Background: With support from NIAAA (#4R44AA016724-02) we are developing an online curriculum to educate and enhance clinical skill development in Year 2 to 4 medical students on at risk drinking and alcohol use disorders.
Objective: Medical students were surveyed to understand learning preferences regarding the topics covered and the case-based learning environment.
Program Description: Recruited through a convenience sampling approach, medical students (n=17) completed an on-line survey regarding their interests and perceived needs. Quantitative analyses of responses to multiple choice and 1-5 point Likert scale questions guided development of a case-based online curriculum.
Program Evaluation Outcome: Students felt inadequately prepared [1=not prepared, 5=fully prepared] to address the following: ability to treat alcohol use disorders in patients with other addictions (1.65), ability to treat alcohol use disorders (1.76), ability to treat alcohol use in patients at risk for alcohol use disorders (1.76), ability to triage alcohol use disorder patients to appropriate treatment areas (2.00), recognition and treatment/proper referral of relapse to alcohol use disorders (1.88). Students were most interested in learning more about [1=uninterested, 5=very interested]: brief interventions (3.94), co-morbidities (3.94) and case studies representing a variety of patient experiences (4.41).
Students would likely use an optional live remote Standardized Patient learning experience [1=strongly disagree, 5=strongly agree] (3.41) and would like to have the option available to them (3.53). A Web-based case interface (4.12) and online chat discussion with the patient (3.94) were preferred. Students preferred to learn clinical skills in multiple short cases compared to one long case (77%).
Conclusions: Medical students identify many deficits in their knowledge and skills especially those skills that would be essential in any practice. They express interest in an experience using a live remote standardized patient which would focus on alcohol intervention skills training.
Background: With support from NIDA (#R44-DA12066) we have developed an online curriculum to educate and further clinical skill development in Year 2 to 4 medical students on buprenorphine treatment for opioid use disorders.
Objective: To educate medical students about treatment of patients with opioid dependence using buprenorphine and impact clinical skills in working with patients with addictive disorders.
Program Description: We are performing a summative evaluation of our curriculum. Each medical student completed a pre/post test effectiveness evaluation of our online curriculum, including pre/post evaluations of clinical skills through a remote live standardized patient (SP) experience. The OSCE style evaluation of the learner's performance during the remote, live SP clinical encounter was assessed by the SP actor and a MA level clinical professional. Measurement was done via: 1) a 9 item Likert scale rating sheet, and 2) a 16 item done/not done checklist. Both modifications were reviewed and approved by two external clinical substance abuse professionals.
Program Evaluation Outcome: Preliminary results (n=25) of this evaluation indicate that the modules have a statistically significantly effect on knowledge and intended behavior related to treatment of patients with opioid dependence (p<.001). Average pre-knowledge score was 68% while the average post-test score was 83% (p<0.001). Attitude and self-efficacy also increased significantly for most modules. Students showed the most improvement in the areas of common comorbidities and pharmacology. Student competency was measured in the following areas: drug detection and screening, comorbid conditions, diagnosis and treatment. Competency (p<0.0007) increased quite significantly from pre to post experience. Competency scores increased an average of 44% from pre to post-interview.
Conclusions: Based on the preliminary results, this curriculum is an effective tool for educating students on buprenorphine and opioid use disorder. The addition of a standardized patient component pre and post curriculum allows the students an opportunity to better demonstrate an increase in competencies and clinical skill in a more true to life situation.
Objective: We completed a needs and preference analysis of primary care providers to guide development of a live remote (offsite) Standardized Patient experience that would be used for skills training. We specifically wanted to understand enthusiasm for the concept of remote (Internet-based) SP-based learning that would occur via live chat or
other real-time communication technology. We also sought preferences regarding such an experience, so the experience could be designed efficiently and be consistent with the target audience s wishes. We specifically sought input regarding an SP experience involving interviewing skills related to recognizing addiction and the risk of potential misuse of controlled substances.
Method: We performed online surveys of convenience samples of 3 groups of practicing physicians (total n=27), residents (n=9), nurse practitioners (n=9), and addiction specialist physicians (n=8) regarding their preference in terms of a remote Standardized Patient experience. Total number of respondents surveyed was 53.
Results or Conclusions: Enthusiasm for learning via a live remote SP experience was strong and consistent across different experience levels of physicians as well as for nurse practitioners. In all groups, 77% or more of respondents expressed willingness to take an online continuation education course or earn CME credits based on a remote Standardized Patient experience. The majority of respondents (50-85%) preferred that Internet-based text chat be used for the remote experience instead of video, telephone, or an asynchronous bboard. Most (55 to 78%) preferred to be able to use a specific time window for the experience compared to setting aside a specific time. The majority also expressed a willingness to be observed by other learners and to observe other learners themselves (50 to 77%). Further investigation of this aspect of live remote SP learning is warranted, since respondents were interested having or serving as an observer. Health care providers are interested and willing to utilize a remote SP experience for clinical skills training. Their needs and preferences can be accommodated efficiently.
Introduction: With funding from a grant from NIH/NIAAA (#1R44AA016724-01A1), we created an online medical student curriculum on alcohol abuse. To assess mastery of clinical concepts, we developed a novel method of conducting remote live standardized patient interviews using Google chat, where a trained staff member is the SP. In advance of a summative evaluation in Spring 2010, we conducted a pilot test to assess utility of the case and gather student feedback.
Project Description/Methods: We developed a standardized patient case, Cynthia Stewart, who presents with insomnia and is diagnosed with alcohol abuse. Five third year students interviewed Cynthia during a 45 minute Google chat. Students completed the online courses, then performed a second SP interview. Clinical skill competency was measured using a 13 item done/not done checklist completed by both the SP and an independent reviewer. Interpersonal skills were evaluated by the SP using a 9-item checklist and a 5 point Likert scale. Student self-assessment, assessment of the SP by the student, and patient notes were also collected.
Outcomes: Clinical skill competency rose modestly from pre-test (64%) to post-test (77%). Interpersonal skills rose modestly from pre-test (2.65) to post-test (3.22). Student self-assessment of interpersonal skills were much higher (4.03 pre and 4.11 post) than those assessed by the SP. Students had a favorable view of the SP performance (3.90 post experience). All students correctly identified alcohol abuse on the patient notes.
Students were asked usability questions about the standardized patient experience. Eighty percent (4/5) agreed or strongly agreed that the interviewing process was a valuable learning experience, that the SP interviews were consistent pre/post experience, and that the patient case was typical of a real patient. All students (n=5) agreed or strongly agreed that the SP interview via Google chat was an interesting way to practice clinical skills. Students provided open-ended feedback on ways to increase the difficulty of the SP case.
Conclusions: Students were able to improve clinical skills through a chat-based SP interview. The data allows the development team to refine the patient case and conduct a more thorough evaluation with a larger n.