Associate Professor of Clinical Medicine, Department of Medicine, University of Miami Leonard M. Miller School of Medicine.
First-Year Resident, Department of Medicine, University of Miami Leonard M. Miller School of Medicine.
MedEdPORTAL. 2022 May 24;18:11248. doi: 10.15766/mep_2374-8265.11248. eCollection 2022.
The overdose crisis remains a critical public health problem, creating an urgent need to train physicians in the treatment and management of opioid use disorder (OUD). Our medicine clerkship module aimed to close this gap by training and assessing students' motivational interviewing skills, harm reduction knowledge, and use of nonstigmatizing language in the treatment of patients with OUD.
We evaluated the impact of a small-group, case-based activity and patient panel on the clinical documentation skills of students in a medicine clerkship. Clinical documentation was based on an observed structured clinical examination of a standardized patient with OUD and was evaluated using a grading rubric that followed the module learning objectives. Students also submitted reflections on the curriculum.
Qualitative responses ( = 40) from students evaluating the small-group activity and patient panel exercise revealed overall student satisfaction with the patient panel and exposure to patients living with OUD. Three themes emerged from student reflections: (1) humanity, (2) different paths to recovery, and (3) using nonstigmatizing language. For the quantitative test, students' ( = 39) mean clinical documentation scores before and after the small-group activity and patient panel increased from 10.1 to 11.3 out of 13.5 possible points. There was a significant difference between mean pretest and posttest scores ( < .001).
The medicine clerkship provided an acceptable and feasible opportunity for implementing a multifaceted educational experience for students with significant immediate impact on their evaluation of patients with OUD.
药物过量危机仍是一个严重的公共卫生问题，因此急需培训医生治疗和管理阿片类药物使用障碍（OUD）。我们的医学实习课程旨在通过培训和评估学生的动机性访谈技能、减少伤害知识以及在治疗 OUD 患者时使用非污名化语言来填补这一空白。
我们评估了基于小组的案例活动和患者小组对医学实习学生临床记录技能的影响。临床记录基于对一名患有 OUD 的标准化患者的观察性结构化临床检查，并使用遵循模块学习目标的评分标准进行评估。学生还提交了对课程的反馈。
对小组成果和患者小组练习进行评估的学生的定性反馈（n=40）表明，学生对患者小组和接触患有 OUD 的患者总体上感到满意。学生反思中出现了三个主题：（1）人性，（2）不同的康复途径，（3）使用非污名化语言。在定量测试中，学生（n=39）在小组活动和患者小组之后的临床记录平均分数从 13.5 分中的 10.1 分提高到 11.3 分。前后测分数之间存在显著差异（p<0.001）。
医学实习为学生提供了一个可接受且可行的机会，让他们获得多方面的教育体验，对他们评估 OUD 患者的能力产生了直接影响。
