Evaluating effectiveness of Indian teachers of psychiatry (IToP)-scholarship for teachers toward enrichment of psychiatry teaching skills (STEPS) training program among psychiatry teachers in India: A cross-sectional study

ABSTRACT

Background:

Mental health disorders constitute a significant public health burden globally and in India. The treatment gap for mental health conditions remains substantial, partly due to inadequate training of healthcare professionals. The Indian teachers of psychiatry (IToP)-scholarship for teachers toward enrichment of psychiatry teaching skills (STEPS) program was developed to enhance teaching skills among psychiatry faculty.

Aim:

To assess the effectiveness of the IToP-STEPS program among trained psychiatry teachers in India.

Methods:

A cross-sectional study was conducted online using Google Forms. A structured questionnaire was administered to all psychiatrists who participated in the IToP-STEPS program from 2020 to 2023. Data were analyzed using descriptive statistics and thematic analysis.

Results:

Overall satisfaction with the program was high (mean score: 4.83 ± 0.21 on a five-point Likert scale). All participants reported improvement in teaching.

Conclusion:

The IToP-STEPS program demonstrated significant effectiveness in enhancing psychiatry teaching skills, with participants reporting improved confidence, adoption of innovative teaching methods, and enhanced student engagement.

INTRODUCTION

The global burden of mental health disorders continues to escalate, with 1 in 8 individuals worldwide living with a psychiatric disorder, according to the Global Health Data Exchange by the Institute of Health Metrics and Evaluation.[1] In 2017, psychiatric disorders ranked as the second leading cause of disease burden in terms of years lived with disability (YLDs) and the sixth leading cause of disability-adjusted life-years (DALYs) worldwide.[2] The National Mental Health Survey 2015–2016 revealed that the lifetime prevalence of mental morbidity in India was approximately 13.67%, with a treatment gap of 84.5% for overall mental morbidity.[3] This substantial treatment gap can be attributed to several factors, including lack of awareness, stigma, and limited availability of resources.

In India, while more than 120,000 doctors graduate annually, only about 1,000 psychiatrists specialize each year.[4] The role of psychiatry teachers is crucial in improving subject interest, knowledge, and skills among medical students, which can ultimately contribute to reducing the treatment gap in mental healthcare.

The National Medical Commission (NMC) implemented Competency-based Medical Education (CBME) in undergraduate medical education in 2019. The CBME framework emphasizes outcome-based, student-centric, participatory, and skill-oriented teaching and assessment methodologies.[5] This paradigm shift has transformed the role of psychiatry teachers from traditional educators to facilitators of student learning and assessment, necessitating the enhancement of teaching skills among psychiatry faculty.

The IToP-STEPS (scholarship for teachers toward enrichment of psychiatry teaching skills) is a comprehensive training program initiated by the Indian Teachers of Psychiatry (IToP) forum in association with Minds United for Health Sciences and Humanity Trust^®, a public charitable trust in Mysore, and funded by Infosys Foundation, Bengaluru. Launched on World Mental Health Day, October 10, 2020, this program was designed to enhance teaching skills among psychiatry teachers across India through a structured 20-session curriculum.[6] The program is grounded in principles of peer-to-peer learning and peer-assisted learning techniques, with experienced resource faculty serving as learning facilitators.[7] Initially conducted online due to the COVID-19 pandemic, the program has since adopted a hybrid approach, combining online and offline modalities, and has been conducted annually since 2020.

Given the importance of evaluating training program effectiveness, this study aims to assess the real-world impact of the IToP-STEPS program among trained psychiatry teachers in India.

Objective

To assess the effectiveness of the IToP-STEPS program among trained teachers of psychiatry in India.

METHODOLOGY

Study design and setting

A cross-sectional study was conducted online using Google Forms. It was conducted between March 2024 and August 2024.

Participants

The study included all psychiatrists who participated in the IToP-STEPS training program across India from 2020 to 2023. The fourth batch (2024–2025) was excluded as they were still undergoing training at the time of data collection. Psychiatry teachers who completed IToP-STEPS training and consented to participate were included in the study. Those with incomplete questionnaire responses and those who did not give consent were excluded from the study.

Data collection

Data were collected through a specifically developed structured questionnaire consisting of three sections:

1. Basic demographic information

2. Participant characteristics and training program feedback—including gender, qualification, work experience, and feedback on various aspects of the training program.

3. Effectiveness assessment—focusing on the impact of the IToP training program on professional practice, primarily through open-ended questions and five-point Likert scale items (1 = lowest, 5 = highest score).

The questionnaire was distributed to all participants via WhatsApp or email.

Ethical considerations

The institutional ethics committee approved the study. Informed consent was obtained from all participants after explaining the study purpose and inviting queries related to the research.

Data analysis

Data were analyzed using Microsoft Excel 2016. Descriptive statistics, including frequencies and percentages, were calculated for quantitative variables. Qualitative responses were analyzed using thematic analysis.

RESULTS

Participant characteristics

A total of 12 participants from 2020 to 2023 batches were included, achieving a 100% response rate. The demographic characteristics are presented in Table 1.

Table 1.

Demographic characteristics of study participants

Variable	Category	Frequency [n]	Percentage [%]
Gender	Male	7	58.33
	Female	5	41.66
Designation	Professor	1	8.33
	Additional professor	1	8.33
	Associate professor	5	41.66
	Assistant professor	5	41.66
Years of work expserience	<10 years	10	83.33
	>10 years	2	16.66
Teaching for	Undergraduates	2	16.66
	Postgraduates	1	8.33
	Both	9	75
Source of information about the course	Social media platform	1	8.33
	Through a colleague	11	91.66
Reason to join the program	To develop additional skills	3	25
	To develop confidence in teaching	1	8.33
	To gain knowledge in psychiatry teaching	8	66.66

Training program feedback

Participant satisfaction with various aspects of the training program was consistently high, as shown in Table 2. The overall mean satisfaction score was 4.83 ± 0.21 on a five-point Likert scale.

Table 2.

Feedback on training program components

Variable	Category (Score out of 5)	Frequency [n]	Percentage [%]
1. Relevance of topics	4	4	33.33
	5	8	66.66
2. Quality of resource persons	4	2	16.66
	5	10	83.33
3. Timeliness of sessions	3	1	8.33
	4	8	66.66
	5	3	25
4. Interaction during the session	4	7	58.33
	5	5	41.66
5. Clarifying the doubts of participants	4	6	50
	5	6	50
6. Online platform chosen for training	4	4	33.33
	5	8	66.66

Effectiveness of training program

1. Improvement in Teaching Confidence

   All participants (100%) reported significant improvement in their confidence in teaching psychiatry following completion of the IToP-STEPS program.

2. Changes in Teaching Approach

   Participants reported marked changes in their teaching approaches following the training program. These changes included improved lesson planning and organization, along with the incorporation of innovative teaching methods, enhanced focus on understanding students’ needs, abilities, and limitations, which helped tailor their instructional strategies more effectively. Additionally, there was a substantial increase in the use of interactive teaching techniques, improving student engagement. Participants further emphasized the integration of competency-based medical education (CBME) objectives into their curriculum delivery, helped in aligning their teaching practices with current educational standards.

3. Key Skills Developed

   Participants identified several areas where the training significantly enhanced their capabilities. These include student engagement techniques, presentation skills improvement, customization of training content to learner needs, awareness of various teaching-learning methods, enhanced planning and feedback mechanisms, innovation in assessment methods, and understanding of learning taxonomy

4. Implementation Challenges

   Five participants (41.66%) reported no challenges in implementing the teaching methods. Among those who experienced challenges, the most reported issues were time constraints/work pressure (25%) and limited resources or infrastructure (25%). Other challenges included lack of team motivation or institutional support (8.33%), student-related factors such as variable motivation and learning levels (8.33%), and limited understanding or experience with work-based assessments (8.33%).

5. Novel Teaching Strategies Implemented

   Most participants successfully implemented various innovative teaching–learning strategies acquired during the program. These included the use of flipped classroom methodology, problem-based learning (PBL), and role-playing exercises to promote active engagement and critical thinking. Many reported that the use of creative approaches like storytelling and movie analysis eased explaining clinical concepts more effectively. In addition, reflective writing exercises, case-based learning (CBL), and self-directed learning approaches are used to foster independent thinking. Video-assisted learning was also widely incorporated, further enhancing the overall teaching and learning experience.

6. Impact on Student Learning Outcomes

   While most participants felt it was too early to evaluate improvement in student learning outcomes, they nonetheless reported several positive initial changes. These included increased student engagement, greater comfort in approaching faculty, as well as increased enthusiasm for psychiatry classes. Participants also observed improvements in students’ understanding of doctor–patient communication and biopsychosocial formulation. Additionally, there was an improved clinical approach to common mental disorders, along with better performance in specialized areas such as consultation-liaison psychiatry, addiction medicine, and geriatric psychiatry.

7. Suggestions for Future Programs

   While most participants expressed satisfaction with the current program content, they also offered several suggestions for future programs. These included incorporating training in time management skills, policy planning for mental health issues, and a focus on primary care psychiatry. Participants also suggested guidance on planning and implementing electives, artificial intelligence applications in teaching and learning. Additionally, they emphasized the need for strengthening competencies in research methodology and manuscript writing skills.

DISCUSSION

This study achieved a 100% response rate from participants in the first three IToP-STEPS training batches (2020–2023), indicating high engagement and enthusiasm among program alumni. The gender distribution (58.33% male, 41.66% female) reflects reasonable representation, though future programs might consider the evolving gender composition of psychiatry faculty in India.

The consistently high satisfaction scores (mean: 4.83 ± 0.21) across all program components indicate effective program design and delivery. The peer-to-peer learning approach appears particularly successful, with participants valuing both content quality and interactive elements.

The universal improvement in teaching confidence represents a significant outcome, as educator self-efficacy strongly correlates with teaching effectiveness. The adoption of diverse innovative teaching methodologies aligns with contemporary medical education principles emphasizing active learning and student engagement.

Implementation challenges identified by participants are consistent with broader medical education literature, highlighting the need for institutional support, resource allocation, and protected time for teaching activities. These findings suggest that individual faculty development must be complemented by organizational change management.

The IToP-STEPS program represents a novel subject-specific approach to faculty development. While the National Medical Commission has conducted general faculty development programs training over 44,900 faculty members through 1,697 workshops by 2018, specialty-specific programs like IToP-STEPS address unique disciplinary needs and challenges.[8]

Limitations

Several limitations should be acknowledged in interpreting the findings of this study. The present study is limited by its small sample size (n = 12), which is inherent to the structured design of this scholarship-based training program, wherein the participants per batch was restricted to four per batch. Although all participants from the three completed batches were included, the modest sample size may limit the generalizability of the findings and reduce statistical power.Second, the reliance on self-reported outcomes introduces the possibility of response bias, including social desirability and recall bias. Third, temporal variation, such as differences in participants’ prior teaching experience and the time elapsed since program completion, may have influenced the reported outcomes. Fourth, the study did not include objective measures of teaching effectiveness or direct student feedback from the institutions of participating faculty. Finally, the relatively short follow-up period may not adequately capture sustained behavioral changes or the long-term impact on student outcomes. Future research should address these limitations by incorporating objective assessments of teaching effectiveness, evaluating student outcomes, and including longer-term follow-up to provide a more comprehensive evaluation of the program’s impact.

CONCLUSION

The IToP-STEPS training program demonstrates significant effectiveness in enhancing psychiatry teaching skills among faculty participants. Key outcomes include universal improvement in teaching confidence, successful adoption of innovative pedagogical approaches, and positive early indicators of enhanced student engagement and learning.

This program represents a pioneering model for specialty-specific faculty development in psychiatry, potentially the first of its kind globally. The findings support scaling up such programs to strengthen psychiatry education nationwide, ultimately contributing to improved mental healthcare delivery through better-trained healthcare professionals.

The success of IToP-STEPS provides a template for developing similar specialty-specific faculty development initiatives across medical disciplines, addressing the unique pedagogical challenges and opportunities within each field.

Declaration regarding the use of generative AI

“The authors attest that there was no use of generative artificial intelligence (AI) technology in the generation of text, figures, or other informational content of this manuscript.”

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.