Discrediting the notion "working with 'crazies' will make you 'crazy'": Addressing stigma and enhancing empathy in medical student education

Advances in Health Sciences Education

Volumn 14, Issue 4, 2009, Pages 487-502

  Cutler, Janis L ^a   Harding, Kelli J ^a   Mozian, Sharon A ^a,b   Wright, Leslie L ^c   Pica, Adrienne G ^c   Masters, Scott R ^a,d   Graham, Mark J ^a  

^a NEW YORK STATE PSYCHIATRIC INSTITUTE   (United States)

^b BERKSHIRE MEDICAL CENTER   (United States)

^c NewYork Presbyterian Hospital   (United States)

^d Columbia University Medical Center ^*

Author keywords

Empathy; Medical students; Psychiatry; Stigma; Stress

Indexed keywords

ADULT; ARTICLE; CURRICULUM; DOCTOR PATIENT RELATION; EDUCATION; EMPATHY; FEMALE; HUMAN; INTERPERSONAL COMMUNICATION; MALE; MEDICAL EDUCATION; MEDICAL SCHOOL; MEDICAL STUDENT; MENTAL DISEASE; MENTAL STRESS; PSYCHIATRY; PSYCHOLOGICAL MODEL; QUALITATIVE RESEARCH; SOCIAL SUPPORT; UNITED STATES;

ADULT; COMMUNICATION; CURRICULUM; EDUCATION, MEDICAL, UNDERGRADUATE; EMPATHY; FEMALE; HUMANS; MALE; MENTAL DISORDERS; MODELS, PSYCHOLOGICAL; PHYSICIAN-PATIENT RELATIONS; PSYCHIATRY; QUALITATIVE RESEARCH; SCHOOLS, MEDICAL; SOCIAL SUPPORT; STRESS, PSYCHOLOGICAL; STUDENTS, MEDICAL; UNITED STATES;

EID: 70349487340     PISSN: 13824996     EISSN: None     Source Type: Journal    
DOI: 10.1007/s10459-008-9132-4     Document Type: Article

References (56)

1. Ay, P., Save, D., & Fidanoglu, O. (2006). Does stigma concerning mental disorders differ through medical education? A survey among medical students in Istanbul. Social Psychiatry and Psychiatric Epidemiology, 41, 63-67. doi:10.1007/s00127-005-0994-y.
2. Bailey, K. E. (2000). Comparison of verbatim transcripts and psychoanalytic process notes for emotion tone, abstraction, and referential activity using computerized text analysis methods. Dissertation Abstracts International, Section B, The Sciences and Engineering, 61, 3269.
3. Balon, R., Franchini, G. R., Freeman, P. S., Hassenfeld, I. N., Keshavan, M. S., & Yoder, E. (1999). Medical students' attitudes and views of psychiatry: 15 Years later. Academic Psychiatry, 23, 30-36.
4. Branch, W., Pels, R. J., Lawrence, R. S., & Arky, R. (1993). Becoming a doctor-critical-incident reports from third-year medical students. The New England Journal of Medicine, 329, 1130-1132. doi:10.1056/NEJM199310073291518.
5. Brockington, I., & Mumford, D. (2002). Recruitment into psychiatry. British Journal of Psychiatry, 180, 307-312. doi:10.1192/bjp.180.4.307.
6. Chew-Graham, C. A., Rogers, A., & Yassin, N. (2003). I wouldn't want it on my CV or their records: Medical students' experiences of help-seeking for mental health problems. Medical Education, 37, 873-880. doi:10.1046/j.1365-2923.2003.01627.x.
7. Coulehan, J., & Williams, P. C. (2001). Vanquishing virtue: The impact of medical education. Academic Medicine, 76, 598-605.
8. Cutler, J. L., Alspector, S. L., Harding, K. J., Wright, L. A., & Graham, M. J. (2006). Medical students' perceptions of psychiatry as a career choice. Academic Psychiatry, 30, 144-149. doi:10.1176/appi.ap.30.2.144.
9. Feifel, D., Moutier, C. Y., & Swerdlow, N. R. (1999). Attitudes toward psychiatry as a prospective career among students entering medical school. American Journal of Psychiatry, 156, 1397-1402.
10. Feldmann, T. B. (2006). Medical students' attitudes toward psychiatry and mental disorders. Academic Psychiatry, 29, 354-356. doi:10.1176/appi.ap.29.4.354.
11. Figley, C. R. (1995). Compassion fatigue. New York: Brunner/Mazel.
12. Fink, P. J. (1983). The enigma of stigma and its relation to psychiatric education. Psychiatric Annals, 13, 669-690.
13. Fischel, T., Manna, H., Krivoy, A., Lewis, M., & Weizman, A. (2008). Does a clerkship in psychiatry contribute to changing medical students' attitudes towards psychiatry? Academic Psychiatry, 32, 147-153. doi:10.1176/appi.ap.32.2.147.
14. Furnham, A. F. (1986). Medical students' beliefs about nine different specialties. British Medical Journal, 293, 1607-1610.
15. Galka, S. W., Perkins, D. V., Butler, N., Griffith, D. A., Schmetzer, A. D., Avirrappattu, G., et al. (2005). Medical students' attitudes toward mental disorders before and after a psychiatric rotation. Academic Psychiatry, 29, 357-361. doi:10.1176/appi.ap.29.4.357.
16. Ginsburg, S., Regehr, G., Stern, D., & Lingard, L. (2002). The anatomy of the professional lapse: Bridging the gap between traditional frameworks and students' perceptions. Academic Medicine, 77, 516-522. doi:10.1097/00001888-200206000-00007.
17. Glaser, B. G. (1992). Basics of grounded theory analysis. Mill Valley, CA: Sociology Press.
18. Grace, S. L., Abbey, S. E., Kapral, M. K., Fang, J., Nolan, R. P., & Steward, D. E. (2005). Effect of depression on five-year mortality after an acute coronary syndrome. American Journal of Cardiology, 96, 1179-1185. doi:10.1016/j.amjcard.2005.06.052.
19. Griffith, C. H., & Wilson, J. F. (2001). The loss of student idealism in the 3rd-year clinical clerkships. Evaluation and the Health Professions, 24, 61-71. doi:10.1177/01632780122034795.
20. Hafferty, F. W. (1998). Beyond curriculum reform: Confronting medicine's hidden curriculum. Academic Medicine, 73, 403-407. doi:10.1097/00001888-199804000-00013.
21. Hafferty, F. W. (2006). Professionalism-the next wave. The New England Journal of Medicine, 355, 2151-2152. doi:10.1056/NEJMe068217.
22. Haidet, P., & Stein, H. F. (2006). The role of the student-teacher relationship in the formation of physicians: The hidden curriculum as process. Journal of General Internal Medicine, 21(supplement 1), S16-S20. doi:10.1111/j.1525-1497.2006.00304.x.
23. Hoifodt, T. S., Olstad, R., & Sexton, H. (2007). Developing psychiatric competence during medical education and internship: Contributing factors. Advances in Health Sciences Education, 12, 457-473. doi:10.1007/s10459-006-9010-x.
24. Huggard, P. (2003). Compassion fatigue: How much can I give? Medical Education, 37, 163-164. doi:10.1046/j.1365-2923.2003.01414.x.
25. Hundert, E. M. (1996). Characteristics of the informal curriculum and trainees' ethical choices. Academic Medicine, 71, 624-633. doi:10.1097/00001888-199606000-00014.
26. Iacoboni, M. (2005). Understanding others: Imitation, language, empathy. In S. Hurley & N. Chater (Eds.), Perspectives on imitation: From neuroscience to social science (Vol. 1). Cambridge, MA: MIT Press.
27. Kelle, U. (1995). Computer-aided qualitative data analysis: Theory, methods, and practice. Thousand Oaks, CA: Sage Publications.
28. Kris, K. (1986). Distress precipitated by psychiatric training among medical students. American Journal of Psychiatry, 143, 1432-1435.
29. Lamm, C., Nusbaum, H. C., Meltzoff, A. N., & Decety, J. (2007). What are you feeling? Using functional magnetic resonance imaging to assess the modulation of sensory and affective responses during empathy for pain. PLoS One, 2(12), e1292. doi:10.1371/journal.pone.0001292.
30. Larson, E. B., & Yao, X. (2005). Clinical empathy as emotional labor in the patient-physician relationship. Journal of the American Medical Association, 293, 1100-1106. doi:10.1001/jama.293.9.1100.
31. Malhi, G. S., Parker, G. B., Parker, K., Kirby, D. C., Boyce, P., Yellowlees, P., et al. (2002). Shrinking away from psychiatry? A survey of Australian medical students' interest in psychiatry. Australian and New Zealand Journal of Psychiatry, 36, 416-423. doi:10.1046/j.1440-1614.2001.00991.x.
32. Martin, V. L., Bennett, D. S., & Pitale, M. (2005). Medical students' perceptions of child psychiatry pre- and post-psychiatry clerkship. Academic Psychiatry, 29, 362-366. doi:10.1176/appi.ap.29.4.362.
33. McIntosh, D. N., Reichmann-Decker, A., Winkielman, P., & Wilbarger, J. L. (2006). When the social mirror breaks: Deficits in automatic, but not voluntary, mimicry of emotional facial expressions in autism. Developmental Science, 3, 295-302. doi:10.1111/j.1467-7687.2006.00492.x.
34. Miller, S. Z., & Schmidt, H. J. (1999). The habit of humanism: A framework for making humanistic care a reflexive clinical skill. Academic Medicine, 74, 800-803.
35. Ndetei, D. M., Khasakhala, L., Ongecha-Owuor, F., Kuria, M., Mutiso, V., Syanda, J., et al. (2008). Attitudes toward psychiatry: A survey of medical students at the University of Nairobi, Kenya. Academic Psychiatry, 32, 154-159. doi:10.1176/appi.ap.32.2.154.
36. Newton, B. W., Barber, L., Clardy, J., Cleveland, E., & O'Sullivan, P. (2008). Is there hardening of the heart during medical school? Academic Medicine, 30, 136-143.
37. Niedermier, J. A., Bornstein, R., & Brandemihl, A. (2006). The junior medical student psychiatry clerkship: Curriculum, attitudes, and test performance. Academic Psychiatry, 30, 136-143. doi:10.1176/appi.ap.30.2.136.
38. Nielsen, A. C., & Eaton, J. S. (1981). Medical students' attitudes about psychiatry: Implication for psychiatric recruitment. Archives of General Psychiatry, 38, 1144-1154.
39. Ormel, J., van Den Brink, W., Koeter, M. W., Giel, R., van Der Meer, K., van De Willige, G., et al. (1990). Recognition, management and outcome of psychological disorders in primary care: A naturalistic follow-up study. Psychological Medicine, 20, 909-923.
40. Rao, N. R. (2003). Psychiatric workforce: Past legacies, current dilemmas, and future prospects. Academic Psychiatry, 27, 238-240. doi:10.1176/appi.ap.27.4.238.
41. Rubinow, D. R. (2006). Treatment strategies after SSRI failure-Good news and bad news. New England Journal of Medicine, 354, 1305-1307. doi:10.1056/NEJMe068029.
42. Sierles, F. S., & Taylor, M. A. (1995). Decline of U.S. medical student career choice of psychiatry and what to do about it. American Journal of Psychiatry, 152, 1416-1425.
43. Sierles, F. S., Yager, J., & Weissman, S. H. (2003). Recruitment of U.S. graduates into psychiatry: Reasons for optimism, sources of concern. Academic Psychiatry, 27, 252-259. doi:10.1176/appi.ap.27.4.252.
44. Singh, S. P., Baxter, H., Standen, P., & Duggan, C. (1998). Changing the attitudes of "tomorrow's doctors" towards mental illness and psychiatry: A comparison of two teaching methods. Medical Education, 32, 115-120. doi:10.1046/j.1365-2923.1998.00162.x.
45. Stern, D. T., & Papadakis, M. (2006). The developing physician-becoming a professional. The New England Journal of Medicine, 355, 1794-1799. doi:10.1056/NEJMra054783.
46. Strauss, A. L., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage Publications.
47. Syed, W. U., Siddiqui, M. N., Dogar, I., Hamrani, M. M., Yousafzai, A. W., & Zuberi, S. (2008). Attitudes of Pakistani medical students towards psychiatry as a prospective career: A survey. Academic Psychiatry, 32, 160-164. doi:10.1176/appi.ap.32.2.160.
48. United States Department of Health and Human Services. (2003). President's new freedom commission on mental health, achieving the promise: Transforming mental health care in America. Final Report. Pub. No. SMA-03-3832. Rockville, MD. Retrieved from http://www.mentalhealthcommission.gov/reports/FinalReport/FullReport.htm. Accessed August 2007.
49. United States National Resident Matching Program. (2006). National resident matching program results and data. Washington, DC.
50. Walter, G. (1989). The stereotype of the mad psychiatrist. Australian and New Zealand Journal of Psychiatry, 23, 547-554. doi:10.3109/00048678909062624.
51. Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005a). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 603-613. doi:10.1001/archpsyc.62.6.603.
52. Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005b). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 629-640. doi:10.1001/archpsyc.62.6.629.
53. Wicker, B., Keysers, C., Plailly, J., Royet, J. P., Gallese, V., & Rizzolatti, G. (2003). Both of us disgusted in my insula: The common neural basis of seeing and feeling disgust. Neuron, 40, 655-664. doi:10.1016/S0896-6273(03)00679-2.
54. Wolfson, A., & Sampson, H. (1976). A comparison of process notes and tape recordings: Implications for therapy research. Archives of General Psychiatry, 33, 558-563.
55. World Health Organization. (2005). Mental health atlas 2005. Available at http://www.who.int/mental_health/evidence/atlas/. Accessed April 2008.
56. World Health Organization. (2006). Depression. Geneva, Switzerland. Retrieved from http://www.who.int/mental_health/management/depression/definition/en. Accessed August 2007.