Gano Laura, Renshaw Scott E, Hernandez Ruben H, Cronholm Peter F
Department of Family Medicine, Indiana University, Indianapolis, IN.
Department of Family and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA.
Fam Med. 2018 Oct;50(9):698-701. doi: 10.22454/FamMed.2018.757385.
The national opioid crisis requires medical education to develop a proactive response centering on prevention and treatment. Primary care providers (PCPs)-many of whom are family medicine physicians-commonly treat patients on opiates, and write nearly 50% of opioid prescriptions. Despite linkages between PCP opioid prescribing patterns and the associated potential for overdose, little is known about how family medicine clerkship students are trained to prevent opioid overdose, including training on the use of naloxone. This study describes the presence of opioid overdose education at the national level and barriers to inclusion. It also discusses implementation strategies along with instructional methodology and learner evaluation.
Data were collected as part of a cross-sectional survey administered electronically by the Council of Academic Family Medicine Educational Research Alliance to 139 family medicine clerkship directors.
A total of 99 clerkship directors (71.2% response rate) responded to the survey. A large majority (86.4%) agreed that it is important to offer opioid overdose prevention education in the clerkship, yet only 25.8% include this topic. Of these, only 50.0% address naloxone use. The most common barriers to including opioid overdose prevention education were prioritization of educational topics (82.1%) followed by lack of available faculty with sufficient experience/expertise (67.7%).
Findings point to a disparity between perceived importance of opioid overdose prevention education and inclusion of this topic in family medicine clerkship-level medical education. Innovative use of online education and partnering with community resources may address barriers related to curricular prioritization while supporting interprofessional education principles.
全国性的阿片类药物危机要求医学教育制定以预防和治疗为核心的积极应对措施。初级保健提供者（其中许多是家庭医学医生）通常治疗使用阿片类药物的患者，并开具近50%的阿片类药物处方。尽管初级保健提供者的阿片类药物处方模式与相关的过量用药可能性之间存在联系，但对于家庭医学实习学生如何接受预防阿片类药物过量的培训，包括纳洛酮使用培训，了解甚少。本研究描述了全国层面阿片类药物过量教育的现状以及纳入该教育的障碍。它还讨论了实施策略以及教学方法和学习者评估。
数据收集是学术家庭医学教育研究联盟理事会以电子方式对139名家庭医学实习主任进行的横断面调查的一部分。
共有99名实习主任（回复率71.2%）回复了调查。绝大多数（86.4%）同意在实习中提供阿片类药物过量预防教育很重要，但只有25.8%纳入了该主题。其中，只有50.0%涉及纳洛酮的使用。纳入阿片类药物过量预防教育的最常见障碍是教育主题的优先级（82.1%），其次是缺乏有足够经验/专业知识的教员（67.7%）。
研究结果表明，在家庭医学实习层面的医学教育中，阿片类药物过量预防教育的认知重要性与该主题的纳入之间存在差距。创新地使用在线教育并与社区资源合作，可能在支持跨专业教育原则的同时，解决与课程优先级相关的障碍。
