Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry

Impact of clinical rotational posting on attitude toward psychiatry of undergraduate medical students in Malaysia

Background

Almost all over the world, psychiatry training of undergraduate medical students has been criticized to be deficient in imparting required knowledge and improving the perception of students towards psychiatry and psychiatric treatment. Considering the large mental health need gap in the community, it is essential to improve undergraduate students' attitude toward psychiatry.

Aim

Hence, this study was planned to study the impact of psychiatry clinical posting on attitude toward psychiatry of undergraduate medical students.

Materials and Methods

Undergraduate medical students undergoing psychiatry posting were assessed on the first and last day of clinical posting with the help of semi-structured proforma consisting of sociodemographic information, favored future career choice, the relevance of psychiatry to their future careers, the usefulness of particular knowledge and skills, the value of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry.

Results

After their clinical posting, students had a more positive attitude towards the usefulness of psychiatry knowledge in future general practice and the usefulness of psychiatry knowledge from undergraduate training in the future. Knowledge of alcohol withdrawal management, detection and management of delirium, and Mental Health Acts were perceived more essential in the future. Also, specialties such as deaddiction and child and adolescent psychiatry were felt more useful in future practice. After posting, students perceived that psychiatry can also be learned at medical and surgical wards as well as during home visits. However, despite some positive changes in attitude toward psychiatry, there was no significant change in choosing psychiatry as a career by the students after posting.

Conclusion

Undergraduate psychiatry training during clinical posting was able to make some positive changes in the knowledge and attitude of students. However, still, there were lacunae in some areas of concern. Preference of psychiatry as a branch of specialization was not increased after posting. This indicates the need for better reforms in psychiatry education at the undergraduate level to improve the perception of undergraduate students about psychiatry.

Enhancing Physician Assistant Psychiatry Interviewing Skills Using Standardized Patients

INTRODUCTION

The aim of this pilot study was to assess whether supplemental psychiatry training in the didactic year increases the scores on the Physician Assistant Education Association (PAEA) Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation.

METHODS

Data were obtained from the physician assistant (PA) students on PAEA Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation for a single institution. Then, a comparison was performed for PA students who did not participate in supplemental psychiatry/behavioral health training (Cohort 1/historical control group; n = 62) and PA students who participated in supplemental psychiatric and behavioral health training (Cohort 2/experimental group; n = 63) to determine the effects of the groups.

RESULTS

An independent t test demonstrated that the experimental group performed significantly better than the control group on both the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation {control group (M = 83.4) and experimental group (M = 86.3; t [117] = 2.8; P < .05)} and the preceptor evaluation {control group (M = 90) and experimental group (M = 92.6; t [112] = 2.1; P < .05)}. In addition, both analyses demonstrated a moderate effect size (End of Rotation examination, d = 0.51; preceptor, d = 0.62). A multiple regression analysis was used to control for age, sex, grade point average (GPA), and training intervention. Age, sex, and GPA were found not to affect the results. However, treatment intervention was statistically significant for both the End of Rotation examination and preceptor evaluation scores.

DISCUSSION

Supplemental training in behavioral health and psychiatry, which included a standardized patient encounter and an interactive session dedicated to psychiatry interviewing techniques, resulted in students performing better on the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation.

A cross-sectional study of opinion about mental illness among undergraduate medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training

Background

A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training.

Materials and Methods

This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data.

Result

Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting.

Conclusion

Opinions can change based on one's experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

Attitude towards patients with psychiatric illness among undergraduate medical students at Government Medical College: A cross-sectional study

Background

People with mental illnesses commonly experience stigma, discrimination, and prejudice from the general public and medical professionals around the world. Numerous research has looked into the unfavourable perceptions that medical students have of those who suffer from mental illness.

Objective

The objective was to study the attitude of undergraduate medical students towards patients with psychiatric illnesses.

Materials and Methods

A cross-sectional study was carried out among undergraduate medical students who were exposed (n = 69) to 2-week psychiatry posting and attended lectures and those who were not exposed (n = 163) to psychiatry training using self-reported Attitude Scale for Mental Illness (ASMI) questionnaire via Google form distributed among medical students.

Results

The findings indicate there is no change in attitude toward the patient with psychiatric illness after exposure to psychiatry training among medical students. However, urban residence and female gender were the factors found to be influencing students' attitudes towards patients with psychiatric illnesses.

Conclusions

There was no change in attitude towards patients with psychiatric illness after psychiatry exposure. Students belonging to urban domicile and female students showed more sympathetic attitudes toward those with mental illnesses.

Absence of undergraduate medical students from psychiatric training: A study from central India

BACKGROUND

Psychiatric problem is as common as among the 25% of the general population and 15% patients attending specialty clinic. Majority of the cases are dealt by primary care physician at the first contact, but there is only 2 weeks of clinical posting and 20 h of theory classes during MBBS course. Earlier studies have reported low attendance during the posting and theory classes. There are few studies on this aspect. On this background, the present study was planned.

METHODOLOGY

One hundred 8^th semester students of MBBS from two medical colleges (Group A government aided college and Group B from Private college under autonomous university) from the same locality of Central Maharashtra were selected for the study after due approval by the Institutional Ethical Committee. Questionnaire was prepared by the psychiatric faculty of both institutes and administered to the individual students. The data were analyzed using suitable statistical methods (Chi-square test and t-test).

RESULTS

Only 27% of the students in Group A attended 25%-30% of clinical posting, whereas none of them attended a single theory class. While in Group B, 1/3^rd of students attended 30%-40% of clinical posting and 20%-25% of theory class. No separate examination in the subject (88%-94%) and adjustment of attendance in the other major subjects (64-86%) were cited as main reasons for nonattendance among the majority of the students in both the groups.

CONCLUSION

Strict adherence to the attendance by the institutional authority, increase in the training hours and separate examination in the subject at undergraduate level may help in improving the attendance and change in attitude of the students toward psychiatry.

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations

BACKGROUND

Globally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude and manifestations of public stigma, and synthesised evidence of recommendations to reduce mental-health-related stigma among young people in India.

METHOD

A systematic review and meta-analysis of observational studies was conducted. Nine electronic databases were searched and 30 studies (n = 6767) met inclusion criteria.

RESULTS

Most studies (66%) focused on youth training to become health professionals. One-third of young people display poor knowledge of mental health problems and negative attitudes towards people with mental health problems and one in five had actual/intended stigmatizing behavior (I2>=95%). Young people are unable to recognize causes and symptoms of mental health problems and believe that recovery is unlikely. People with mental health problems are perceived as dangerous and irresponsible, likely due to misinformation and misunderstanding of mental health problems as being solely comprised of severe mental disorders (e.g. schizophrenia). However, psychiatric labels are not commonly used/understood.

CONCLUSION

Public education may use symptomatic vignettes (through relatable language and visuals) instead of psychiatric labels to improve young people's understanding of the range of mental health problems. Recommended strategies to reduce public stigma include awareness campaigns integrated with educational institutions and content relevant to culture and age-appropriate social roles.

The impact of a psychiatry clinical rotation on the attitude of South African final year medical students towards mental illness

BACKGROUND

Stigmatising attitudes of health care professionals towards mental illness can impede treatment provided for psychiatric patients. Many studies have reported undergraduate training to be a critical period for changing the attitudes of medical students, and one particularly valuable intervention strategy involves time spent in a clinical psychiatric rotation. In South Africa, medical students are exposed to a clinical rotation in psychiatry but there is no evidence to show whether this has an effect on attitudes toward mental illness.

METHODS

This prospective cohort study involved a convenience sample of 112 South African medical students in their 5th or 6th year of undergraduate training. This sample attended a 7-week psychiatry rotation. The Attitudes to Mental Illness Questionnaire (AMIQ) was used to assess students' attitudes toward mental illness before and after the clinical rotation which includes exposure to a number of psychiatric sub-divisions and limited didactic inputs.

RESULTS

There was a significant improvement (p < 0.01, t-test) in the students' attitude toward mental illness following the psychiatric rotation. Females displayed a more positive attitude towards mental illness at the end of the rotation compared to males. The participants' attitude significantly deteriorated for the non-psychiatric vignette describing diabetes (< 0.01, t-test).

CONCLUSIONS

Our findings suggest that clinical training and exposure to a psychiatric setting impacts positively on medical students' attitude towards mental illness, even when this training does not include any focused, didactic anti-stigma input.

Stigma in health facilities: why it matters and how we can change it

Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. Addressing stigma is fundamental to delivering quality healthcare and achieving optimal health. This correspondence article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge-both approaches and methods-regarding interventions to reduce stigma in health facilities, and explores the potential to concurrently address multiple health condition stigmas. It is supported by findings from a systematic review of published articles indexed in PubMed, Psychinfo and Web of Science, and in the United States Agency for International Development's Development Experience Clearinghouse, which was conducted in February 2018 and restricted to the past 5 years. Forty-two studies met inclusion criteria and provided insight on interventions to reduce HIV, mental illness, or substance abuse stigma. Multiple common approaches to address stigma in health facilities emerged, which were implemented in a variety of ways. The literature search identified key gaps including a dearth of stigma reduction interventions in health facilities that focus on tuberculosis, diabetes, leprosy, or cancer; target multiple cadres of staff or multiple ecological levels; leverage interactive technology; or address stigma experienced by health workers. Preliminary results from ongoing innovative responses to these gaps are also described.The current evidence base of stigma reduction in health facilities provides a solid foundation to develop and implement interventions. However, gaps exist and merit further work. Future investment in health facility stigma reduction should prioritize the involvement of clients living with the stigmatized condition or behavior and health workers living with stigmatized conditions and should address both individual and structural level stigma.

Attitudes of undergraduate medical students toward mental illnesses and psychiatry

BACKGROUND

Worldwide, studies show negative attitude among medical students toward psychiatry and mental illness. The knowledge of the attitude and awareness of the undergraduate medical students toward psychiatry, mental health, and psychiatric disorders are most important as they are going to be involved in the care of these patients either directly or indirectly during the later years of their careers.

AIM

This study aims to assess attitude toward psychiatry and mental illness among undergraduate medical students.

METHODOLOGY

The responses of 67 medical students from the 6^th semester (third professional year) batch who completed their 2-week clinical posting of psychiatry in 4^th semester (i.e., second professional year) were collected using validated questionnaires, attitude towards mental illness (AMI), and attitude towards psychiatry (ATP) that assessed their attitudes to psychiatry and mental illness. Double data entry and validation were done using EpiData and analysis using Epi Info software.

RESULTS

Median AMI score was 54 (out of maximum 100) showing a neutral AMI. Median ATP score was 82 (out of maximum 150) also showing a neutral ATP. The theme-wise analysis showed that the attitude of students toward psychiatrist and psychiatry branch was relatively better compared to their AMI.

CONCLUSION

Undergraduate students have a neutral attitude to psychiatry and mental illness. More efforts are needed to change the attitude to favorable side.

Indian nursing students' attitudes toward mental illness and persons with mental illness

BACKGROUND

Nursing fraternity play a pivotal role in psychiatric services. Negative attitudes toward mental illness have been consistently reported in nursing students. Psychiatric conditions and persons suffering from them may elicit different kinds of attitudinal responses.

OBJECTIVE

The current study aimed at assessing the attitude toward mental illness and also at comparative evaluation of the attitude toward persons with different psychiatric, physical, and social conditions.

MATERIALS AND METHODS

The present study was carried out among conveniently selected nursing students (n = 100) using Attitude Scale for Mental Illness (ASMI) and Attitude to Mental Illness Questionnaire (AMIQ) on their 1^st day of psychiatric posting.

RESULTS

Higher stereotype (3.1 ± 0.8), benevolence (3.7 ± 0.6), and pessimistic prediction (3.4 ± 0.9) were reported toward mental illness. Negative attitude was noted toward persons with criminal background (4.8 ± 3.7), heroin abuse (3.2 ± 3.6), suicidal depression (1.36 ± 3.6), alcohol use (0.59 ± 4.38), and schizophrenia (0.03 ± 3.2) in the same order, with positive attitude toward diabetic (-4.4 ± 3.9) and religious persons (-5.13 ± 3.6). Significant correlation of ASMI scores was noted mainly with schizophrenia of AMIQ but not with other psychiatric conditions.

CONCLUSION

High negative attitudes in nursing students underline the need for stronger antistigma measures. Differences in attitude toward mental illness in general and specific psychiatric conditions need further systematic evaluation.

Effect of a mental health training programme on Nigerian school pupils' perceptions of mental illness

BACKGROUND

Stigmatizing attitudes and discriminatory behaviour towards persons with mental illness are known to start in childhood. In Nigeria, it is not unusual to see children taunting persons with mental illness. This behaviour continues into adulthood as evidenced by the day-to-day occurrences in the community of negative attitudes and social distance from persons with mental illness. School-based interventions for pupils have been found to increase knowledge about mental illness. Children are recognised as potential agents of change bringing in new ways of thinking. This study determined the effect of a 3-day mental health training for school pupils in Southwest Nigeria, on the perceptions of and social distance towards persons with mental illness.

METHODS

A total of 205 school pupils drawn from two administrative wards were randomly assigned to control and experimental groups. The mean age of the pupils was 14.91 years (±1.3). The pupils in the intervention group received a 5-h mental health training session spaced out over 3-days. Apart from didactic lectures, case history presentations and discussions and role-play were part the training. Outcome measures were rated using a knowledge, attitude and social distance questionnaire at baseline, immediately following the training for both group and 3-week post intervention for the intervention group. A Student Evaluation Form was administered to evaluate the pupils' assessment of the training programme. Frequencies, Chi square statistics, paired t test were used to analyse the data received.

RESULTS

At immediate post-intervention, the intervention group had a significantly higher mean knowledge score compared to controls, 21.1 vs. 22.0; p = 0.097 to 26.1 vs 22.0; p < 0.01. Respondents in the intervention group had a higher mean attitude score of 5.8 compared to 5.6 in the control group although this was not statistically significant (p < 0.627). Comparisons within the intervention group from baseline to immediate post-intervention showed a significant increase in mean knowledge and attitude scores of respondents, 21.0-26.2: p < 0.001 and 4.8-5.8; p = 0.004 respectively. This change was sustained at 3 weeks post intervention. The majority (98.8%) noted that the training was useful to them.

CONCLUSIONS

Multiple contacts and mixed-method training sessions produced a positive and sustained change in knowledge of and attitude towards persons with mental illness in school pupils in Nigeria.

What they think of us: A study of teaching medical specialists' attitude towards psychiatry in India

CONTEXT

Attitudes of teaching medical specialists are important in shaping medical students' attitudes toward psychiatry. Data on attitudes of teaching medical specialists of India toward psychiatry are limited.

AIMS

The aim was to study the attitude of teaching medical specialists of an academic medical center in East India toward psychiatry.

SETTINGS AND DESIGN

This was a cross-sectional descriptive study.

MATERIALS AND METHODS

We administered attitude toward psychiatry-30 (ATP 30) scale to teaching medical specialists of the All India Institute of Medical Sciences, Bhubaneswar, based on convenience sampling. Of 104 specialists contacted, 88 returned the completed questionnaire.

STATISTICAL ANALYSIS

We carried out descriptive statistical analysis and expressed results in mean and standard deviation. We analyzed the association of demographic characteristics, specialization, and duration of professional experience with total ATP scores using Chi-square test. We used subgroup analysis to compare mean ATP scores in different demographic and professional groups. We used independent t-test and ANOVA for between group comparisons.

RESULTS

The response rate was 84.62% with a mean ATP score of 88.60. Female gender and having a family member with mental illness was significantly associated with favorable ATP. Notable findings were that 97% of participants were favorable toward patients with psychiatric illness, 90% felt psychiatric interventions as effective whereas 87% found psychiatry unappealing and 52% said that they would not have liked to be a psychiatrist.

CONCLUSIONS

While favorable attitudes toward patients with psychiatric illness and psychiatric interventions may mean better patient care; unfavorable attitudes toward psychiatry as a career choice may adversely affect postgraduate recruitment rates.

Attitude of interns towards mental illness and psychiatry: A study from two medical colleges in South India

OBJECTIVE

This study aims to assess the intern's beliefs about mental illness, their attitude towards psychiatry and psychiatry as a career choice.

METHODS

In a cross-sectional design, one hundred and seventy six interns from the two medical colleges completed the Belief about Mental illness scale and Attitudes Towards Psychiatry (ATP-29) scale.

RESULTS

Majority of the interns considered mentally ill patients as dangerous, unpredictable, cannot take up major responsibilities, cannot be a good parent, have poor interpersonal or social skills. The attitude towards psychiatry overall, functioning of a psychiatrist, efficacy of psychiatry treatment was found to be good in over 90% of the interns. The attitude towards career and reward aspect of psychiatry was not favorable in about 40%. About 13% considered psychiatry as a career choice.

CONCLUSIONS

Beliefs about mental illness continue to be negative. Though the attitude towards psychiatry, psychiatrist and treatment efficacy is good, the social and reward aspects of psychiatry are not encouraging. Steps for changes in undergraduate medical education policies are required.

Attitude towards psychiatrists: A comparison between two metropolitan cities in India

BACKGROUND

Few patients in need of mental health care have access to psychiatric care in low and middle income countries. Public attitudes towards psychiatrists have not been adequately studied in most developing countries and especially in India, where on average one trained psychiatrist is available for 300,000 people. The aim of our study was to explore attitudes towards psychiatrists in the general population in two Indian metropolitan cities (Chennai and Kolkata) and to identify factors that could influence these attitudes.

SUBJECTS AND METHODS

Explorative surveys in the context of public attitudes towards psychiatrists were conducted in a convenience sample from the general population in Chennai (n=166) and Kolkata (n=158). Sampling was balanced for age, gender and school education.

RESULTS

Comparing the two samples using a multivariate analysis, we found more negative attitudes towards psychiatrists in Chennai compared to Kolkata (p<0.0001). Negative attitudes correlated with lower education levels (p<0.001) and stronger religious beliefs (p<0.05) in both cities.

CONCLUSION

Attitudes towards psychiatrists differed widely between two large metropolitan cities in India. In line with previous studies, negative attitudes correlated with lower level of education and stronger religious beliefs across both cities. Future studies may identify finer cultural and social factors that play an important role in attitudes towards psychiatrists in a diverse country like India.

Impact of differences in psychiatry curriculum of undergraduate medical and physiotherapy students on their attitude towards psychiatry

BACKGROUND

Negative attitude toward psychiatry (ATP) among medical students is a serious concern. Some studies have concluded that after training in the subject, attitude changes toward positive side. Currently in India, medical students have a less intense course without separate exam or binding to attend training whereas physiotherapy students have more intense course with separate subject exam and binding to attend training in psychiatry.

OBJECTIVE

To ascertain and compare the positive and negative ATP in final year MBBS students and final year physiotherapy (BPTh) students who have completed psychiatry curriculum.

METHODS

This is a cross-sectional study with semi-structured pro forma for sociodemographic variables and ATP-30 questionnaire to evaluate ATP of 94 medical and physiotherapy students each. Nonparametric methods were used for statistical analysis with appropriate tests of significance and P value was set at 0.05.

RESULTS

Mean ATP-30 score for medical students was 91.9 (standard deviation [SD] =7.0) and that of physiotherapy students was 105.8 (SD = 9.7), this difference in two groups was highly significant (Kruskal-Wallis H = 81.3, df = 1, P < 0.001). Of all medical students, 36 (41.4%) had negative attitude while only 2 (2.1%) of the physiotherapy students had negative ATP (χ(2) = 41.7, P < 0.001). Boys were 2.6 times more likely to have negative ATP than girls (relative risk = 2.6, P = 0.005).

CONCLUSIONS

Physiotherapy students with intense and planned training in psychiatry as an exam subject have significantly more positive ATP than medical students.

Perception, knowledge, and attitude toward mental disorders and psychiatry among medical undergraduates in Karnataka: A cross-sectional study

CONTEXT

Globally, psychiatry as a subject, psychiatrists as professionals, and patients with psychiatric disorders are subjected to cultural stereotypes and negative attitude by the general population. What is of alarming concern is that these prejudices exist within the medical community as well.

AIMS

This study aims at evaluating the perception, knowledge, and attitude toward psychiatric disorders, therapeutic modalities used in psychiatry, psychiatry as a subject and psychiatrists as professionals among undergraduate medical students in Karnataka.

SETTINGS AND DESIGN

This is a descriptive, cross-sectional type of study conducted in three medical colleges located in Karnataka.

MATERIALS AND METHODS

A sample of 500 students from all three professional phases of MBBS was selected using purposive sampling. A semistructured prevalidated questionnaire was used to assess the perception, knowledge, and attitude of undergraduate medical students toward psychiatric disorders and psychiatry.

STATISTICAL ANALYSIS

Data were analyzed using Statistical Package for Social Sciences, version 16.0.

RESULTS

The undergraduate medical student population had significant shortcomings in knowledge and attitude pertaining to psychiatric disorders, more glaring in the initial years of education. A comparatively positive opinion was obtained regarding psychiatry as a subject and psychiatrists as professionals, which may reflect the changing trends and concepts, both in society and medical community.

CONCLUSION

This study highlights the need for better educational measures at undergraduate level in order to shape a positive attitude of the health care providers towards psychiatry, which is essential for ensuring better care for patients as well as reduction of stigma surrounding psychiatric disorders.

Attitudes toward people with mental illness among medical students

Background:

Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’ attitudes toward people with mental illness is limited from India.

Aim:

The aim was to assess and compare the attitudes toward people with mental illness among medical students’.

Materials and Methods:

A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire.

Results:

Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013) and stigmatization (t = 2.656, P < 0.009) domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students’ attitudes toward mental illness.

Conclusion:

The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.

Changing Medical Students' Attitudes to Psychiatry through Newer Teaching Techniques

The significance of mental health in the entire health scenario has increased. However, the representation of psychiatry in the current MBBS curriculum for undergraduate students in India still remains much less than desirable. Further, stigmatising attitudes lessen these future doctors’ ability to detect and manage patients with psychological problems despite adequate knowledge about psychiatry. Students believe that psychiatrically ill patients are unpredictable and can be dangerous to others. Some feel that psychiatry is unscientific, imprecise and treatment is not effective. Traditional teaching methods are directed more towards imparting knowledge than changing the attitudes of students. Newer teaching and assessment techniques should be used to bring about attitudinal changes and develop interest among medical students. Case based and problem based learning, small group teaching, simulated patients, using movies, multidisciplinary seminars, integrated teaching, attitude questionnaires, objective structured clinical examinations etc., could be introduced in the curriculum to achieve this objective.