Use of Innovative Method to Create Suicide Prevention Awareness among Undergraduate Medical Students : Annals of Indian Psychiatry

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Use of Innovative Method to Create Suicide Prevention Awareness among Undergraduate Medical Students

Varma, Jagdish; Patel, Tejas; Prabhakaran, Anusha; Contractor, Jaikumar1; Mahida, Ankur; Kharod, Utpala2; Pandya, Himanshu3

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Annals of Indian Psychiatry 7(1):p 85-86, Jan–Mar 2023. | DOI: 10.4103/aip.aip_47_23
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The competency-based medical education (CBME) curriculum for undergraduate medical students in India has enlisted global competencies including recognition and initial stabilization of psychiatric emergencies. The aspects of professional formation of the Indian medical graduate are covered in competencies listed in attitudes, ethics, and communication module.[1,2] However, challenges in the implementation of the CBME curriculum are envisaged.[3] Educational leaders at medical colleges face the following challenges: (1) To mobilize faculty for this change, (2) teaching competencies in the affective domain because they are perceived as difficult to teach and assess and, (3) to change students’ attitude toward medical education as requiring the acquisition of medical knowledge and skills to also learn professionalism skills.[4,5]

On the occasion of World Suicide Prevention Day 2021, the departments of psychiatry, health humanities, and social sciences and Physiology collaborated to create an educational activity using clue-based treasure hunt titled “Save Charlie.” The faculty from the department of psychiatry acted as “Charlie” sitting at various places in the college building. Each “Charlie” posed as a medical student with mental health issues related to suicidal ideation.

The four scenarios included in the educational activity were about medical students who had the following issues: First had posted a suicide on social media, the second had written a good-bye letter, the third had been consuming alcohol and not attending classes, and the fourth had become socially isolated. A brief description of each “Charlie” was provided to the participating teams of medical students before starting a clue-based treasure hunt. When a team was able to trace Charlie using the clues, they were instructed to discuss in their group and formulate a strategy to interact with Charlie. The task expected of them was to interact, listen and respond to Charlie in a manner that encourages him to seek further help. Each Charlie scored the team on its ability to show empathy, communications, and persuasion skills and noted the flaws during the interaction. Common flaws observed during the exercise were failure to explore suicidal ideations, focusing on the reason for the ideations and premature counseling, minimizing, challenging, and taking on the role of therapist.

The educational activity was followed by debriefing wherein knowledge base and common flaws in communicating with a suicidal person were discussed. Finally, a role play prepared by the students on mental health awareness was presented.

The salient features of the organization of the event were: Student-led initiative with guidance from faculty; voluntary participation by medical students; collaboration of various departments; generous support by the leadership of the institute. The educational activity was attended by 90 medical students, with the participation of 20 teams. First, second and third prizes were awarded to the teams based on their performance on a rating scale.

Krathwohl, Bloom, and Masia have described five levels of affective domain-receiving, responding, valuing, organizing, and characterizing.[6] At the lowest level (receiving), the learner may have awareness about a concept or belief, be willing to hear about it, and focus selective attention toward it. At the highest level, the value is internalized. We believe that the innovative educational intervention worked to engage the learners at the level of receiving. On informal feedback at the end of the session, the students reported that the session helped them understand how to approach a suicidal person and realize the mistakes they were making when talking to a person in distress.

Undergraduate medical students have a brief clinical posting of 4 weeks in psychiatry spread over the second and third professional years, where interaction with a suicidal patient can at best be an outside chance. Simulations can be run to provide learning opportunities for students; however, they need to be as close to an authentic learning environment as possible. Authenticity indicates how close the learning environment mirrors the workplace. More authentic the learning environment, the more possibility that the knowledge and skills acquired will be accessible in the future.[7] The authors believe the educational activity provided an opportunity for participation in near-authentic settings to demonstrate empathy and communication skills.

Having the knowledge of the affective domain does not ensure that a desired behavior will be enacted by physicians in making. Shaping attitudes by integrating of affective domain in the curriculum using practical and innovative approaches are required. The authors believe that a broader discussion and analysis of teaching and assessment of the affective domain for students of health professions education in India is required.

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Conflicts of interest

There are no conflicts of interest.


1. Medical Council of India. Competency Based Undergraduate Curriculum for the Indian Medical Graduate. Vol. III 2018 Available from: Last accessed on 2019 Oct 21.
2. Medical Council of India. AETCOM. Attitude, Ethics and Communication. Available from: Last accessed on 2019 Oct 21.
3. Supe A. Graduate Medical Education Regulations 2019: Competency-driven contextual curriculum. Natl Med J India 2019;32:257–61.
4. Mitra J, Saha I. Attitude and communication module in medical curriculum: Rationality and challenges. Indian J Public Health 2016;60:95–8.
5. Cate TJ, De Haes JC. Summative assessment of medical students in the affective domain. Med Teach 2000;22:40–3.
6. Krathwohl DR, Bloom BS, Masia BB. Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook II: Affective Domain. New York: David McKay Co., Inc 1964.
7. Fauth F, González-Martínez J. On the concept of learning transfer for continuous and online training: A literature review. Educ Sci 2021;11:133.
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