Requiring a one-week addiction treatment experience in a six-week psychiatry clerkship: Effects on attitudes toward substance-abusing patients

Background: Medical education shapes students' attitudes toward substance-abusing patients, often in negative ways. Curricular interventions to foster more positive attitudes toward such patients and their treatment can have lasting effects on clinical practice. The nature and duration of such interventions, however, requires clarification. Purpose: To test the hypothesis that spending 1 week of a 6-week psychiatry clerkship on an addiction treatment site would improve attitudes toward substance-abusing patients without reducing the clerkship's benefits on attitudes toward, and knowledge about, psychiatry patients. Method: Using the Medical Condition Regard Scale, preclerkship and postclerkship attitudes toward patients with alcoholism, major depression, and emphysema (a control condition) were examined in 3rd-year medical students following the conversion of 1 of the clerkship's weeks to an addiction treatment site assignment. Psychiatric knowledge was assessed by comparing scores on the Psychiatry Subject Examination before and after the change. Results: Mean regard scores increased significantly for patients with alcoholism and for patients with major depression but did not change for patients with emphysema. Subject examination scores before and after the curriculum change were not significantly different. Conclusions: Spending 1 week of a 6-week psychiatry clerkship on an addiction treatment site increased regard for patients with alcoholism without adversely affecting measures of attitudes toward, and knowledge about, psychiatric patients.