Conference Papers

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Factor structure of medical students’ attitudes towards psychiatry: findings from a nationally representative sample from Sri Lanka
(Cambridge University Press, 2021) Baminiwatta, A.; Chandradasa, M.; Ediriweera, D.; Dias, S.
AIMS : The aim of this study was to examine the factor structure of attitudes towards psychiatry among medical students by using the ‘Attitude towards psychiatry-30’ (ATP-30) scale, which is one of the most widely used psychometric tools in assessing medical students’ attitudes regarding psychiatry. We also aimed to explore the possible existence of meaningful subscales in the ATP-30 scale. METHOD: Secondary data from a survey of 743 final-year medical students from nine medical schools in Sri Lanka were subjected to factor analysis. Models based on empirical evidence were tested with Confirmatory Factor Analysis (CFA) for model fit using Comparative Fit Index (CFI), Tucker Lewis Index (TLI), root mean square error of approximation (RMSEA) and Chi square. To explore the underlying latent structure of the scale, Exploratory Factor Analysis (EFA) with oblique (i.e. Promax) rotation was employed. Horn's parallel analysis and goodness-of-fit statistics for a series of EFA models tested with different numbers of factors were used in determining the number of factors to retain. Items conceptually external to the emerging factors or with factor loadings less than 0.4 were discarded. Gender invariance of the final model was tested by configural, metric and scalar invariance. Internal consistency of subscales was assessed using McDonald's omega (ω). RESULT: Three models based on literature (one-, five-, and eight- factor) were disproved by CFA. EFA revealed a six-factor solution, encompassing 18 out of the 30 items, to be the most theoretically meaningful factor structure. This six-factor model was affirmed by a CFA (CFI = 0.94, TLI = 0.92, RMSEA = 0.036). These factors were, namely, ‘the image of psychiatrists’, ‘psychiatric patients and mental illness’, ‘efficacy of treatment’, ‘psychiatric teaching’, ‘career choice’, and ‘psychiatry as an evidence-based discipline’. This six-factor solution was invariant across gender. ‘The image of psychiatrists’ appeared to be the most salient factor, and formed the most consistent subscale (ω = 0.71). The internal consistencies of the other subscales were modest (ω = 0.55–0.67). The overall 18-item scale showed good internal consistency (ω = 0.78). CONCLUSION: Our findings provide evidence of a multi-dimensional structure in medical students’ attitudes towards psychiatry, endorsing six meaningful subscales of the ATP-30. Future researchers and educators can utilize these subscales in identifying specific attitudinal domains which are more closely associated with students’ future choice of a career in psychiatry, and also in identifying specific areas where attitudes are more stigmatized, so that appropriate interventions can be incorporated into the undergraduate psychiatric curriculum.
Exploring the impact of student-led peer assisted learning (‘kuppi classes’) on examination performance and mental, social and emotional development of medical students of a Sri Lankan medical school
(Sri Lanka Medical Association, 2017) Chandrasekara, S.; Bandara, H.; Chandrasiri, N.; Choden, T.; Chandratilake, M.
INTRODUCTION & OBJECTIVES: Peer-assisted-learning (PAL) is the acquisition of knowledge and skills through active helping and supporting among status equals or matched companions. In ‘kuppi classes’, a local term for an informal form of PAL, students of a junior batch learn from students of a senior batch in a didactic manner. The aims of this study were: to explore the educational environment and the reasons for attending kuppi classes; to determine the correlation between attendance of kuppi classes and student performance at examinations. METHODS: The study focused on kuppi classes for preclinical subjects, the student experience of the first two years, and their performance at the second-year summative examination. Two focus group discussions were carried out with 14 medical students to identify the breadth of the issues related to each objective. The transcriptions were thematically analysed and a selfadministered questionnaire was developed based on these themes. It was administered to 178 third-year medical students. RESULTS: The qualitative component revealed that the learning environment in kuppi classes were much more relaxed and acceptable compared to formal teaching sessions. According to the questionnaire, the main reason for attendance is as a backup for formal lectures. For the tutoring student it is a revision. The attendees expect kuppi classes to be more examination oriented. However, the association between kuppi attendance and subsequent examination performance was not statistically significant. CONCLUSION: Didactic and informal near-peer-learning sessions may provide students with the conducive social and emotional environment to learn. However, it may not have an impact on examination performance.
Perceptions of Sri Lankan medical students on selecting and pursuing medicine as a career
(Sri Lanka Medical Association, 2017) Karunaratne, D.R.
INTRODUCTION & OBJECTIVES: Although the choice of pursuing medicine as a career has long been a topic of interest, the rapidly changing socioeconomic environment warrants a revisit. This study explored the current factors which influence this choice among medical students. METHODS: A mixed-method study was conducted among first and fourth year students in the Faculties of Medicine of universities of Kelaniya, Colombo and Sri Jayewardenepura. The perceptions of 30 medical students were explored using focus group discussions. The contents were thematically analysed to develop a valid self-administered questionnaire, which was given to 364 medical students. The responses were analysed both descriptively and inferentially. RESULTS: A total of 63.5% respondents were females and 44% were first-year students. The foremost reason for selecting medicine was to help people (mean= 2.28). The least important reason was parental pressure (mean=1.5). A/L marks (mean=2.19), social status of being a doctor (mean=1.74), job guarantee (mean=1.83) and self-interest (mean=1.98) were ranked in between. The regret of choosing medicine as a career was higher among females (p=0.035) and fourth-year students than their counterparts. The reasons appeared to be the stressfully high workload and external political issues in medical education. The interest on postgraduate studies was higher among 1st A/L attempt entrants than 3rd A/L attempt entrants (p=0.011); the interest appeared to grow along the course. CONCLUSION: Choosing medicine still has an altruistic preponderance. However, a regret of selecting medicine appears to grow along the course. The desire to pursue postgraduate studies is more if entered to medical school in the 1st attempt.

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