Research in Psychiatry Medical Education through “MUST Enrich Grant”: A Scoping Review

Abstract

Background:

The Indian Teachers of Psychiatry (IToP) forum introduced a unique research grant scheme- IToP-MUST (Minds United Scholarship for Teachers) Enrich Research Grant- for conducting research in psychiatry education. This scoping review’s objectives are to (a) assess the research areas and methodologies of MUST Enrich grant-supported research, (b) identify strengths and limitations of these research works, and (c) inform the researchers and funding agency concerning robust methodologies and study areas that can be considered in the future.

Methods:

We included all MUST-funded original educational research projects from their inception (2020) to the present, which were either published or, although unpublished, available in the public domain.

Results:

Eleven research projects were identified. Most awardees were junior academic faculty members (n = 9, 82%). Eight (73%) studies were related to Competency-Based Medical Education (CBME) and were based on teaching-learning (TL) or related methods under the CBME framework, focusing on newer TL methods. Seven of eight (88%) were based on undergraduate TL. Most (n = 8, 73%) of the studies had an observational cross-sectional design, whereas the rest were interventional studies. Almost all were quantitative studies (n = 10, 91%). The prime themes of the research were students’ and teachers’ perspectives on the study topic, innovations in psychiatry TL, and their educational impact.

Conclusion:

This review’s findings will inform funders and researchers about future research areas and help formulate robust methodologies. Other funders must earmark their funding for educational research to grow this field.

There are approximately 1,08,940 MBBS and 71,000 post-graduate (PG) seats, including all the disciplines currently in India. ¹ It has been 5 years since the NMC (National Medical Commission, erstwhile Medical Commission of India-MCI ) rolled out the new CBME (Competency Based Medical Education) curriculum in August 2019. New concepts like competency and outcome-based teaching-learning (TL), integrated teaching, Attitude, Ethics, and Communication (AETCOM), etc., were brought forth. The introduction of CBME has resulted in the implementation of new and innovative TL and assessment methods at an unprecedented scale. There is a need to conduct education research studies related to medical education to evaluate the effectiveness of this new curriculum model and to find out the perspectives of various stakeholders like the students, the teachers, and the educational outcomes of the novel TL methodologies utilized by the medical educators across the country.

In the Indian scenario, medical teachers do not receive proper training in research methodology during their degree and PG courses, which results in a lack of motivation to conduct research after obtaining their degree. ² The conduct of research on topics related to medical education is even less common, as training in medical education-related topics is even less common. There are also few avenues to conduct funded research in the field of medical education in India. Conducting a research project in medical education is mandatory as part of courses like ACME (Advanced Course in Medical Education) and FAIMER (Foundation for Advancement of International Medical Education and Research) Fellowship; however, they are not funded. Funding is usually provided by agencies like ICMR (Indian Council of Medical Research) and by institutes, particularly the institutes of national importance (INIs), as intramural research grants. Professional bodies such as the Indian Psychiatric Society (IPS) also provide funds for conducting multicentric studies at the national level or various other research projects related to psychiatry at the zonal/state level. However, these funds are not only earmarked for research in medical education, including psychiatry, which is often considered a low-priority subject in the medical field, as evidenced by not a single certifiable competency required in it to pass MBBS. ³ A review of research on medical education in India during the COVID-19 pandemic showed that none of the 22 studies analyzed were from psychiatry. ⁴

The Indian Teachers of Psychiatry (IToP) forum has significantly promoted research in psychiatry medical education from 2020 onwards. It is a novel step, a teacher’s platform raising funds from Minds United for Health Sciences & Humanity Trust, Mysore. This Trust has received additional funds from the Infosys Foundation. Thus, the IToP Forum introduced a unique scholarship grant called the IToP-MUST (Minds United Scholarship for Teachers), an enriching research grant for psychiatry teachers. This grant provides a Rs 10,000 scholarship exclusively for conducting research projects related to topics on psychiatry education under the guidance of two peer mentors. ⁵

Despite the significant strides in psychiatry medical education research through grants like the MUST Enrich grant, there needs to be a comprehensive review of the quality and content of this funded research work, including the characteristics of the grant awardee. Therefore, this scoping review aims to fill this gap by reviewing all the information available regarding the research projects supported by the IToP-MUST research grant from its inception till now. The objectives of the current article are to (a) Methodically assess the research areas and methods of research works conducted under the MUST Enrich grant, (b) Identify strengths and limitations of these research works, and (c) Inform the researchers and funding agency concerning robust methodologies and study areas that can be considered in future.

Methods

The current research was intended to review all MUST Enrich grants awarded to various researchers (psychiatry faculty members) nationwide. We restricted our review to the MUST Enrich grant as, to the best of our knowledge, this is the only award dedicated to psychiatry teachers and focused on medical education-related research. As this was a review paper, it is exempted from the institute’s ethical boards’ review. Moreover, since this is research didn’t involve any participants, there was not point of obtaining any participants’ consent.

Inclusion and Exclusion Criteria

We included all MUST-funded educational research projects from its inception (the year 2020) to date, which were either published in a peer-reviewed journal or, although unpublished, presented in the National CME on Psychiatry Education and Faculty Training at St. John’s Medical College, Bengaluru on January 15, 2022, or presented on the virtual mode in the Sunday Special 60 minutes for psychiatry teachers launched by the IToP Forum. Only original research works were included in this review; non-original works (review papers, opinions, commentaries) were excluded.

Search Strategy

We obtained the list of all the MUST awardees from the IToP website and their contact details. ⁵ One of the authors (NV) contacted individual authors over the phone or email, explaining the rationale of the current review and requesting they share their research, either published papers or presentations. Authors were assured that their unpublished work would be handled with confidentiality, appropriately cited in the review work, and not shared with a third party without their permission.

Process of Data Curation

Two authors (NV and PS) independently reviewed individual papers/presentations and entered the data into a Google spreadsheet, with predefined variables mutually identified by the investigators.

Differences in opinions and doubts were cleared through a collaborative process of mutual discussion between the data curators and by seeking the opinion of an independent author (SG), who also reviewed the spreadsheet data entry for ambiguity, inaccuracy, missing data, etc. This collective approach ensures the thoroughness and accuracy of our review.

Notably, the awardees and their respective guides were also contacted if necessary. The data screening process is depicted in a flowchart (see Figure 1).

Figure 1. Flowchart Depicting the Process of Data Curation.

MUST: Minds United Scholarship for Teachers Enrich Research Grant, IToP: Indian Teachers of Psychiatry.

Results

We identified 11 research projects for the present scoping review and have presented crucial characteristics of these research works.

Overview of Projects

Three (27%) of them were already published,^6–8 and eight (73%) were unpublished/in the process of publication at the time of conduct of this review. All eight unpublished studies were either presented or findings disseminated in various academic fora: four (50%) were presented in the Sunday Special 60 Minutes for Psychiatry teachers^9–12; two (25%) were presented in the National CME on Psychiatry Education and Faculty Training at St. John’s Medical College, Bengaluru,^13,14 whereas two (25%) were presented at both places.^15,16

Author Characteristics

Concerning the gender distribution of the grant recipients, seven (64%) awardees were males, and four (36%) were females. Two (18%) were senior psychiatry faculty (professors),^9,14 whereas the remaining nine (82%) were junior faculty (assistant or associate professors) at the time of grant receipt. With regards to the regional distribution of the researchers, seven (64%) were from the IPS-South Zone, two (18%) were from IPS-West Zone,^9,15 and one (9%) each was from IPS-Central ¹² and East Zones ¹⁶ (Table 1).

Table 1.

MUST Enrich Awardee’s Characteristics and Publication Status of their Research Works.

Awardee/Author Characteristics
Name (Place)	Gender	Designation	MUST Enrich Research Grant Year/Publication Status	Study Title	Ref no.
1. Dr Vasantmeghna Murthy (KIMS, Karad*)	Female	Assistant Professor	2020-21/Unpublished	Online modular teaching to promote self-directed learning among second-year undergraduate medical students	15
2. Dr Sharmishtha Deshpande (SKN Med. Clg., Pune)	Female	Professor & Head	2021-22/Unpublished	Psychiatry internship in CBME curriculum	9
3. Dr Amit Singh (KGMU, Lucknow)	Male	Assistant Professor	2021-22/Unpublished	Rise of sub/super-specialization in psychiatry—A new endeavor in India	12
4. Dr Nimmy Chandran (GMC, Palakkad#)	Female	Assistant Professor	2020-21/Published (Kerala Journal of Psychiatry 2022)	Effect of online customized psychiatry teaching on the perceptions about psychiatry among undergraduate medical students: A randomized controlled study	6
5. Dr Johnson-Pradeep Ruben (St John’s Medical College, Bengaluru,)	Male	Associate Professor	2020-21/Published (Indian Journal of Psychiatry 2022)	Effective and innovative teaching methods in psychiatry for the medical undergraduates in South India: An exploratory study of teachers’ and students’ perspectives	8
6. Dr K Raman (Saveetha Medical College, Chennai)	Male	Professor	2020-21/Unpublished	Psychiatry residents as teachers: The need for development of structured training module for Pedagogy	14
7. Dr Raviteja Innamuri (GMC, Nizamabad, Telangana and CMC, Vellore)	Male	Asst Prof CMC Vellore/Consultant Psychiatrist	2020-21/Published (International Journal of Health and Allied Sciences 2023)	Perceived adequacy of training and identification of barriers to choosing academic faculty positions among psychiatry postgraduate students in India	7
8. Dr Suvarna Jyothi Kantipudi (Shri Ramchandra Institute of Higher Education and Research Chennai)	Female	Associate Professor	2020-21/Unpublished	Development and validation of a script for simulation-based teaching of suicide-risk assessment competencies to undergraduates in India	13
9. Dr Suhas Satish (NIMHANS,)	Male	Assistant Professor	2021-22/Unpublished	Scripting originality- Analyzing plagiarism attitudes and perspectives	11
10. Dr Sujoy Ray (IQ City Medical College, Durgapur$)	Male	Asst Prof/Specialty Doctor, Southampton, UK	2020-21/Unpublished	Podcasts as a teaching-learning method for undergraduates in psychiatry	16
11. Dr Guruprasad (BMCRI Bangaluru)	Male	Assistant Professor	2021-22/Unpublished	A comparative study of the outcome of teaching cum learning related to suicide-risk assessment using mobile app versus conventional teaching for ug medical students	10
12. Dr Rajiv Saini (Command Hospital, Kolkata)	Male	Professor	2020-21/Published (Indian Journal of Psychiatry)	Selecting a thesis topic: A postgraduate’s dilemma	–

*Maharashtra, #Kerala, $ West Bengal.

Study Characteristics

Area of the Study

Eight (73%) studies were related to the NMC’s newer CBME. Seven of those eight (88%) were based on undergraduate teaching. All eight (100%) were based on the TL or related methods under the CBME framework.

Study Design

Most (n = 8, 73%) of the studies had an observational cross-sectional study design, whereas the rest (n = 3, 27%) were interventional studies.^6,15,16 Notably, out of the three interventional studies, only one (33%) had a comparison arm. ⁶

Study Type

Ten (91%) studies were quantitative in nature, whereas only one (9%) study used a mixed-methods approach. ⁹ None of them used a purely qualitative approach to research the TL approaches under the CBME.

Sample Characteristics (Participants, Sampling Technique, and Sample Size)

Ten out of 11 studies (91%) employed purposive sampling techniques, whereas only one study (9%) used a randomized sampling technique. ⁶

Six studies (55%) had participants in the form of medical undergraduate students and/or interns, three studies (27%) had PG students,^7,11,12 and two studies (18%) had psychiatry teachers or psychiatrists as expert participants^13,14; notably, one study (9%) also involved non-psychiatrist medical education experts as participants. ¹³

The sample size of the reviewed studies ranged from 22 ¹⁵ to 227. ¹⁴ Most of the studies (n = 7, 64%) were unicentric, whereas four (36%) also involved participants from more than one center (recruited through online survey methods).^7,12–14

Instruments

Seven studies (64%) used a self-designed semi-structured questionnaire to realize their research objectives. Three studies (27%) used pre-designed validated scales,^6,11,15 whereas one (9%) modified a pre-designed scale to suit the objectives ⁸ (Table 2).

Table 2.

Details of the Research Methodology, Findings and Critical Appraisal of the Research Work.

Author & Study Title	Aim & Objective(s)	Methods	Results	Current Investigators’ Remark
1. Dr Vasantmeghna Murthy (Online modular teaching to promote self-directed learning among second-year undergraduate medical students)	To examine the effects of online modular teaching-learning of psychopharmacology on self-reported self-directed learning among second-year medical students	Participants: Second-year MBBS students (n = 22) Study type: Interventional (online teaching module on pharmacology; 10 weeks pre-post type) Broad area of research: CBME/Teaching methods Sampling method: purposive Instruments: Self-rating scale for SDL	Non-significant changes in the mean SDL score before (231.3 ± 26.6) & after the intervention (227.3 ± 31.3).	No control group. The small sample size & high attrition rate are the major limitations of the study.
2. Dr Sharmishtha Deshpande (Psychiatry internship in CBME curriculum)	To document knowledge and views of interns toward the psychiatry internship posting with FGD	Participants: Interns (115) Study design: Observational, cross-sectional, Mixed-method (FGDs) Sampling method: Purposive Broad area of research: CBME/Teaching methods Instruments: semi-structured questionnaire	Interns gained knowledge but did not attain the required competencies in handling common mental disorders, Psychiatric emergencies, and prescribing psychotropics.	Details of the thematic analyses are not provided. Change in knowledge assessed through MCQs; however, details not provided.
3. Dr Amit Singh (rise of sub/super-specialization in psychiatry—A new endeavor in India)	To understand the perspectives of psychiatry students and psychiatrists from India on the need of sub/super-specialization courses in psychiatry & To explore the structural components of the curriculum for sub/super-specialization courses in India	Participants: Psychiatrists & Residents (n = 148) Study design: Observational, cross-sectional (Survey) Sampling method: Purposive Sampling Broad area of research: Higher education in psychiatry Instruments: Semi-structured questionnaire	Child & Adolescent Psychiatry, De-addiction Psychiatry, and psychotherapy were perceived as branches needing further exposure. The best course recommended was a PDF of 1 year duration.	Perspectives could have been assessed better through qualitative research (in-depth interviews and/or FGDs). Purposive sampling & subsequent findings may not be representative of national sentiments.
4. Dr Nimmy Chandran (Effect of online customized psychiatry teaching on the perceptions about psychiatry among undergraduate medical students: A randomized controlled study)	To assess the effect of online customized psychiatry learning on perceptions about Psychiatry among undergraduate medical students	Participants: Second-year MBBS students (two groups, each comprising 16 students) Intervention: Online customized psychiatry teaching (vs. regular curriculum teaching) Study design: Interventional-RCT Broad area of research: CBME/Teaching methods Instruments: Images of Psychiatry questionnaire	Online customized psychiatry teaching did not improve perceptions about Psychiatry compared to regular curriculum teaching during two weeks of intervention.	Negative results can be attributed to the small sample size & short duration of the intervention. Details of randomization and allocation concealment process not mentioned. The phase of MBBS may have influenced the results; second-year students have other major subjects to focus on, while Psychiatry is a part of Medicine in the final year.
5. Dr Johnson-Pradeep Ruben (Effective and innovative teaching methods in psychiatry for the medical undergraduates in South India: An exploratory study of teachers’ and students’ perspectives)	To evaluate the teachers’ and students’ perspectives of effective teaching methods in psychiatry for medical undergraduates. To assess the concordance of each item and explore innovative teaching methods	Participants: 34 UG students, 26 interns, 15 teachers Study design: Observational, cross-sectional, exploratory Sampling technique: Purposive sampling Broad area of research: CBME/Teaching methods Instruments: Modified teachers and medical students perspectives of effective psychiatry teaching methods	Role play-based learning and live/simulated-based learning were reported as the most commonly used innovative teaching methods by both the students and teachers.	Validation of the two modified scales is not mentioned.
6. Dr K Raman (Saveetha Medical College, Chennai)	To propose a module for pedagogy training of psychiatry residents as teachers	Participants: 227 Psychiatry teachers (faculty & SR) Study design: Observational, cross-sectional (survey) Sampling technique: Purposive sampling Broad area of research: CBME/Teaching methods Instruments: Semi-structured questionnaire	The components of the teaching module agreed upon by the majority included knowledge about curriculum, TL methods, and microteaching skills.	The proposed 30-hour teaching module needs to be validated/pilot-tested for its usefulness.
7. Dr Raviteja Innamuri (Perceived adequacy of training and identification of barriers to choosing academic faculty positions among psychiatry postgraduate students in India)	To explore the perceived adequacy of training and identification of barriers to choosing academic faculty positions among psychiatry postgraduate students in India	Participants: 101 Psychiatry postgraduate students Study design: A cross-sectional survey Sampling technique: Purposive sampling Broad area of research: residents’ perspectives on academic faculty position as a career option Instruments: Semi-structured questionnaire	61% participants rated their overall training in psychiatry as “average and above.” Deficient areas- psychotherapy, ECT, rTMS and subspecialties. Facilitators for academic psychiatry career were interest in academic career, interest in both teaching and research and better work-life balance. Barriers were inadequate pay, politics, and lack of independence job-wise.	Qualitative research (using In-depth interviews/FGD) would have suited the objective better. Purposive sampling limits generalizability. The questionnaire used was not validated.
8. Dr Suvarna Jyothi Kantipudi (Development and Validation of a script for simulation-based teaching of suicide-risk assessment competencies to undergraduates in India	To develop a reliable culturally sensitive script designed to instruct medical students in suicide-risk assessment competency	Participants: Psychiatry and medical education experts (n = 44) Study design: A cross-sectional validation study Sampling technique: Purposive sampling Broad area of research: CBME/Teaching methods (simulation-based teaching methods) Instruments used: Semi-structured questionnaire	Content Validation Ratio (CVR) score 1, unanimous agreement is shown on most parameters, partial disagreement on- confidentiality (CVR: 0.32) acknowledgment of stressors (CVR: 0.77) and debriefing elements (CVR: 0.73)	Validation of the semi-structured questionnaire used to determine CVR among experts is not mentioned. Further refinement of the script based on continuous feedback, testing its effectiveness in educational settings, and exploring its applicability across diverse contexts will help improve the CVR in different domains.
9. Dr Suhas Satish (Scripting Originality- Analyzing plagiarism attitudes and perspectives)	To study knowledge and attitudes toward plagiarism in postgraduates, SR, and PhD scholars	Participants: 81 psychiatry trainees/research scholars Study design: observational cross-sectional Sampling technique: Purposive sampling Broad area of research: perspectives on plagiarism in research Instruments: ATPQ (Attitude Toward Plagiarism Questionnaire) and Plagiarism knowledge detection.	The overall attitude toward plagiarism by the respondents was in the moderate range for all three attitudinal factors: Positive, negative and subjective norms. None of the JR or SR scored 9 or 10 (out of 10) on knowledge assessment, median knowledge scores JR1(4), JR2(4) JR3(4) SR1(4) SR2(2) SR3(3.5), PhD scholars(5).	Individual perspectives have not been reported in the study. Qualitative analysis would be needed for a better understanding of individual perspectives on the topic.
10. Dr Sujoy Ray (Podcasts as a teaching-learning method for undergraduates in psychiatry)	To evaluate the improvement of knowledge of undergraduates in topics of psychiatry following learning through podcasts	Participants: UG students (n = 100) Study design: interventional Intervention: topic-specific podcasts Sampling technique: Purposive sampling Instruments: MCQ-based questionnaire Broad area of research: CBME/Teaching methods	A significant change in mean score on topic test pre-podcast:3.64 and post-podcast:18.94; P < .001	First study on the use of podcasts in Psychiatric education in India. No comparison with lecture or other modes of TL. Sample size calculation not mentioned.
11. Dr Guruprasad (A comparative study of the outcome of teaching cum learning related to suicide-risk assessment using mobile app versus conventional teaching for ug medical students)	To study the outcome of teaching cum learning related to suicide-risk assessment using mobile app versus conventional teaching for ug medical students	Participants: Third year UG students (138; 67 in conventional teaching and 67 in mobile app-based teaching) Study design: Observational cross-sectional comparative study Sampling technique: Purposive Instruments: semi-structured questionnaire Broad area of research: CBME/Teaching methods (comparison of self-assessment for life mobile App with conventional TL)	No significant difference between test scores or modality preference between the two groups. 87.61% found the mobile application easier to comprehend than the conventional teaching methods. Mobile application learning for the implementation of suicide-risk assessment in MBBS students is not inferior to conventional teaching methods.	An interventional pre-post-study design with an assessment of the difference between the change in mean scores in both groups (post-intervention) would have given a better idea of the outcomes.
12. Dr Rajiv Saini (Selecting a thesis topic: A postgraduate’s dilemma) is excluded as it is an opinion paper, not an original article

FGDs: focused group discussions, JR: junior resident, PDF: post-doctoral fellowship, RCT: randomized control trial, SDL: self-directed learning, SR: senior resident, TL: teaching-learning.

Discussion

The present scoping review is intended to synthesize the characteristics of all MUST Enrich grants (researchers, areas of research work, and methodologies) awarded to psychiatry teachers across the country. The strength of the present review lies in being the first to assess the characteristics of the funded research work in psychiatry education supported by the MUST Enrich research grant scheme. Moreover, our data extraction technique and systematic review approach added value to the current research work.

Overall, we found that most of the research was geared at the CBME, conducted by junior psychiatry faculty, observational in nature, and aimed at assessing the perspective/perceptions of students and teachers, innovations in psychiatry teaching and learning, and their educational impact. Additionally, topics like suicide risk assessment, which is otherwise difficult to teach and an area of public health importance, received greater emphasis in this funded research.

We found that eight out of 11 teachers focused on CBME in their research (seven on UG CBME and one on PG CBME). This finding is crucial given that the NMC has implemented the CBME curriculum for medical undergraduates since August 2019, and the number of teaching hours allotted to psychiatry has increased considerably; it still needs to be a major subject. Moreover, no certifiable skill has been earmarked in psychiatry. ¹⁷

Hence, psychiatry teachers are responsible for making psychiatry TL appealing to undergraduates so that they can learn effectively and maximally in the allotted time and improve the country’s overall mental health. ¹⁸ The MUST grant awardees’ preference to take up CBME as a research topic might be an attempt to make psychiatry teaching more effective or engage stakeholders (students and residents) in psychiatry.

Furthermore, the MUST awardees have focused on newer TL methods in psychiatry. These include online teaching,^6,15 mobile app-based TL methods, ¹⁰ simulations, ¹³ and podcasts to enrich learners’ learning experiences. ¹⁶ Importantly, Ruben et al. explored both students’ and teachers’ perspectives on effective and innovative TL methods for undergraduates; the author found that role play-based TL and live/simulated patient-based TL were the most used innovative TL methods. ⁸ Strikingly, a senior faculty member ⁹ , focused on aligning the CBME principles during the psychiatry internship.

Another senior faculty developed a 30-hour module for enhancing the TL skills of residents. ¹⁴ This work is vital given that NMC also emphasizes the importance of training PGs in TL skills. ¹⁹ More research must be conducted in this area as it would raise interest among future psychiatrists in TL methods and underscore the importance of psychiatry teaching for psychiatry residents in mental health promotion and reducing psychiatry or mental health-related stigma.

Even though the researchers have worked on newer TL methods, an important component of the CBME, a few important areas under the CBME still need to be explored, such as formative and summative assessments for the medical UGs or psychiatry PGs. ²⁰ This becomes essential given that CBME/NMC emphasizes periodic formative assessments (FA) to promote learning. ¹⁷ Future research must delve into newer and more effective ways of implementing assessments in psychiatry.

Two researchers have looked into the usefulness of online platforms.^6,15 Both used an asynchronous mode of online TL and did not find any significant improvement. Such research is vital when CBME envisages a learner-centric and flexible approach to continue training till the desired competencies are achieved.^17,18 Online platforms offer various advantages in this regard. The recorded TL sessions available online can be reviewed several times by the learner, which promotes flexibility and self-paced learning.^15,20,21 However, both the above asynchronous TL methods lacked learner-learner and learner-teacher interactions, which is an important aspect of conventional TL. ²¹ Future research may use synchronous mode, favoring both teacher-learner and learner-learner interactions, along with asynchronous TL to determine its role in improving learning outcomes.

Future researchers may also study virtual objective structured clinical examinations (OSCEs) and simulated patient videos as assessment methods. ²⁰

Other potential research topics could be the implementation of electives and how electives could help improve learners’ knowledge and skills and reduce stigma toward psychiatry. The role of sensitizing undergraduates toward mental disorders in their foundation course, including its role in reducing the stigma toward psychiatry and increasing students’ interest/improving their perception toward psychiatry, is another potential area of research. Moreover, effective ways of integrating psychiatry with other disciplines and its educational outcomes may also be studied.

Similarly, studies may focus on the role of early clinical exposure to psychiatry and short-term enrichment programs in helping learners learn essential competencies along with soft skills like communication and empathy at the earlier stages of their education and its impact on the attitude and skills of young budding doctors.

Researchers could also focus on feedback, its implementation, its role in improving learning outcomes and experiences, and the challenges of both students and teachers in giving and receiving feedback.

Reflection at the end of every lecture or narrative writing to train students on critical aspects of AETCOM may be studied to enhance self-directed learning (SDL), which is important for fulfilling the role of a lifelong learner as defined by the NMC for Indian Medical Graduates.

Two researchers have worked on newer TL methods for suicide risk assessment for undergraduates. One has focused on simulation-based TL, ¹³ whereas the other has focused on mobile-app-based TL. ¹⁰ With a suicide rate of 12 per lakh population in 2022, suicide is a major issue of national public and mental health importance. ²²

When assessing a patient’s risk of suicide directly through interaction, several challenges must be overcome. These include privacy invasions, confidentiality, stigma issues, a lack of standardized learning experiences, limited case diversity, learning time constraints, challenges obtaining patient consent, subjectivity in measurement, inconsistent case distribution, and patient resistance.^13,18 Hence, researchers’ efforts in describing novel and innovative TL methods are laudable and call for replication across settings and student populations (year-wise).

Future researchers could explore innovative and newer TL methods on similar sensitive topics like psychosexual health, forensic psychiatry, dealing with vulnerable populations (LGBTQ+, victims of abuse), and ethics in psychiatry for undergraduates.

We found that the researchers explored the usefulness of newer TL methods, but only a few compared them with conventional methods.^6,10 For instance, podcasts were used as a TL method to evaluate the improvement in knowledge. ¹⁶ However, there was no comparison with lecture or other online modes of TL. Therefore, it is challenging to elucidate how podcasts fare compared to conventional or other modes of TL for improving knowledge/cognitive domain in undergraduates. As CBME focuses more on competencies, future researchers could use podcasts in combination with other TL approaches to provide comprehensive coverage, that is, covering attitude and skill domains along with the cognitive domain of the topic and comparing them with conventional TL methods.

Only some studies have attempted to validate their assessment tools or interventions to promote psychiatry training. For instance, a script was developed as a TL method for suicide risk assessment competency. ¹³ Content Validity Ratio was calculated among various experts for the script’s components using a semi-structured questionnaire. However, the researcher needed to provide the details of the validation of the semi-structured questionnaire, thus limiting its replicability or usability. Along similar lines, a 30-hour module was proposed for enriching the TL skills of residents, but the module needed to be validated or pilot-tested. ¹⁴ Another researcher modified a pre-designed scale to meet his research objectives, but he also needed to give details of how the two modified scales were validated. ⁸

Future grants must endeavor to provide a more granular account of their methodologies or frame a robust methodology to overcome these limitations.

We found that researchers have also focused on novel topics like analyzing knowledge and attitudes toward plagiarism ¹¹ and the need for sub/super-specialization courses in psychiatry, ¹² which is highly appreciated. Along similar lines, future researchers could focus on the AETCOM module and the alignment and integration of psychiatry with other subjects. Forty-five of 119 psychiatry competencies have been integrated vertically or horizontally in the CBME. ¹⁷ Researchers can look into how far integration and alignment are being implemented, the experiences and challenges faced, and feedback from both faculty and students to modify it further.

We also noticed that researchers who studied online TL methods did not find any significant improvement with this compared to conventional methods.^6,15 This can be attributed to the small sample sizes of the studies (32 and 22 participants, respectively) and the short duration of their interventions (2 weeks and 10 weeks, respectively). Moreover, both had 2nd-year undergraduates as participants. The MBBS phase may also have influenced the results as 2nd-year students have other major subjects to focus on, and psychiatry is a subject in 3rd year/final year. A larger sample size, longer duration of intervention with regular periodic follow-ups, and having undergraduates from phase III (part 1 or 2), where Psychiatry forms a part of the theory examination, could help better assess the effect of these TL methods.

We observed that six authors’ objectives were to evaluate participants’ perspectives/perceptions, and most of them used a quantitative design to assess their objectives.^{6–9, 12, 14} Only one author used a mixed-methods approach in her study, though the researcher did not perform a detailed thematic analysis of the responses. ⁹ A qualitative study design could have explored these more effectively.

We also found that no systematic review and meta-analysis (SRMA) was carried out as a part of the MUST research grant. Future researchers could present SRMA of various TL/assessment methods and other topics of importance in the CBME.

One reason for the above-mentioned methodological limitations of the reviewed research is the limited time duration, that is, 1 year, allotted to complete the grant work. Finalizing a research topic and obtaining ethics approval may take much time, including 3–4 months, and the awardee needs more time to collect and analyze data. Moreover, qualitative research using in-depth interviews or focused group discussions and their content/thematic analysis takes more time than quantitative research.

We recommend that the MUST Enrich research grant organizers extend the time limit granted to the awardees for completing their projects to a minimum of 2 years to improve the quality of the research projects. Authors may need to purchase certain copyrighted scales or software for their research. The grant organizers may also consider giving a second award to the awardees to help them realize their goals.

Most awardees were junior faculty members from the South zone of India. We recommend that various psychiatric associations, like the Indian Psychiatry Society and its zonal branches, make the MUST Enrich grant more popular so that more interested researchers can benefit from it and we have more quality research from the country (e.g., IPS multicentric study with a theme on psychiatry education-related research). Similarly, various intramural (institutional) and extramural funding (Indian Council of Medical Research, Department of Health Research) must be earmarked for educational research.

Also, senior faculty should be encouraged to take up MUST grant-funded projects and work on research related to psychiatry teaching. This will help better implement the results in the existing system. Also, the administration and Medical Education Unit may be more easily involved by senior faculty in psychiatric teaching than junior faculty.

Most of the research carried out in teaching institutes focuses on clinical aspects. ²³ To conduct more quality research on psychiatry education, faculty may be trained to conduct educational research. Moreover, Psychiatry journals (including IPS zonal journals) may dedicate a regular column to educational research (like a dedicated column “Learning Curve” on statistics in the IJPM) to encourage similar research works.

Limitations of the Present Study

Most of the research done is still unpublished. We focused on a single research grant scheme and did not involve non-psychiatry-related educational research work that may have psychiatry teaching as an important component or be relevant to psychiatry teaching. We also did not explore the perspectives of the MUST grant awardees, which could have provided important insights into the topic.

Conclusion

This review will inform readers and funding agencies regarding the current trends in psychiatric medical education research toward the new CBME curriculum introduced by NMC, focusing on TL methods and sensitive topics like assessment of suicidality. The research was mostly conducted by junior faculty and had a cross-sectional and quantitative design. Future research may focus on qualitative or mixed-method study designs and assessment methods, including novel areas like AETCOM, integrated TL, and better methodologies. Other funders must earmark their funding on educational research for the growth of this field.