medical students’ empathy in Japan: A pre-post study. BMC Medical Education, 23, Article 67. https://doi.org/10.1186/s12909-023-04054-1
Shapiro, J. (2008). Walking a mile in their patients' shoes: Empathy and othering in medical students' education. Philosophy, Ethics, and Humanities in Medicine, 3, Article 10. https://doi.org/10.1186/1747-5341-3-10
Silins, E. C. K., Rakvin C., Dobbins T., & Curry K. (2007). The influence of structured education and clinical experience on the attitudes of medical students towards substance misusers. Drug and Alcohol Review, 26(2), 191–200. https://doi.org/10.1080/09595230601184661
Van Boekel, L. C., Brouwers, E. P., Van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 131(1–2), 23–35. https://doi.org/10.1016/j.drugalcdep.2013.02.018
Walker, H. K., Hall, W. D., & Hurst, J. W. (1990). Clinical methods: The history, physical, and laboratory examinations. Annals of Internal Medicine, 113(7), 563. https://doi.org/10.7326/0003-4819-113-7-563_2
Woloschuk, W., Harasym, P. H., & Temple, W. (2004). Attitude change during medical school: A cohort study. Medical Education, 38(5), 522–534. https://doi.org/10.1046/j.1365-2929.2004.01820.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
