Psychiatry teaching amongst medical undergraduates: stories that matter and mediators of better learning outcome

Objectives Psychotic disorders can exact a toll on both patients and caregivers. Whilst the desired teaching goals include gaining an understanding of the manifestations, neurobiology and treatment of these conditions, such concepts may appear abstract to medical undergraduates new to psychiatry before their clinical rotation. This study aimed to examine the use of patient narratives in teaching. Based on self-determination and Kolb's learning theories, it was hypothesized that intermediate processes (such as engagement, motivation, reflection) mediate narratives' effectiveness as a pedagogical tool. Methods Narratives in the form of stories of prominent individuals with psychotic disorders (such as John Nash) were incorporated in undergraduate teaching. Overall, 1014 out of 1500 (67.6%) medical undergraduates provided feedback over 2014-2018 through an anonymized questionnaire after the teaching session. Relationships between the use of narratives, intermediate processes, and overall effectiveness of session were assessed using correlation, regression, and structural equation modeling analyses. Results Most learners (97.2%) found that use of narratives helped them better appreciate the topic. Use of narratives correlated with better engagement, motivation, feeling equipped, reflection about the topic, and effectiveness as a pedagogical medium. The use of narratives was significantly predictive of ratings on these intermediate processes (allp< 0.001), which in turn mediated the relationship between narratives and overall session ratings. Conclusion Consistent with adult learning theories, the use of narratives can improve appreciation of psychotic spectrum disorders via better engagement, motivation, and reflection within learners. Appropriate narratives can be incorporated into other topics to enhance undergraduate psychiatry education.