A national survey of training in substance use disorders in residency programs.

Isaacson, J. Harry; Fleming, Michael P.; Kraus, Michael; Kahn, Ruth; Mundt, Marlon

doi:10.15288/jsa.2000.61.912

Cited by 107 publications

(99 citation statements)

References 14 publications

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“…Third, training in substance abuse and pain management is lacking in medical school and residency, and the subtleties of UDT interpretation are omitted from standard curricula. [35][36][37][38][39][40] Physician overconfidence can lead to diagnostic errors, 32 in this case leading to either under-diagnosis or over-diagnosis of abuse or diversion, with potentially negative consequences for patients. 18 One way overconfidence can cause diagnostic error is through premature closure, for example, concluding without further investigation that an opiate-positive urine drug screen reflects a patient's prescribed oxycodone use.…”

Section: Discussionmentioning

confidence: 99%

They Don’t Know What They Don’t Know: Internal Medicine Residents’ Knowledge and Confidence in Urine Drug Test Interpretation for Patients with Chronic Pain

et al. 2012

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BACKGROUND: Urine drug testing (UDT) can help identify misuse or diversion of opioid medications among patients with chronic pain. However, misinterpreting results can lead to false reassurance or erroneous conclusions about drug use. OBJECTIVE: To examine the relationship between resident physicians' knowledge about UDT interpretation and confidence in their ability to interpret UDT results. DESIGN: Cross-sectional survey. PARTICIPANTS: Internal medicine residents in a university health system in the Bronx, from 2010 to 2011. MAIN MEASURES:We assessed knowledge using a 7-item scale (UDT knowledge score), and confidence in UDT interpretation using a single statement ("I feel confident in my ability to interpret the results of urine drug tests"). We conducted chi-square tests, t-tests, and logistic regression to determine the association between knowledge and confidence, and in exploratory analyses to examine whether resident characteristics (gender, training level, and UDT use) moderated the relationship between knowledge and confidence. KEY RESULTS: Among 99 residents, the mean UDT knowledge score was 3.0 out of 7 (SD 1.2). Although 55 (56 %) of residents felt confident in their ability to interpret UDT results, 40 (73 %) of confident residents had a knowledge score of 3 or lower. Knowledge score was not associated with confidence among the full sample or when stratified by training level or UDT use. The association between knowledge and confidence differed significantly by gender (interaction term p< 0.01). Adjusting for training level and UDT use, knowledge was positively associated with confidence among females (AOR 1.79, 95 % CI: 1.06, 3.30), and negatively associated with confidence among males (AOR 0.47, 95 % CI: 0.23, 0.98). CONCLUSIONS: Despite poor knowledge about UDT interpretation, most resident physicians felt confident in their ability to interpret UDT results. Gender differences warrant further exploration, but even confident physicians who use UDT should evaluate their proficiency in interpreting UDT results. Educational initiatives should emphasize the complexities of UDT interpretation.KEY WORDS: urine drug testing; chronic pain; opioid medications; physician self-assessment.

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Section: Discussionmentioning

confidence: 99%

They Don’t Know What They Don’t Know: Internal Medicine Residents’ Knowledge and Confidence in Urine Drug Test Interpretation for Patients with Chronic Pain

et al. 2012

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“…16,20,28 Inadequate substance abuse education has been documented both at the undergraduate and graduate medical education levels. [29][30][31][32] For example, in 1991-92 only eight U.S. medical schools had required courses in substance abuse treatment. 33 Furthermore, education and training interventions focusing on management of opioid addiction have been associated with improved ratings of confidence in opioid addiction treatment, and increased likelihood of treating opioid addiction with pharmacologic therapy.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Obtaining Waivers to Prescribe Buprenorphine for Opioid Addiction Treatment Among HIV Physicians

et al. 2007

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“…Researchers have highlighted the role of medical education in ensuring that doctors become competent in managing patients with substance abuse. However, some studies have shown that the integration of training in substance abuse management into medical curricula is suboptimal (19,20), leaving physicians unprepared to address these issues in patient care (21). Therefore, measuring students' knowledge and attitudes towards substance use reflects how well medical schools prepare them to address this problem in practice.…”

Section: Introductionmentioning

confidence: 99%

Medical students' knowledge, attitudes and behaviours related to substance use in Lebanon: a cross-sectional study

Assaf¹,

Noureddine²,

Kouyoumdjian³

et al. 2017

East Mediterr Health J

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Connaissances, attitudes et comportements des étudiants en médecine en matière de consommation de substances psychoactives au Liban : étude transversaleRÉSUMÉ La présente étude vise à explorer les connaissances, les attitudes et les comportements des étudiants en médecine libanais en matière de consommation de substances psychoactives, ainsi qu'à déterminer leur prévalence et les prédicteurs psychosociaux. Une étude transversale auprès de 231 étudiants en médecine (48,6 % de sexe masculin ; 53,1 % en études précliniques, 46,9 % en études cliniques) a été conduite de juin 2012 à juillet 2013. Le questionnaire abordait les connaissances et les attitudes en matière de consommation de substances, la religiosité, la dépression, l'anxiété et les caractéristiques démographiques. Le score des connaissances était de 52,7 % (ET = 14,4 %), et était significativement moins élevé en deuxième qu'en troisième et quatrième années (48,53 % contre 57,51 % et 57,4 %, p < 0,05 ABSTRACT The study aims were to explore the knowledge, attitudes and behaviours of Lebanese medical students related to substance use and to determine prevalence and psychosocial predictors. A cross-sectional survey of 231 medical students (48.6% male; 53.1% preclinical, 46.9% clinical) was conducted during June 2012-July 2013. The questionnaire addressed knowledge and attitudes about substance use, religiosity, depression, anxiety and demographic characteristics. The knowledge score was 52.7% (standard deviation 14.4%), and was significantly lower in 2nd year students (48.53%) than in 3rd and 4th year students (57.5% and 57.4%) (P < 0.05). Students reported more training in drug abuse than alcohol abuse (38.2% vs. 34.4%). One-fourth reported smoking, 57.7% using alcohol and 46.8% using drugs. Significant predictors of lower substance use included intrinsic religiosity and interest in working in the field. The findings reveal inadequate knowledge and considerable substance use in Lebanese medical students. Therefore, training in substance use and counseling of students are necessary.

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A national survey of training in substance use disorders in residency programs.

Cited by 107 publications

References 14 publications

They Don’t Know What They Don’t Know: Internal Medicine Residents’ Knowledge and Confidence in Urine Drug Test Interpretation for Patients with Chronic Pain

They Don’t Know What They Don’t Know: Internal Medicine Residents’ Knowledge and Confidence in Urine Drug Test Interpretation for Patients with Chronic Pain

Barriers to Obtaining Waivers to Prescribe Buprenorphine for Opioid Addiction Treatment Among HIV Physicians

Medical students' knowledge, attitudes and behaviours related to substance use in Lebanon: a cross-sectional study

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