Fockele Callan, Lindgren Elsa, Ferreira Jordan, Salehipour Dena, Shandro Jamie, Jauregui Joshua
Department of Emergency Medicine University of Washington School of Medicine Seattle Washington USA.
University of Washington School of Medicine Seattle Washington USA.
AEM Educ Train. 2024 May 18;8(3):e10989. doi: 10.1002/aet2.10989. eCollection 2024 Jun.
The impact of opioid use disorder (OUD) in the United States continues to rise, yet this topic has limited coverage in most medical school curricula. The study partnered with academic and community harm reductionists to design a peer-assisted learning case of opioid withdrawal to teach fourth-year medical students about trauma-informed OUD care and harm reduction services during their emergency medicine clerkship.
Academic and community harm reductionists iteratively codesigned this case in partnership with the research team. Community-engaged pedagogy informed this process to promote social action and power sharing through education. This case was integrated into the existing weekly peer-assisted learning curriculum (i.e., medical students teaching medical students through a structured case) for all fourth-year medical students during their required emergency medicine clinical rotation. Participants completed a postcase evaluation survey.
Sixty-four medical students completed the survey between June and November 2022. A total of 98.5% of participants found the educational session quite or extremely relevant to their medical education, and 87.5% believed the case to be quite or extremely effective in achieving the learning objectives. A total of 45.3% initially felt quite or extremely competent in talking with patients about their drug use, whereas 53.2% felt quite or extremely more competent after participating in the case. Finally, 21.9% initially felt quite or extremely competent in proposing a treatment plan for a patient who uses drugs, whereas 62.5% felt quite or extremely more competent after participating in the case.
This study supports the feasibility and importance of incorporating the voices of people with lived and living experience into medical school curricular development. This peer-assisted learning case focused on the treatment of OUD in the emergency department was seamlessly integrated into the existing curriculum and well received by medical students. By engaging local experts, it could easily be adapted and expanded to other sites.
在美国，阿片类药物使用障碍（OUD）的影响持续上升，但在大多数医学院课程中，这个话题的覆盖范围有限。该研究与学术和社区减少伤害专家合作，设计了一个阿片类药物戒断的同伴辅助学习案例，以便在四年级医学生的急诊医学实习期间，教授他们有关创伤知情的OUD护理和减少伤害服务的知识。
学术和社区减少伤害专家与研究团队合作，反复共同设计了这个案例。社区参与式教学法为这一过程提供了指导，以通过教育促进社会行动和权力共享。这个案例被整合到现有的每周同伴辅助学习课程中（即医学生通过结构化案例互相教学），供所有四年级医学生在必修的急诊医学临床轮转期间学习。参与者完成了案例后的评估调查。
64名医学生在2022年6月至11月期间完成了调查。共有98.5%的参与者认为该教育课程与他们的医学教育非常相关或极其相关，87.5%的人认为该案例在实现学习目标方面非常有效或极其有效。共有45.3%的人最初觉得在与患者谈论其药物使用方面非常有能力或极其有能力，而在参与案例后，53.2%的人觉得自己在这方面的能力有了很大提高。最后，21.9%的人最初觉得在为吸毒患者提出治疗方案方面非常有能力或极其有能力，而在参与案例后，62.5%的人觉得自己在这方面的能力有了很大提高。
本研究支持将有实际生活经验者的声音纳入医学院课程开发的可行性和重要性。这个专注于急诊科OUD治疗的同伴辅助学习案例无缝融入了现有课程，并受到医学生的好评。通过与当地专家合作，它可以轻松地改编和扩展到其他地点。
