Shufflebarger Erin F, Hicks Sherell, Marshall Stacy, Walter Lauren A
Emergency Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, USA.
Cureus. 2025 Jan 3;17(1):e76855. doi: 10.7759/cureus.76855. eCollection 2025 Jan.
Introduction Amid the opioid crisis, emergency medicine (EM) physicians increasingly tackle opioid use disorder (OUD) in the emergency department. Although the "X waiver" is no more, OUD-specific education requirements persist for EM clinicians and trainees. Traditional EM education emphasizes pathophysiology but overlooks the role of stigma in OUD as well as the importance of a peer recovery support specialist (peer) and community referral partners. We aimed to create and deliver a holistic EM OUD curriculum to boost practical OUD-specific knowledge and address OUD perceptions. Methods A task force of EM clinician-educators with expertise in OUD developed a four-hour educational curriculum to implement during a single EM residency didactic day. The curriculum highlighted a panel of peers, a series of lectures detailing specific aspects of OUD management, and an OUD tabletop simulation that focused on stigma. Pre- and post-participant surveys were obtained. Surveys assessed participant content knowledge via self-assessment as well as attitudes regarding persons with OUD via the Medical Condition Regard Scale (MCRS). A descriptive analysis was performed. Results Participants included 21 EM residents at various levels of training and faculty members, with 23 participants completing the pre-survey and 21 completing the post-survey. Post-curriculum delivery, all self-assessed knowledge categories demonstrated improvement; as examples, post-intervention, 100% of respondents reported understanding of medications for OUD (buprenorphine) indications and comfort with prescribing, compared to 52.7% and 56.5% prior to the intervention, respectively. Pre-survey MCRS assessments were largely positive; however, post-curriculum MCRS responses trended toward additional improvements in reported participant attitudes toward persons with OUD. A majority (95.2%) of respondents felt the curriculum improved topic understanding, and 90.5% reported improved confidence in treating patients with OUD. The peer panel and lectures were rated the most meaningful, followed by the simulation. Conclusion This OUD curricular intervention demonstrates the feasibility and perceived participant value of a holistic OUD curriculum. This curriculum improved participant OUD-specific knowledge and attitudes toward persons with OUD.
引言 在阿片类药物危机期间，急诊医学（EM）医生在急诊科越来越多地应对阿片类药物使用障碍（OUD）。尽管“X豁免”已不复存在，但针对OUD的教育要求仍适用于EM临床医生和实习生。传统的EM教育强调病理生理学，但忽视了耻辱感在OUD中的作用以及同伴康复支持专家（同伴）和社区转诊合作伙伴的重要性。我们旨在创建并提供一个全面的EM OUD课程，以增强实用的OUD特定知识并解决对OUD的认知问题。方法 一个由在OUD方面具有专业知识的EM临床教育工作者组成的特别工作组制定了一个四小时的教育课程，在EM住院医师教学日期间实施。该课程突出了一组同伴、一系列详细介绍OUD管理具体方面的讲座以及一个关注耻辱感的OUD桌面模拟。获取了参与者前后的调查问卷。调查通过自我评估评估参与者的内容知识，并通过医疗状况尊重量表（MCRS）评估对患有OUD者的态度。进行了描述性分析。结果 参与者包括21名处于不同培训水平的EM住院医师和教员，23名参与者完成了预调查，21名完成了后调查。课程交付后，所有自我评估的知识类别都有改进；例如，干预后，100%的受访者表示了解用于OUD的药物（丁丙诺啡）适应症并对开处方感到放心，而干预前分别为52.7%和56.5%。预调查的MCRS评估大多是积极的；然而，课程后的MCRS回答显示，参与者对患有OUD者的态度有进一步改善的趋势。大多数（95.2%）受访者认为该课程提高了对主题的理解，90.5%的受访者表示治疗患有OUD的患者的信心有所提高。同伴小组和讲座被评为最有意义，其次是模拟。结论 这种OUD课程干预证明了全面的OUD课程的可行性和参与者所感知到的价值。该课程提高了参与者的OUD特定知识以及对患有OUD者的态度。
