Fleming M F, Manwell L B, Kraus M, Isaacson J H, Kahn R, Stauffacher E A
University of Wisconisin-Madison Medical School, USA.
J Fam Pract. 1999 Sep;48(9):725-9.
Studies indicate that physicians are poorly prepared to identify and treat tobacco, alcohol, and drug use disorders. Several faculty development programs have been created to increase the number of residency teaching faculty with expertise in this area. There is limited information, however, on those who currently teach residents about these problems and whether there is a need for additional faculty development programs.
We conducted a 2-stage national survey of faculty who teach residents about substance use problems. First, residency directors from 7 specialties (family medicine, psychiatry, internal medicine, pediatrics, obstetrics and gynecology, emergency medicine, and osteopathy) responded to a mailed questionnaire asking them to identify faculty who teach residents about substance use disorders. Second, those identified were contacted and asked to participate in a telephone interview.
Of 1293 faculty identified by the residency directors, 769 participated in a research interview. Most of these teachers were full-time physician faculty, men, white, and based in departments of family medicine or psychiatry. Teaching was primarily conducted in hospitals, general outpatient clinics, and classrooms rather than alcohol and drug treatment programs. Less than 10% of the faculty performed clinical work in alcohol and drug treatment programs, and only 19% were certified addiction specialists. The respondents reported a definite need for additional development programs for themselves and other residency teaching faculty.
We suggest a modest increase in the number of faculty who teach residents about substance abuse disorders, and the creation of additional faculty development programs.
研究表明，医生在识别和治疗烟草、酒精及药物使用障碍方面准备不足。已经设立了几个教员发展项目，以增加在该领域有专业知识的住院医师带教教员的数量。然而，关于目前向住院医师讲授这些问题的教员以及是否需要额外的教员发展项目的信息有限。
我们对向住院医师讲授物质使用问题的教员进行了一项两阶段的全国性调查。首先，来自7个专业（家庭医学、精神病学、内科、儿科、妇产科、急诊医学和整骨疗法）的住院医师主任回复了一份邮寄问卷，要求他们指出向住院医师讲授物质使用障碍的教员。其次，与那些被指出的教员取得联系并邀请他们参加电话访谈。
在住院医师主任指出的1293名教员中，769名参加了研究访谈。这些教师大多是全职医生教员，男性，白人，就职于家庭医学或精神病学系。教学主要在医院、普通门诊诊所和教室进行，而不是在酒精和药物治疗项目中。不到10%的教员在酒精和药物治疗项目中从事临床工作，只有19%是认证成瘾专家。受访者表示他们自己和其他住院医师带教教员确实需要额外的发展项目。
我们建议适度增加向住院医师讲授物质滥用障碍的教员数量，并设立更多的教员发展项目。
