Medical Students' Attitudes toward Self-harm, and Curricular Influences on Attitude Development.

ABSTRACT

OBJECTIVES: The authors explore attitudes that first and final year medical students have toward self-harm, and examine how the curriculum may influence the development of these attitudes. METHODS: Six focus groups, involving a total of 21 medical students, were used to explore the objectives. Thematic framework analysis was used to analyze the data through iterative development of a coding framework and identification of themes. RESULTS: Medical students demonstrated simultaneously positive and negative attitudes. Students reported minimal exposure to self-harm through the formal curriculum and being exposed to negative attitudes exhibited by healthcare professionals through the informal curriculum. Students felt that self-harm was not as important as other subjects competing for their attention in their curriculum. Many students were discouraged by healthcare staff from seeing people who self-harm, in particular on psychiatry placements. The hidden curriculum may be encouraging negative attitudes toward people who self-harm; students learn that self-harm is "not important." CONCLUSIONS: Findings from this study identify how the curriculum might influence the development of negative attitudes toward self-harm. Students would benefit from being encouraged to interact with people who self-harm and then having the opportunity to discuss the emotions these interactions create.