Teaching undergraduate psychiatry in primary care: the impact on student learning and attitudes

Abstract

Objective: To explore the impact of undergraduate psychiatry placements in primary care settings on students' learning and attitudes to mental illness.

Design: Questionnaire survey and qualitative in-depth interviews.

Setting: A primary care-based psychiatry undergraduate teaching programme at Royal Free and University College Medical School, London.

Participants: A total of 145/183 (79.2%) students attending the primary care-based programme over 2 academic years completed a questionnaire survey. In-depth interviews were conducted with 14 students, 12 general practitioner (GP) tutors and 20 patients participating in the course.

Results: In the questionnaire survey, 121/144 (84.0%) students valued the primary care-based teaching highly. In total, 87/139 (62.6%) students felt their attitudes to mental illness had changed as a result of the course. In-depth interviews demonstrated 4 key benefits of the teaching programme: increasing breadth of experience, understanding the patients' experience, learning about mental illness from a GP's perspective and changing students' attitudes towards mental illness. The students' attitudinal shift comprised 2 main dimensions; 'normalisation' of mental illness and increased empathy.

Conclusions: Learning psychiatry in primary care settings offers students a broader experience of a range of patients than in hospital settings and encourages a 'person-centred' approach, which in turn can have a positive impact on their attitudes to mental illness, reducing stereotyping and increasing empathy.