To determine if an educational intervention can reduce external stigma of patients with cervical dystonia (CD) in medical students/residents.

Medical trainees may or may not have exposure to the psychosocial implications of neuropsychiatric disease. An educational intervention was designed to evaluate whether stigma and perception of dystonia can be affected by education.

Medical trainees (total N=44), including neurology residents (N=17), psychiatry residents (N=14), and medical students (N=15) were enrolled. The educational intervention consisted of an interactive lecture on stigma in neuropsychiatric disease, including videotaped testimonies from patient volunteers describing their experience with CD and botulinum toxin demonstrations. Before and after the educational intervention, participants were asked to rate a series of videos of patients with CD (and one control patient without CD) on oddness, open-mindedness, likability, trustworthiness, attractiveness, self-confidence, accountability, and piteousness according to the Rinnerthaler stigma survey. Paired T-tests were used for statistical analysis and thematic analysis was used for free response.

Prior to this educational intervention, 4/44 personally knew someone with dystonia, 36/44 had previously had a lecture on dystonia, and 43/44 had heard of dystonia before. Prior to the educational intervention, the control subject without CD was perceived significantly higher in all 8 domains compared to the subjects with CD. Following the educational intervention, there was significant improvement in the perception of patients with CD, with improved ratings of oddness (p=0.0006), likability (p=0.020), trustworthiness (p=0.034), and attractiveness (p=0.043). Thematic analysis revealed that medical trainees had a greater appreciation of how neuropsychiatric disease impacts quality of life and planned to use what they had learned to improve their approach to patient care.

This educational intervention reduces stigma and improves perception of patients with CD in medical trainees. This teaching paradigm can be expanded to other patient conditions and is potentially applicable across a vast range of medical specialties.