Medical student change during a psychiatry clerkship: evaluation of a program

The psychiatry clerkship at the University of British Columbia (U.B.C.) emphasizes the teaching model of the student as primary therapist. In the adult program this takes the form of a ward in which clinical clerks are the primary medical agents. In the child program each clerk assesses and treats a new family referral. While the student-ward model has been described previously, this is the first report which attempts to evaluate some aspects of this innovative approach to teaching clinical psychiatry. Student knowledge, attitudes, personality attributes, and expectations were assessed at the beginning and end of the eight-week rotation, and the changes are described. Principal findings included significant differences in the following: psychiatric knowledge, attitudes about psychiatric illness, ratings of the students by the psychiatrist-supervisor, and some student personality characteristics. Most students had rotation experiences which went beyond prior expectations. The changes which occurred were thought to be important, although modest. The implications of the changes are discussed. The level of the patient care in the programs described compared favorably with similar situations in which residents are the primary therapists.