|Year : 2016 | Volume
| Issue : 1 | Page : 4-5
Promoting of medical education in teaching and learning of psychiatry
Siddharth Sarkar, Rajesh Sagar
Department of Psychiatry and National Drug Dependence Treatment Centre, All Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||10-May-2016|
Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sarkar S, Sagar R. Promoting of medical education in teaching and learning of psychiatry. J Mental Health Hum Behav 2016;21:4-5
|How to cite this URL:|
Sarkar S, Sagar R. Promoting of medical education in teaching and learning of psychiatry. J Mental Health Hum Behav [serial online] 2016 [cited 2019 Jun 17];21:4-5. Available from: http://www.jmhhb.org/text.asp?2016/21/1/4/182086
Medical education has gathered extensive attention in the recent decades, and its role in improving learning outcomes of medical students is being widely acknowledged., Systematic analysis of medical course and curricula has been gaining popularity and assessment methods are being critically evaluated. Theories of pedagogy (and andragogy) are being developed, refined, and applied in the field of medical education to make the learning more effective and responsive to the needs to the society. Medical education, previously given a fleeting thought by medical teachers, has now emerged as a discipline in its own right. The process and outcomes of medical education are being given due consideration. The teaching and learning in medical education now recognizes the needs of different kinds of learners and attempts to optimize learning by employing different methods of teaching. A considerable amount of research is being generated to build the evidence base and inform students and teachers about the various aspects of medical education. The scope of the field has been demonstrated by the rising number of publications pertaining to this area, and through setting up of medical education units in various medical schools, and the emergence of specific journals catering to the field (e.g., Medical Education, Medical Science Educator, and International Journal of Medical Education).
Going with the momentum, strides are also being made in the teaching and learning of psychiatry as a specialty., Psychiatry offers unique needs with regard to the teaching methods that would be considered most suitable. Similarly, the outcomes of teaching are also somewhat different from other branches of medicine. Psychiatry, as a specialty, dwells substantially on the patient–therapist communication to elicit signs and symptoms to make the diagnosis. Furthermore, patient–therapist alliance is an important ingredient in the effective treatment process. Subjectivity is inherent in the field of psychiatry along with interindividual differences in making a diagnosis and providing psychotherapy. This is at a variance with the other medical specialties. Such a difference in outlook and approach may be overwhelming to some of the students who are more inclined toward facts, test reports, protocols, and treatment algorithms. Nonetheless, psychiatric training provides an opportunity to sharpen skills of communication and empathy and develop compassionate attitude toward patients. These skills may help the students in dealing with “humane” aspects of care in other specialties as well, especially while dealing with patients who are labeled as “difficult.”
In India, there is a growing view toward designating psychiatry as a separate subject in medical graduate curriculum. Such a need has been felt because of the high prevalence of psychiatric disorders, increasing recognition of such disorders, need of medical graduates to provide competent psychiatric care for common mental disorders to avoid overburdening limited trained manpower, and presentation of patients with psychiatric disorders across as wide variety of specialties. Such a transition of carving out psychiatry as a specialty is also expected to be accompanied by the greater allocation of time towards teaching of theoretical and practical aspects of psychiatry in the medical undergraduate curriculum. This is likely to translate into greater teaching and supervisory role of teachers from the departments of psychiatry from all over the country. Such a role transition probably requires faculty from the departments of psychiatry to be acquainted with the latest developments in the field of psychiatric teaching.
The changes that have been accruing in the process of psychiatric medical education have been pronounced on two fronts. The first is the exploration of the optimal teaching–learning methods, and the second is the refinement in the methods of assessment. The common parlance of “teaching-learning” in the field of medical education conveys a subtle departure from the erstwhile emphasis of mere teaching, i.e., imparting whatever the educator thought relevant in the manner considered appropriate by him/her. The focus is now on learning aspects as well, suggesting that the process of teaching and learning is completed when the learner grasps the knowledge, demonstrates the skill, and internalizes the attitude that is desired to be imparted. This has led to the use of multiple modes of teaching (including didactic lectures, small group teaching, coursework, and problem-based learning to name a few) as well as attempts at making teaching more interactive. Techniques of medical education have become more responsive to the observation that different students learn by different means. The ultimate aim has been suggested to make medical students stimulated to embark upon a course of self-directed lifelong learning. Hence, curriculum delivery attempts provide students with learning opportunities in different formats so that they can identify what suits best for them.
The other change that has occurred in the field of medical education pertains to refinement in methods of assessment and evaluation. Over time, the limitations of the usual essay type questions for theory assessment and short and long patient-based cases for practical evaluation have been mulled over, and alternatives have been explored. To decrease subjectivity in grading, multiple choice questions, extended matching questions, and short answer questions have been considered. Development of questions and marking them has started to use systematic methods such as item response theory for grading students. For practical examination, Objectively Structured Clinical Examination and simulated patients have been evaluated as options. In addition, workplace-based assessments, portfolios, and 360-degree feedback have been considered as options for comprehensive evaluation of students to eliminate the artificialness of examination situation. The changes in assessment methods have provided a larger basket of options to choose from, and usually, a combination of several evaluative strategies gives a better picture of student's performance than a single one.
The newer thought in the field of medical education pertains to competency-based learning., The medical students are expected to demonstrate specific competencies in the management of patient. Such an approach is in consonance with the society's expectations of the doctors. Hence, the aim of undergraduate medical teaching has been conceptualized to make competent doctors, who can be entrusted with patient care. This shift in paradigm emphasizes not only what is learned during the graduate medical course but also on pragmatic skills such as how to access medical information using information technology effectively, and how to appropriately communicate with the patients. Psychiatric medical graduate curriculum would also probably need to be aligned in such a manner to cater to the needs of the community and provide doctors who can provide effective care and service to the society.
Teaching of medical students can be a very satisfying experience. A teacher is not only able to convey wisdom but also can shape attitude and career directions. However, a psychiatrist juggling several clinical and administrative responsibilities may find it difficult to find dedicated time to keep abreast with the ever-evolving field of medical education. Still, teaching medical students would be an important instructional activity under the responsibility of psychiatrists, for which some specific time needs to be allocated. Time is required not only for actual teaching but also for planning curricula and methods of teaching to make the teaching and learning more effective and evaluation more meaningful. Curriculum reforms aimed at making psychiatric teaching more comprehensive requires further thought about how to kindle the interest of teacher, pragmatically improve upon the existing methods of teaching in the discipline, and deliver competencies to students who graduate out as medical professionals.
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