National Clinician Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Psychiatry, Center for Mental Health, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
J Am Assoc Nurse Pract. 2023 Dec 1;35(12):826-834. doi: 10.1097/JXX.0000000000000949.
The lack of clinicians comfortable prescribing buprenorphine is a barrier to access for people with opioid use disorder (OUD). Accordingly, a telehealth OUD treatment clinic, Ophelia, launched a clinical training program for nurse practitioner (NP) students. The goal of this study was to assess a telehealth-based model of OUD clinical training. To evaluate the program, we (1) identified students' knowledge related to providing OUD care to patients before and after their clinical rotation with Ophelia and (2) characterized students' attitudes about providing OUD care following their clinical rotation with Ophelia. Online pre- and postsurveys were conducted with 57 and 29 students, respectively, and semistructured interviews were conducted with 19 students who completed clinical rotations with Ophelia. We used quantitative descriptive analysis to compare presurvey and postsurvey results and conducted thematic analysis to analyze qualitative interview data. We identified three themes from the interviews: the continuum of learning opportunities, the comfort providing OUD treatment following participants' clinical rotation, and the relevance of a substance use disorder clinical rotation for all NP students. The survey also supported these findings. Of note, there were descriptive differences between presurvey and postsurvey responses related to an increase in knowledge, preparedness, and acquisition of skills to treat OUD. Using a telehealth clinical rotation for NP students to learn about OUD treatment may represent an important step in increasing the number of clinicians who can prescribe buprenorphine. These findings can inform interventions and policies that target clinician training barriers.
缺乏能够开处丁丙诺啡处方的临床医生是阿片类药物使用障碍(OUD)患者获得治疗的障碍。因此,一家名为 Ophelia 的远程 OUD 治疗诊所为护士从业者(NP)学生启动了一项临床培训计划。本研究的目的是评估一种基于远程医疗的 OUD 临床培训模式。为了评估该计划,我们(1)确定了学生在与 Ophelia 进行临床轮转前后与为患者提供 OUD 护理相关的知识,(2)描述了学生在与 Ophelia 进行临床轮转后提供 OUD 护理的态度。分别对 57 名和 29 名学生进行了在线预调查和后调查,并对完成 Ophelia 临床轮转的 19 名学生进行了半结构化访谈。我们使用定量描述性分析来比较预调查和后调查的结果,并对定性访谈数据进行了主题分析。我们从访谈中确定了三个主题:学习机会的连续性、参与者临床轮转后提供 OUD 治疗的舒适度以及物质使用障碍临床轮转对所有 NP 学生的相关性。调查也支持了这些发现。值得注意的是,与知识、准备和获得治疗 OUD 技能的增加相关的预调查和后调查反应之间存在描述性差异。对 NP 学生使用远程医疗临床轮转来学习 OUD 治疗可能代表增加能够开处丁丙诺啡处方的临床医生数量的重要步骤。这些发现可以为针对临床医生培训障碍的干预措施和政策提供信息。