Teaching Psychiatry for Fifth-Year Medical Students at Saint-Joseph University, Beirut: Evaluation of the Four-Step Method
To the Editor: For the past 10 years, the faculty of medicine of Saint Joseph University-Beirut has been using a “four-step method” to teach psychiatry to the fifth-year medical students.
The students are divided into two groups of 30 students. Each group is asked to come to the Psychiatric Hospital of the Cross, an academic hospital affiliated with the faculty of medicine of Saint Joseph University, for 4 hours, twice a week, for 3 months. A teaching day is divided into “four steps” (each lasting an hour): a lecture on a specific subject, selected in the frame of the psychiatric integrated certificate program; a discussion of the same subject according to the clinical experience of another teacher; real-life clinical interviews for three patients who suffer from the same pathology that was introduced, led by one of the two teachers who treated the subject; and a clinical vignette on the same pathology, which is read and commented on interactively by one of the teachers with whom the students worked in the morning.
The different themes cover the whole spectrum of mental pathologies. Furthermore, the two psychiatry teachers utilize summarized lecture notes that closely correspond to and illustrate these clinical themes.
An 11-item questionnaire to evaluate this method was distributed to 64 fifth-year medical students during the 2005–2006 academic year. It was individually completed, anonymously, in the presence of one of the two teachers, without the teacher’s intervention. Another 6-item questionnaire was randomly distributed to 10 teachers. These questionnaires were accepted by the School of Medicine Education Committee. The overwhelming majority (90%) of students (n=57) estimated that this four-step method is useful for good comprehension of the subject; very few indicated a preference for a lecturing method separated from an immediate practical application. Only one teacher had applied an analogous teaching method in the discipline that he teaches. A majority (80%) considered this method safe and applicable with real benefits (n=51). Only a few recommended separating the four sequences.
The teaching method that we follow is similar to behaviorist and cognitive teaching, and it is inspired by problem-based learning (1, 2). This method of teaching provides an in-depth, comprehensive review of various topics and seems to be greatly appreciated and valued by both our students and teachers. We believe that this method should be compared with other methods of teaching, such as traditional lectures, problem-based learning, and regular case discussions.
Dr. Baladi died before publication. At the time of submission, the authors disclosed no competing interests.