Developing and Implementing a Multispecialty Graduate Medical Education Curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Abstract

The authors sought to evaluate the feasibility and acceptability of initiating a Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and other drug use curriculum across multiple residency programs. SBIRT project faculty in the internal medicine (traditional, primary care internal medicine, medicine/pediatrics), psychiatry, obstetrics and gynecology, emergency medicine, and pediatrics programs were trained in performing and teaching SBIRT. The SBIRT project faculty trained the residents in their respective disciplines, accommodating discipline-specific implementation issues and developed a SBIRT training Web site. Post-training, residents were observed performing SBIRT with a standardized patient. Measurements included number of residents trained, performance of SBIRT in clinical practice, and training satisfaction. One hundred and ninety-nine residents were trained in SBIRT: 98 internal medicine, 35 psychiatry, 18 obstetrics and gynecology, 21 emergency medicine, and 27 pediatrics residents. To date, 338 self-reported SBIRT clinical encounters have occurred. Of the 196 satisfaction surveys completed, the mean satisfaction score for the training was 1.60 (1 = very satisfied to 5 = very dissatisfied). Standardized patient sessions with SBIRT project faculty supervision were the most positive aspect of the training and length of training was a noted weakness. Implementation of a graduate medical education SBIRT curriculum in a multispecialty format is feasible and acceptable. Future efforts focusing on evaluation of resident SBIRT performance and sustainability of SBIRT are needed.

Screening, Brief Intervention, Referral to Treatment (SBIRT), and Motivational Interviewing for PGY-1 Medical Residents

“…32,33 Residents' satisfaction with SBIRT/MI training is important. 34,35 Although prior research implies that shorter MI trainings may produce higher levels of resident satisfaction, 16,23 our results indicate generally high levels of satisfaction with both trainings, while highlighting differences in satisfaction between the trainings. However, it is unclear which variables contributed to the variance between training types, which differed for residency program, race, prior experience with SBIRT, length, and structure, when the trainer and core curriculum were held constant.…”

“…Residents were from 3 separate medical specialties. Although SBIRT trainings have been tested in EM, 36 IM, 16 and PEDS programs with similar results, residents from each specialty may have interpreted the survey differently. Further, because all residents were from a single site, these results may not be generalizable.…”

“…15 One possible cause of this resistance may be residents' intensive workload and work hour restrictions. [16][17][18] Most counseling curricula for medical students and residents involve less than 8 hours of training. 19 Further, many recent MI trainings for medical residents have Funding: The authors report no external funding source for this study.…”

Factors Influencing Smoking Cessation Counselling: A Qualitative Study of Medical Residents

“…Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to early intervention and treatment services through universal screening for persons with substance use disorders and those at risk (Babor et al, 2007;Madras et al, 2009). The addition of SBIRT training to residency programme has been shown to greatly improve counselling skills and confidence in these skills (Tetrault et al, 2011). It has also been demonstrated that knowledge and confidence in working with patients for promoting smoking cessation as well as other behavioural change can be improved by brief (1-2 hour) training sessions, including brief web-based intervention (Pederson, Blumenthal, Dever, & McGrady, 2006;Roman, Borges, & Morrison, 2011).…”

A Scoping Review of Interdisciplinary Collaboration in Addictions Education and Training

“…For example, related concepts such as ''interprofessional education'' and ''interdisciplinary collaboration'' were often conflated, with limited conceptual clarity between the two (Oandasan & Reeves, 2005;Reeves et al, 2011). In addition, several addictions education initiatives were deemed ''multispecialty,'' which referred to the involvement of more than one subspecialization within medicine (e.g., family medicine, obstetrics/gynecology, psychiatry; Rasyidi et al, 2012;Tetrault et al, 2012). Although these initiatives do not take the conventional definition of ''interdisciplinary,'' we included these articles because of their clear intent to train a wide range of providers in addiction and because many physicians consider these initiatives ''interdisciplinary'' (Grant, Finocchio, & Pew Health Professions Commission, 1995).…”