Medicine Resident Preparedness to Diagnose and Treat Substance use Disorders: Impact of an Enhanced Curriculum

Wakeman, Sarah E.; Kanter, Genevieve P.; Baggett, Meridale V; Campbell, Eric G.

doi:10.1080/08897077.2014.962722

Cited by 27 publications

(24 citation statements)

References 18 publications

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“…Ratings of the quality of instruction have been related to perceptions of preparedness to provide treatment. An enhanced curriculum increased perceptions of preparedness to diagnose and treat and educational quality ratings (Wakeman, Pham-Kanter, Baggett & Campbell, 2014 ). Further research is required on the actual content and quality of the curricula offered in the different areas across universities.…”

Section: Discussionmentioning

confidence: 99%

New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

Singh

Booth²,

Choto³

et al. 2015

South African Journal of Communication Disorders

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BackgroundUpon graduation, newly qualified speech-language therapists are expected to provide services independently. This study describes new graduates’ perceptions of their preparedness to provide services across the scope of the profession and explores associations between perceptions of dysphagia theory and clinical learning curricula with preparedness for adult and paediatric dysphagia service delivery.MethodsNew graduates of six South African universities were recruited to participate in a survey by completing an electronic questionnaire exploring their perceptions of the dysphagia curricula and their preparedness to practise across the scope of the profession of speech-language therapy.ResultsEighty graduates participated in the study yielding a response rate of 63.49%. Participants perceived themselves to be well prepared in some areas (e.g. child language: 100%; articulation and phonology: 97.26%), but less prepared in other areas (e.g. adult dysphagia: 50.70%; paediatric dysarthria: 46.58%; paediatric dysphagia: 38.36%) and most unprepared to provide services requiring sign language (23.61%) and African languages (20.55%). There was a significant relationship between perceptions of adequate theory and clinical learning opportunities with assessment and management of dysphagia and perceptions of preparedness to provide dysphagia services.ConclusionThere is a need for review of existing curricula and consideration of developing a standard speech-language therapy curriculum across universities, particularly in service provision to a multilingual population, and in both the theory and clinical learning of the assessment and management of adult and paediatric dysphagia, to better equip graduates for practice.

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Section: Discussionmentioning

confidence: 99%

New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

Singh

Booth²,

Choto³

et al. 2015

South African Journal of Communication Disorders

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“…5,6 Despite high rates of opioid prescribing, the majority of primary care clinicians receive little or no training during medical school and residency in prescribing opioids or managing substance use disorders. [7][8][9] As a result, few primary care clinicians feel prepared to screen for, diagnose, and treat prescription medication misuse. [10][11][12][13][14] In recent years, a growing number of resources have been released to assist clinicians with managing opioid prescribing.…”

Section: Introductionmentioning

confidence: 99%

Chronic Opioid Prescribing in Primary Care: Factors and Perspectives

et al. 2019

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BACKGROUND Primary care clinicians write 45% of all opioid prescriptions in the United States, but little is known about the characteristics of patients who receive them and the clinicians who prescribe opioids in primary care settings. Our study aimed to describe the patient and clinician characteristics and clinicians' perspectives of chronic opioid prescribing in primary care.METHODS Using a mixed methods approach, we completed an analysis of 2016 electronic health records from 21 primary care practices to identify patients who had received chronic opioids, which we defined as in receipt of an opioid prescription for at least 3 consecutive months. We compared those receiving chronic opioids with those not in terms of their demographics, prescribing clinician characteristics, and risk factors for opioid-related harms, as identified by the Centers for Disease Control and Prevention Guideline on Opioid Prescribing for Chronic Pain. We then interviewed 16 primary care clinicians about their perspectives on chronic opioid prescribing. RESULTSOf 84,029 patients, 1.1% (902/84,929) received chronic opioid prescriptions. Characteristics associated with being prescribed chronic opioids include being female, being of black or African American race, and having risks for opioid-related harms, such as mental health diagnoses, substance use disorder, and concurrent benzodiazepine use. Clinicians report multiple difficulties in weaning patients from chronic opioids, including medical contraindications of nonopioid alternatives and difficulty justifying weaning by stable long-term patients.CONCLUSION Although patients prescribed opioids in primary care have higher risks of opioid-related harms, clinicians report multiple barriers in deprescribing chronic opioids. Future studies should examine strategies to mitigate these harms and engage patients in shared decision making about their chronic opioid use.

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“…The widespread integration of substance use disorder care and competencies into graduate medical education is needed [17] and few studies have reported on patient [10, 18–21] or provider outcomes [10, 22–24]. A recent review of graduate medical education models of OUD training found that only 29% of interventions included explicit training in providing medications for OUD (i.e.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of a novel office-based opioid treatment program in an internal medicine resident continuity practice

Pytell

Buresh

Graddy

2019

Addict Sci Clin Pract

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BackgroundThe integration of opioid use disorder (OUD) care and competencies in graduate medical education training is needed. Previous research shows improvements in knowledge, attitudes, and practices after exposure to OUD care. Few studies report outcomes for patients with OUD in resident physician continuity practices.MethodsA novel internal office-based opioid treatment (OBOT) program was initiated in a resident continuity clinic. Surveys of resident and staff knowledge and attitudes of OBOT were administered at baseline and 4 months. A retrospective chart review of the 15-month OBOT clinic obtained patient characteristics and outcomes.ResultsTwelve patients with OUD were seen in the OBOT clinic. Seven patients (58%) were retained in care at the end of the study period for a range of 9–15 months. Eight patients demonstrated a good clinical response. Surveys of residents and staff at 4 months were unchanged from baseline showing persistent lack of comfort in caring for patients with OUD.ConclusionsOBOT can be successfully integrated into resident continuity practices with positive patient outcomes. Improvement in resident and staff attitudes toward OBOT were not observed and likely require direct and frequent exposure to OUD care to increase acceptance.

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Medicine Resident Preparedness to Diagnose and Treat Substance use Disorders: Impact of an Enhanced Curriculum

Cited by 27 publications

References 18 publications

New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

Chronic Opioid Prescribing in Primary Care: Factors and Perspectives

Outcomes of a novel office-based opioid treatment program in an internal medicine resident continuity practice

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