Cluster analysis of medical students' attitudes regarding people who use drugs: a first step to design a tailored education program

Abstract

Introduction: People with a substance use disorder (SUD) are dealing with many stigmas including from the health care system. In this study, we investigated the attitudes of final year medical students towards SUD people and tried to understand what influence. Methods: We conducted a two-stage cluster analysis (hierarchical ascending classification followed by K-means clustering) based on the “beSAAS”. We administrated this 23-item questionnaire to 923 final-year medical students in Belgium (response rate = 71,1%). Socio-demographic characteristics were compared between the clusters. Results: 4 clusters of students with specific characteristics emerged. The first, “The Inclusive” (including 27,9% of respondents) had the less negative attitudes, they wanted to specialize mainly into psychiatry and gynecology. The second, “The Centrists" (23,6%) consisted mainly of male students. They had many private and professional experiences with substance use and considered themselves less healthy than the others. Most of them wanted to specialize in pediatrics and general practice. Their attitudes were slightly negative towards people with SUD. The third, “The Moralists” (27,6%), were mainly older, from non-European countries, had the least experience with substance use (or contact mainly in hospitals), had the less high mother’s level of education and reported excellent health. They were heading toward other specialities. They had the most stereotypes and moralism and the less treatment optimism. The fourth, “The Specialists” (20,8%), were the most in favor of specialized treatment. This group had a higher proportion of Belgians, females, and students with specific contacts with this population. They intended especially to specialize into internal medicine. This study revealed 4 profiles of medical students with different attitudes towards SUD people. “The Moralists", including more than a quarter of the respondents, were characterized by strong stereotypes and moralism and very little treatment optimism. Conclusion: These clusters could contribute to designing a learner-centered program aimed at addressing stigma within the main curriculum.