<p>Medical Student Attitudes Toward Substance Use Disorders Before and After a Skills-Based Screening, Brief Intervention, and Referral to Treatment (SBIRT) Curriculum</p>

Abstract

Purpose: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidencebased framework for assessing and addressing risky substance use. This study evaluated the substance-related attitudes of medical students who participated in an Enhanced Pre-Clinical SBIRT Curriculum designed to reduce stigma, help students empathize with the experiences of people using alcohol and drugs, understand substance use in-context, and feel more optimistic about efforts to prevent and treat substance use disorders (SUDs). Methods: Students (N=118; 73.8% of eligible) completed the Attitudes and Opinions Survey for alcohol and drugs before and after this 2-year, multi-modality curriculum. The authors classified attitudes as "positive" or "negative" and grouped students by pre-post attitudinal change: persistently negative, persistently positive, negative-to-positive, positive-to-negative. Using chi-square tests, the authors assessed differences by sex, race/ethnicity, and whether students had a family member or friend with an SUD. Results: Most students (>90%) reported persistently positive attitudes regarding physicians in recovery, societal contributions of patients with SUDs; ability to learn from such patients; and general attitudes toward SUD treatment. This skewed distribution precluded the investigation of subgroup differences. Fewer students reported persistently positive attitudes regarding SUD patients' healthcare utilization (alcohol 58.5%; drug 57.8%) and impact on other patients' care (alcohol 73.7%; drug 72.4%), compared to other attitudinal domains (at p-values < 0.0001 in the McNemar's tests). Approximately, 1 in 5 students reported more negative healthcare utilization attitudes on follow-up. There were no demographic differences in these two attitudinal domains. Conclusion: Unlike previous studies of medical student attitudes, most students who participated in the Enhanced Pre-Clinical SBIRT Curriculum reported an enduring appreciation for the educational and societal contributions of patients with SUDs. Attitudes toward healthcare utilization and the impact of patients with SUDs on the care of other patients were more resistant to change, possibly due to the predominance of acute-care inpatient settings in clinical training.

Exploratory Factor Analysis of a French Adapted Version of the Substance Abuse Attitude Survey among Medical Students in Belgium

“…The informal and hidden curricula play a key role in the transmission of attitudes and values [ 24 ]. This is consistent with the study of Kidd et al in 2020 [ 25 ], which justified the fact that students tended to adopt more negative attitudes towards SUD people over time by the potential impact of the “hidden curriculum” through which students internalize the “negative” attitudes of their supervisors. The hidden curriculum includes “ a set of values, behavioral norms, attitudes, skills, and knowledge that medical students learn implicitly ” [ 26 ].…”

Attitudes Toward Organ Donation for Persons Who Have a Substance Use Disorder Relative to Other Health Conditions

“…This is a positive outcome, because it suggests that efforts to reduce stigma toward a health condition could be effective ( 17 , 30 , 31 ), particularly in healthcare settings ( 17 , 25 , 32 ). Short Brief Intervention and Training (SBIRT) programs with healthcare providers have also been shown to produce enduring reductions in stigma toward persons who have a SUD ( 33 , 34 ). SBIRT interventions may be optimal for medical settings because their short time commitment increases feasibility of delivery ( 35 ).…”

Using SBIRT (Screen, Brief Intervention, and Referral Treatment) Training to Reduce the Stigmatization of Substance Use Disorders Among Students and Practitioners

“…Studies have found mixed results on the impact of SBIRT on students’ attitudes, ranging from negligible effects 24 , 25 to small-to-moderate improvements in attitudes. 12 , 26 - 28 Recently, a growing number of academicians and practitioners have developed and evaluated studies that used an interprofessional education approach to deliver SBIRT. These studies have found improvements in attitudes toward SUD across multidisciplinary samples.…”