This toolkit is based on a study that aimed to establish the feasibility and accessibility of training primary care practitioners in addiction medicine.
In particular how international models of addiction medicine training might inform the future of development of General Practice education in Ireland.
The study had three phases: in the first phase we conducted a literature review, the second phase assessed needs in both systems. And in the third phase we explored the feasibility of the education.
Today, this toolkit is presented in a webinar, that can be accessed here:
The main results of the study are outlined in this webinar. First will present the results of a literature review, second will be quantitative findings, then mixed methods findings, pilot online module in addiction medicine, and finally we will point out some directions for future research.
In terms of the focused review of literature, this was the longest running stage of the whole study. We developed at protocol in collaboration with the Best Evidence in Medical Education organization.
The review was published just recently in the MedEdPublish Journal, which is the Official Journal of the AMEE Association. The main conclusions of the review were that there was little evidence for and a substantial heterogeneity in training needs of early career professionals working in addictions medicine.
And particularly at the level of skills and knowledge. The study quality varied greatly. Early career professional training needs assessment is therefore a priority for future research.
Now moving on to the quantitative findings.
First this study draws upon extensive expert consultations that were conducted with the international experts on addiction medicine competencies
We will not go through each of those competencies, but they are part of the toolkit and I will point you to a link (here) where you can download the toolkit and also review all of these competencies in detail.
Moving on to some specific populations
First, the nurses and the nurse practitioner. There seems to be quite high need for further training in addiction medicine which was also confirmed by a pilot evaluation of our online training that I will present later.
Secondly, clinician scientists who are already practicing physicians interested in developing skills in addictions research and for them there has been a growth in terms of the programs provided as fellowships across the world.
And finally, social workers, who also play an important role in the care of people who have substance use disorders and sometimes their needs sometimes tend to be overlooked.
In terms of the needs of our learners in Dublin, we have conducted a study that focused on one particular substance of use – opioids. We assessed the experiences of medical students and also their satisfaction with learning and attitudes towards community provision of an overdose antidote called naloxone.
Their experiences in terms of using naloxone very different than those of practicing GPs however their support for wider availability of naloxone and opinions regarding community distribution were quite similar, with majority of the participants being in support of such distribution.
Next, we assess training needs in four countries using a structured tool that is called Addiction Medicine training needs assessment. We have found excellent reliability and validity of the new tool that was developed by the Radboud University in Netherlands.
Moving on to the mixed methods evaluation.
The study was conducted in a hospital training environment where learners and physicians alike have an opportunity to participate in an elective rotation with a dedicated team of addiction medicine specialists, working with inner city populations.
In qualitative interviews, the participants felt that their understanding of the alcohol use disorders and specifically diagnosis moved from being theoretical or academic to being practical and more clinical.
Moving on to the development and evaluation of the online course.
This was developed with our partners at the University of British Columbia and evaluated as a novel program that is available free of charge to anyone in the world, regardless of their health care practitioner status.
As seen during the first six months of the new course, there was a huge interest in enrolling and the interest varied according to the discipline. The highest numbers of participants who enrolled in this new course were coming from the nursing disciplines.
For future research, several gaps persist, despite the huge need for training across the globe.
The provision of training should be aligned with the training needs better and for this purpose we now collaborate with the World Health Organization and the Network of Early Career Professionals Working in the Field of Addiction Medicine to reduce those gaps.
In conclusion, experiential training is feasible, but adjustments are needed, specifically embedding the curriculum into the GP mental health training. Primary care has a role to play here. And it’s a very important role. The pilot curriculum needs further evaluation, specifically its impact on career.
The three years of the project have yielded an array of scientific outputs, including a dozen peer-reviewed studies describing the project’s impacts.
While significantly important, these reports represent academic publications that are not sufficiently accessible to all educators, key stakeholders and the general public. The following toolkit, therefore, provides a lay person’s description of the project in 12 key insights, as well as summaries of the research findings. We hope that this report will offer clarity to all on the issue of inclusive health education for doctors and allied health professionals.
Access the toolkit here: http://hdl.handle.net/10197/11557
If you enjoyed reading this post, you might like reading about all educational evaluations here.