Patient involvement in undergraduate psychiatric education: an international survey

The concept of patient involvement refers to the active participation of individuals with lived experience in roles such as teaching, assessment, or curriculum development. These individuals bring a unique perspective enriching education with their experiential knowledge ¹ , ² . Patient involvement can vary widely, ranging from being entirely absent, to existing in a limited or partially operational capacity, to being fully active, integrated and sustainable ¹ . Previous research has emphasized its potential to enrich students’ learning by adding realism and fostering stronger connections between students and patients ³ . It also empowers patients, making them feel valued through their contribution to teaching ⁴ . Despite these benefits, the implementation of patient involvement strategies remains inconsistent across medical schools worldwide.

The existing literature highlights the positive impact of patient involvement, demonstrating improvements in students’ communication skills, empathy, and understanding of patient‐centred care ⁵ , ⁶ , ⁷ , ⁸ . However, much of the available research is outdated, country‐specific or focused on general medical education rather than addressing the unique needs within psychiatry ⁹ , ¹⁰ . The lack of international and standardized approaches further underscores the need to assess and improve patient involvement in psychiatry curricula.

To address these gaps, and in line with the WPA Action Plan 2023‐2026 ¹¹ , ¹² , ¹³ , the WPA Section of Early Career Psychiatrists conducted an international online survey of medical schools, in collaboration with the International Federation of Medical Students’ Associations (IFMSA). This study aimed to assess the current state of patient involvement in undergraduate psychiatry education globally. Responses were gathered from medical students in 47 countries across six continents. The sample distribution included 23 medical schools from 13 countries in Europe (25.8%); 21 medical schools from 11 countries in Africa (23.6%); 17 medical schools from 10 countries in Asia (19.1%); 18 medical schools from 9 countries in the Americas (20.2%); one medical school from Oceania (1.1%); and 9 medical schools from three countries in transcontinental regions (10.1%). This diverse sample provided a broad perspective on patient involvement in psychiatry education across different regions and economic contexts.

Our findings revealed that patient involvement in undergraduate psychiatry education remains limited in many medical schools. Over half (53.3%) reported no active participation of patients in developing or revising the psychiatry undergraduate curriculum. Furthermore, 62.2% did not involve patients in curriculum quality assurance or as patient‐educators, and 63.3% indicated that patients do not play an active role in curriculum assessment. More than half (52.3%) of the institutions lack independent bodies within the medical school or teaching hospital for patients with lived experience of a mental health condition, and 52.2% do not provide financial support for patient‐educators.

This study also identified widespread knowledge gaps. Over a quarter (27.7%) were unaware of whether academic staff engaged with patients involved in the undergraduate psychiatry course. Nearly a quarter (23.4%) did not know if patient‐educators received educational support, and over a third (35.6%) were uncertain about the availability of counselling and well‐being support services for patients involved in the psychiatry undergraduate course. There was also uncertainty about the provision of financial (32.2%) and non‐financial (32%) support, the existence of independent bodies (26.7%), and the presence of dedicated administrative personnel to support patient‐educators (41.1%).

Interestingly, some of the highest levels of patient involvement were reported in low‐income countries. Notable exceptions included Sweden, where patients played a significant role in curriculum design and assessment, and Austria, which reported the existence of full‐time administrative personnel dedicated to supporting patient involvement as well as active staff engagement with patients in the undergraduate psychiatry course. Oman adapted facilities and covered all costs associated with patient‐educators, while Slovenia provided ongoing well‐being support. Bulgaria also offered ongoing training for patient‐educators. The highest levels of patient involvement in psychiatry undergraduate education were reported in Peru and Argentina.

Differences in patient involvement were also found. All Ethiopian medical schools in this study reported conducting regular emotional safety and well‐being checks during and after the teaching period. Bulgarian medical schools consistently paid salaries to those involved in the educational process. In Hungary, independent bodies within medical schools or teaching hospitals were generally present, albeit with varying levels of involvement. In Romania, there were stark contrasts between institutions: some medical schools reported lack of patient involvement, while others offered continuous well‐being support throughout the course, with high levels of patient involvement in curriculum assessment and design, active staff engagement with patients, and financial support for patient‐educators.

These findings highlight the urgent need to standardize patient involvement in psychiatry education globally. Standardization would help establish benchmarks, promote best practices, and ensure that patient involvement is not only present but effectively integrated into educational strategies. Addressing challenges, such as the lack of financial and administrative support, is essential for ensuring sustainability and equity. Collaborative efforts from medical schools, health care institutions, and policy makers are needed to ensure that patient involvement becomes a more integral and effective component of psychiatry undergraduate education worldwide.

This study, which benefited from patients’ advice in both its design and the interpretation of findings, provides a foundation for further research. Patient involvement holds immense potential to transform psychiatry education by fostering empathy, communication skills, and patient‐centred care among future doctors. However, inconsistent implementation and inadequate support hinder its widespread adoption.