Objective: To determine if an educational intervention can reduce external stigma of patients with cervical dystonia (CD) in medical trainees.

Background: 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 impacted by education.

Method: Medical trainees (total N=82), including neurology residents (N=13), psychiatry residents (N=16), medical students (N=48), and undergraduate students (N=5) were enrolled. The educational intervention consisted of an interactive lecture on stigma in neuropsychiatric disease, including videotaped testimonies from patients 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 and ANOVA with Bonferroni post-hoc tests were used for statistical analysis.

Results: Prior to this educational intervention, 5/82 knew someone with dystonia, 60/82 previously had a lecture on dystonia, and 75/82 had heard of dystonia before. Prior to the 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=6.13E-08), open-mindedness (p=0.03), likability (p=0.0005), trustworthiness (p=0.0007), attractiveness (p=0.0005), self-confidence (p=0.002), and piteousness (p=0.0002). ANOVA with Bonferroni post-hoc tests showed statistically significant differences in perception based on trainee-type, with psychiatry residents scoring higher in the majority of domains compared to undergraduate students, medical students, or neurology residents (Table 1).

Conclusion: This educational intervention reduces stigma and improves perception of patients with CD in medical trainees. Further exploration into why there were rating differences based on trainee-type is needed. This teaching paradigm can be expanded to other patient conditions and is potentially applicable across a vast range of medical specialties.

Table 1

References: A version of this abstract with preliminary, pilot data will be presented at AAN on April 8, 2025. This current abstract includes updated data, including enrollment of an additional 38 subjects, and also includes updated statistical analysis with ANOVA with Bonferroni post-hoc tests.

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