Robbins Jonathan L, Bonuck Kathryn, Thuillier Philippe, Buist Catriona, Carney Patricia A
Internal Medicine, Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
Subst Abus. 2022;43(1):825-833. doi: 10.1080/08897077.2021.2010260.
Addressing the opioid crisis requires an understanding of how to train both health professional students and practicing clinicians on medications for opioid use disorder (mOUD). We designed a robust evaluation instrument to assess the impact of training on perceived clinical knowledge in these different categories of learners. We enrolled 3rd and 4th year medical, physician assistant (PA), and nurse practitioner (NP) students, as well as practicing PAs, NPs, and physicians to undertake the Drug Addiction Treatment Act (DATA) Waiver Training for mOUD. We designed and implemented a cross-sectional survey to assess perceived change in clinical knowledge as a result of training in opioid use disorder and satisfaction with training. Twenty-one MD/DO and 45 NP/PA students, and 24 practicing MD/DO and 27 NP/PAs completed the survey. Among health professional students ( = 66) and practicing clinicians ( =51), perceived clinical knowledge scores increased significantly ( < 0.001) for all 13 variables. Program evaluation scores for the buprenorphine waiver training were high with no statistical differences between students and practicing clinicians. Overall, the majority of participants indicated they would recommend the training to a colleague (Students' score = 4.84; practicing clinician scores = 4.53; scale = strongly disagree = 1 to strongly agree = 5). Our novel instrument allowed us to determine that the implementation of buprenorphine waiver trainings for health professional students and practicing clinicians leads to significant increases in perceived knowledge, interest and confidence in diagnosing and treating OUD. Although the buprenorphine waiver can now be obtained without training, many waivered providers still do not prescribe buprenorphine; integrating training into medical, NP, and PA curriculum for students and offering the training to practicing clinicians may increase confidence and uptake of mOUD.
应对阿片类药物危机需要了解如何对健康专业学生和执业临床医生进行阿片类药物使用障碍（mOUD）药物方面的培训。我们设计了一个强大的评估工具，以评估培训对这些不同类别学习者的临床知识认知的影响。我们招募了医学专业三、四年级学生、医师助理（PA）和执业护士（NP）学生，以及执业医师助理、执业护士和医生，参加针对mOUD的《药物成瘾治疗法案》（DATA）豁免培训。我们设计并实施了一项横断面调查，以评估因阿片类药物使用障碍培训导致的临床知识认知变化以及对培训的满意度。21名医学博士/医学博士（MD/DO）和45名执业护士/医师助理（NP/PA）学生，以及24名执业医学博士/医学博士和27名执业护士/医师助理完成了调查。在健康专业学生（n = 66）和执业临床医生（n = 51）中，所有13个变量的临床知识认知得分均显著提高（P < 0.001）。丁丙诺啡豁免培训的项目评估得分很高，学生和执业临床医生之间没有统计学差异。总体而言，大多数参与者表示他们会向同事推荐该培训（学生得分 = 4.84；执业临床医生得分 = 4.53；量表范围 = 强烈不同意 = 1至强烈同意 = 5）。我们的新型工具使我们能够确定，为健康专业学生和执业临床医生实施丁丙诺啡豁免培训可显著提高对诊断和治疗阿片类药物使用障碍的知识认知、兴趣和信心。尽管现在无需培训即可获得丁丙诺啡豁免，但许多获得豁免的提供者仍然不开具丁丙诺啡；将培训纳入医学、执业护士和医师助理专业学生的课程，并为执业临床医生提供培训，可能会增加对mOUD的信心和使用。
