Effective continuing medical education (CME) about substance use disorders and treatment can improve physicians' knowledge of the topic and confidence in intervening, which may lead to positive outcomes for patients. With funding from the NIDA and the NIAAA, we have developed and evaluated two Internet-based substance abuse CME programs: one program featuring 12 courses about opioid dependence and buprenorphine treatment (BuprenorphineCME.com), and the other featuring five courses about alcohol abuse and treatment (AlcoholCME.com). Approximately 2000 participants viewed online courses over the past two years and completed a knowledge test, a satisfaction survey, and a self-efficacy, attitude, and intended behavior questionnaire. Preliminary analysis of this data indicates that the educational experience has a statistically significant impact on self-efficacy, attitude, and intended behavior. Also, results show that the CME courses improve knowledge of the topic and that satisfaction with the courses is consistently high (as of 9/15/05, the overall mean satisfaction rating for courses on both sites was 4.5/5.0). An additional upcoming analysis will examine the impact of each entire program on the outcome measures; we will report these findings during the conference presentation. This type of comprehensive evaluation is novel in the world of online CME. We are optimistic that this research will yield useful information about the most effective approach for educating health professionals about substance abuse.

Medical students need to understand the role of practicing physicians in substance abuse treatment. In addition they may not be aware of complicated multi-disciplinary treatment issues, the biological and social basis of addictions, and how new treatments are developed then moved into practice. The topic of detection and treatment of opioid addiction is an excellent one to teach these basic skills and convey essential knowledge. By teaching medical students we can impact future physicians before potential negative attitudes regarding substance dependence have developed or solidified.

With research funding from NIDA/NIH, we are developing outlines for a suite of online educational modules addressing these issues. Curriculum development included medical school professionals and substance abuse experts. The prototype module, "Prevalence, Trends and Impact on Health: Opioid Addiction" was pilot tested with 22 medical students in their 2nd through 4th years of study. Pre/post-assessments of knowledge, attitudes, self-efficacy, and intended behavior showed significant increases following completion of the module. Satisfaction with the module was high and there was an interest in learning more about substance abuse. During the coming year (2008), we will perform a large-scale evaluation of the project using an innovative virtual standardized patient. As the need for physicians to recognize and treat addiction disorders grows, these online modules hold promise for integrating the necessary knowledge, skills, and attitudes into the medical school curriculum.

Survey notes:
Primary care physicians have indicated they are very interested in and likely to use a web based SP. Also in POC. Undereducated on Brief Treatment. Indicated that referrel resources as well as adolescent education is important on a website.

Abstract potential...
Primary care physicians are undereducated on and lack resources to correctly administer the Screening, Brief Intervention, Brief Treatment, and Referral to Treatment [SBIRT] protocol. The goal of this new project is to establish a solution beyond education and attitude change; our goal is to effect clinical skills and measure that effect. Specifically, we plan to demonstrate the ability of web-based training to effect the ability of primary care physicians (PCPs) to screen, intervene with, and refer patients who have substance use disorders. We propose the novel approach of utilizing a web-based standardized patient (SP) interviewing system to effectively deliver skills training. Preliminary study results indicate that PCPs are very interested in learning through web-based SPs and report that they would be very likely to engage in such an experience. Our educational materials will be enhanced with case-based education, interactive how-to guides, and an extensive resource section including a referral database and downloadable practice materials. Phase I will complete a needs assessment with PCPs to determine what novel resources are needed and interest in inclusion of other drugs of abuse. Phase I will also complete a needs assessment with addiction experts to fully understand their perception of PCP needs. Based on those result, with expert consultation, we will outline a curriculum.

Introduction: To deliver buprenorphine training to a larger number of physicians, we developed an Internet-based buprenorphine training program consisting of 12 online continuing medical education (CME) modules organized into 8 hours of learning. Education could be completed in any order and at the learner's convenience. In total, 1180 learners completed the program between April 2007 and April 2009; 95% were physicians.

Methodology: For each course, learners completed pre- and post-test measures on knowledge about substance abuse and treatment, attitudes toward treating addiction, intended behavior toward addicted patients, self-efficacy in understanding and treating addiction, and satisfaction with the learning experience. For analysis purposes, knowledge post-tests recorded only the learners' first answers to each question. The data reported here was collected from April - October 2008 (n=243).

Results: Data analysis revealed that the mean scores increased from the pre- to post-test in 12/12 courses for all outcomes measured: knowledge, attitude, intended behavior, and self-efficacy (p< .0001 for each outcome). Of learners who completed the optional post-training satisfaction survey (n= 243), 89.7% agreed/strongly agreed that the training program was a valuable learning experience and 95% said that they had colleagues who could benefit from the program. Convenience, organization, and availability of the online program were strong assets.

Conclusion: Online training on buprenphine is well received and effective. The value of online training to other topics and for alternative audiences should be studied further.

Disclaimer/Funding: The training program was developed with funding from NIDA (#R44DA12066) and is supported by ASAM as a DATA-qualifying buprenorphine training program.