A Novel Refractory Mood Disorders and Electroconvulsive Therapy Elective for Medical Students: Fighting Stigma through Experience.

Treatment resistant mood disorders (TRMD) have a significant impact on patients and society. Electroconvulsive therapy (ECT) has been shown to be effective for treatment resistant depression (TRD). Despite the effectiveness and safety of ECT, there remains significant stigma surrounding its use. Studies worldwide have shown that many medical students receive their knowledge from the media, which often portrays ECT in a negative light, and very few have exposure to ECT prior to their psychiatric clinical rotations. In this article we highlight the importance of medical education and introduce a novel approach in helping to fight the stigma of ECT through educational intervention for medical trainees that combines active, longitudinal and theoretical learning. By ensuring that trainees have a robust education in this arena, we can help them educate patients about treatment options, improve confidence in prescribing and administering these therapies, and ultimately improve patient and societal outcomes.

An Internal Perspective: the Psychological Impact of Mistreatment.

OBJECTIVES: Student mistreatment remains a prominent issue in medical education. Mistreatment has been linked to negative mental health outcomes, including depression, anxiety, and burnout. Continued challenges in this arena include difficulties in identifying mistreatment and underreporting. The objective of this study was to better understand the nuances of individual students' reactions to mistreatment. METHODS: Medical students, who had experienced mistreatment, were invited to participate in this study. Individual, semi-structured, peer-to-peer interviews were conducted with 21 students. Interview transcriptions were coded using grounded theory and inductive analysis, and themes were extracted. RESULTS: The interviews generated 34 unique mistreatment incidents. Four major themes arose in students' reactions to mistreatment. (1) Descriptions-the student described the incident as inappropriate, unusual, or unnecessary. (2) Recognition-most students did not immediately recognize the incident as mistreatment. (3) Emotions-the student described negative emotions (negative self-views, anger, powerlessness, shock, discomfort) associated with the mistreatment incident. (4) Coping mechanisms-the student utilized avoidance and rationalization to process their mistreatment. CONCLUSIONS: Mistreatment generates complex emotions and coping mechanisms that impair the learning process. These complex emotions and coping mechanisms also make it difficult for trainees to identify mistreatment and to feel safe to report. Increasing understanding of the psychological impact of mistreatment can help peers and educators better screen for mistreatment in trainees and guide them in reporting decisions.

Soliciting feedback on the wards: a peer-to-peer workshop.

BACKGROUND: For medical students, soliciting feedback is a critical but difficult skill that merits proper training. This skill may be taught effectively by peers who have experienced challenges with feedback on the wards. METHODS: Two medical students developed and taught a workshop on feedback skills. The workshop was presented to 248 third-year students. The workshop trained students in soliciting, receiving and responding to feedback through interactive discussions of case scenarios. Students were given pre- and post-surveys to assess changes in their confidence in and attitudes towards the feedback process. RESULTS: There were statistically significant increases in students' likeliness to solicit feedback and confidence in their ability to solicit feedback. Students' view on the importance of feedback did not change. The most commonly cited barriers to feedback were time constraints, fear of negative feedback, emotions and skills when asking for feedback, and student-mentor relationship. The content the students valued the most was management of internal triggers to negative feedback. Students noted that the peer-to-peer format, case scenarios, and interactive questions were strengths of the workshop. DISCUSSION: Although medical students recognise the importance of feedback, they often lack the confidence and skills to obtain quality feedback. A peer-to-peer workshop on soliciting, receiving, and responding to feedback can be an effective method to improve students' confidence and skills in this area. More research needs to be done to conclude if this workshop increases the instances of students soliciting high-quality feedback on the wards and improves clinical performance.