Journal Article

Narrative Podcasts to Foster Empathy and Reduce Stigma Among Third-Year Medical Students

Craig, Wendy, Kohut, Michael, Hallward, Anne, Powers, Sara

2023

Overview

Mental health–related stigma may not improve over the course of medical training, even after participating in a psychiatry clerkship; this is worrisome, as medical students are already susceptible to stigma toward their patients [7–9]. Studies of anti-stigma interventions suggest that personal contact with individuals with mental illness, including stories of recovery, reduces mental health–related stigma among medical students [10]. Eighty-two surveys were completed out of 212 opportunities (38.7% response rate) (Table 1). Participant responses to survey questions after listening to weekly narrative podcast episodes Questionnaire items n Frequency, n (%) Strongly disagree/disagree Strongly agree/agree Was beneficial for my medical education 81 3 (3.7) 78 (96.3) Was interesting and engaging 81 3 (3.7) 78 (96.3) Helped me identify with people who have this particular struggle 80 3 (3.8) 77 (96.2) Will help me provide better care for patients 80 4 (5.0) 76 (95.0) Made me feel more prepared to work with individuals sharing similar experiences 81 5 (6.1) 76 (93.9) Increased my knowledge about these topics 81 6 (7.4) 75 (92.6) Motivated me to learn more 81 6 (7.4) 75 (92.6) Recommend module to other medical students 82 6 (7.7) 72 (92.3) Increased my confidence to bring up this subject with patients 81 11 (13.6) 70 (86.4) Increased my interest in working with this population 79 12 (15.2) 67 (84.8) Overall, students were highly positive about the educational value of the podcast series. Themes and examples from the students’ free-text questions Themes Sub-themes Examples of previous assumptions that were challenged1 Reported takeaways and intended changes to practice2 Empathy Us vs. them, “othering” People with mental illness are low functioning, irrational, and possibly dangerous, not like “us” To feel hopeful for many of the patients I have already seen this week Impact on the family As a provider, my primary focus is the patient Really listen to understand the patient and family’s experience Patients’ struggles with stigma Stigma is abstract and does not have a real impact on life Approach my patients with a different attitude, appreciating the societal challenges/systemic issues of having a mental illness (separate from the illness itself) like stigma, lack of affordable care, and housing Challenge of accessing care Treatment is easily accessible and available Stigma Reduction Moral judgment Addiction is a choice Hear patients out first rather than jumping to conclusions Taboo subjects Suicidal thinking cannot be talked about, it might make things worse Ask about difficult feelings Hope for prognosis Poor outcome is inevitable See mental illnesses as treatable medical conditions Medical Humility Harms of treatment (restraints, diagnoses, warehousing, language like “commit”) The medical system is always benign Be mindful of the language of diagnosis and the trauma of hospitalization Limits of treatment (chronic illness, the power of addiction) Once the patient is in treatment, the biggest challenges are over Appreciate that addiction is a lifelong challenge (despite treatment) Medical knowledge vs. patient knowledge My medical knowledge is more valuable than the patient’s experience Recognize and honor that the patient is the authority on their own experience 1These data were in response to the first open-ended question, “What was one assumption that you had about these individuals (or their families) that was challenged?” 2These data were in response to the following questions, “What was the most

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Addictions / Behavioral Objectives / Curricula / Digital broadcasting / Education / Educational Benefits / Educational Case Report / Empathy / Feedback (Response) / Humans / Interpersonal Relationship / Learning / Learning Motivation / Listening / Medical Education / Medical students / Medicine / Medicine & Public Health / Mental disorders / Mental health / Narration / Patient satisfaction / Patients / Physician Patient Relationship / Podcasts / Psychiatry / Questionnaires / Radio / Social Stigma / Stigma / Students, Medical - psychology / Suicides & suicide attempts / Value Judgment