| Abstrakt: |
PURPOSE The CDC reports that in 2017, the leading cause of injury-related death in the United States was drug overdoses, and almost 68% of those deaths involved a prescription or illicit opioid. As medical educators navigate the public health emergency caused by opioid use disorder (OUD), need is growing for effective instruction to train healthcare providers to recognize and manage OUD. Inserting robust training and assessment into the PA curriculum is challenging, and finding the appropriate timing for this training is essential to increasing the confidence of students treating patients with OUD. This study sought to evaluate cohorts trained at different points in the PA curriculum, and the students' perceived confidence in their ability to evaluate patients with OUD. Determining the most effective timing for OUD training will help PA programs insert this important and timely information into their curriculum. METHODS Cohort I (n = 59) was instructed on OUD after their second didactic semester; training included interviewing and counseling techniques, referral, and treatment including medication-assisted treatment (MAT). Next, standardized patients were used to simulate patients with chronic pain complaints. Cohort II (n = 48) received the same instruction after completing their core rotations. Both cohorts completed a 5-point Likert scale survey before and after the patient simulation, assessing perceived confidence in: history taking, patient education and counseling, formulating a treatment plan, discussing abnormal urine drug screen results, and overall OUD treatment knowledge base. To determine which cohort perceived greater confidence in these areas, the survey results were compared. Statistical significance was set at P < .05. Institutional review board approval was granted for this study. RESULTS Seventy-five PA students completed the survey, for a response rate of 71%. When compared with cohort I, cohort II had higher perceived confidence in their ability to discuss abnormal urine drug screen results with patients (P = .05) and patient education and counseling skills (P = .007) before the patient simulation. Although both cohorts demonstrated improved confidence levels after the patient simulation, cohort II also had higher perceived confidence in their history-taking skills (P = .022), patient education and counseling skills (P = .009), and ability to formulate a treatment plan for patients with chronic pain complaints (P = .013). CONCLUSIONS PA programs struggle to find time to add new material to their already jam-packed curricula. Determining the most efficacious timing for the insertion of OUD training is beneficial and improves student confidence and preparation for new PA graduates. Our results indicate that clinical-year students are more confident in their patient communication and clinical assessment skills before OUD patient simulations compared with didactic-year students. However, receiving this instruction improved perceived confidence levels in both didactic- and clinical-year students after completing the patient simulation, indicating that both groups can benefit from this training. One limitation of this study is the use of two cohorts in a single program. This can be improved by including additional programs in the future. [ABSTRACT FROM AUTHOR] |
