Evaluating a case-based lecture to educate internal medicine interns about depression and suicide risk assessment

Although primary care providers are often the first line in identifying and treating mental illness, there is limited published mental health curriculum for trainees in internal medicine. The goal of this single-arm prospective longitudinal study was to evaluate the impact of a case-based lecture on the evaluation and management of depression and suicidality.

The lecture was delivered to 72 internal medicine interns at a single academic medical center between 2019 and 2021. A 9-item survey measuring confidence in assessing patients with depression and suicidal ideation (SI) and confidence in managing SI was administered pre-lecture, immediately post-lecture, and 6 months after the lecture. Knowledge of depression symptoms was assessed at all three time points among the 2020-2021 participants.

Repeated effects regression models revealed a significant effect of time for both confidence in assessment (F[2,83] = 32.91, p < 0.001) and management of SI (F[2,83] = 130.55, p < 0.001) of patients. Pairwise comparisons indicated that participants scored significantly higher on both confidence measures immediately after and at 6 months following the lecture; however, there was a significant decrease in confidence in management of SI across the 6-month follow-up period. Knowledge of depression symptoms did not change across time (F[2,43] = 0.55 p = 0.58).

Significant increases in confidence suggest both immediate and lasting positive effects of the curriculum for internal medicine interns. However, the significant decrease in confidence in managing SI across the 6-month follow-up period may indicate the need for a booster session. Overall, a plurality of participants accurately identified all symptoms of depression at all time points, suggesting that the curriculum works to improve confidence in already achieved skills.