There is a lack of standardized education on topic of harm reduction for graduate medical students. In order to fill this curricular gap, we delivered a two-hour pilot training introducing local community harm reduction organizations and harm reduction ideology and strategies for people who inject drugs to graduate medical students at Boston University. We used pre-post survey design to evaluate attendee demographic characteristics and training efficacy. We matched 29 attendees responses, 69% were first and second year medical students, and found that our training positively reinforced comfort and knowledge surrounding harm reduction ideology, safer injection techniques, and naloxone administration. Delivering trainings covering harm reduction early in graduate medical schools may be beneficial in giving students initial exposure to practical risk mitigation tools they can utilize later in their clinical careers.
Background: Front-line providers working with people who inject drugs (PWID) are at increased risk of experiencing burnout. Few studies have examined protective factors against burnout incurred in the care of PWID, including harm reduction counseling skills. We measured self-efficacy in harm reduction counseling, burnout, and compassion satisfaction among Internal Medicine (IM) trainees caring for PWID. Methods: In this cross-sectional study, we surveyed IM interns and residents. Self-efficacy was assessed by asking trainees about attitudes, comfort, and knowledge in harm reduction counseling on a five-point Likert scale. Burnout and compassion satisfaction were assessed via an adapted 20-question Professional Quality of Life Scale. We compared self-efficacy in harm reduction counseling, compassion satisfaction, and burnout between interns and residents using ANOVA and Mann-Whitney U tests. We used Spearman's rho correlational analysis to examine the relationship between these three variables. Results: Seventy-nine IM trainees (36 interns, 43 residents) completed the survey for a 52% response rate. Residents reported higher self-efficacy in harm reduction counseling, similar levels of burnout, and higher compassion satisfaction compared to interns. Across training levels, we found a negative correlation between burnout and compassion satisfaction (r ¼ À0.55, p < 0.01) and a positive correlation between compassion satisfaction and comfort counseling PWID on harm reduction (r ¼ 0.30, p < 0.01). Conclusions: Among IM trainees at an urban institution serving a large population of PWID, self-efficacy in harm reduction counseling and compassion satisfaction increase with time in training while burnout remains similar. Strengthening trainees' capacity to counsel PWID on harm reduction may improve their compassion satisfaction in caring for this population, potentially leading to improved care. This relationship should be explored longitudinally in larger cohorts and through evaluations of harm reduction-focused medical education.
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