Does Contact-Based Learning Influence Medical Students' Attitude to Mental Illness in a Developing Country? A Pre-and Post-Design.

Abstract

Background: Despite the enormous burden of stigma toward people with mental illness in Africa and the presence of evidence-based interventions to reduce it; there is dearth of data in Africa on how to improve attitudes of students in training about mental illness. Objectives: This study aimed to determine the impact of a 4-week contact-based education on knowledge and attitudes of medical students in a Nigerian tertiary institution. Methods: A total population sample of 5th year medical students on 4-week psychiatry rotation was utilized using a prospective pre-/post-test design. Researcher designed questionnaire based on the literature on stigma in Africa and this was administered at the beginning and within one week after the posting ended. The rotation involved didactic lectures, case-based learning, individual case presentation, clinics and ward rounds. The pre- and post-test responses was compared using McNemar Chi-square. Results: After 4 weeks of contact-based learning, the following thoughts and attitudes of the students' about persons with mental illness significantly improved: being dangerous (p=0.001), giving them job (p=0.001), comfortable examining them (p=0.02) and the genetic basis of the disease (p=0.001). However, the intervention did not significantly change such attitudes related to more personal relationship like maintaining a friendship (p=0.73) and marrying them (p=0.25). Conclusion: The findings of this study suggest that contact-based education is useful in improving knowledge about causation of mental illness and some general stereotypes about them (e.g., being dangerous), but was not useful in improving personal and more intimate relationship with them.