Medical Student Education on Alcohol Abuse and Dependence

描述(由申请人提供)：这是针对NOT-OD-09-058“NIH宣布恢复法案资金可用于竞争性修订申请”而提出的竞争性修订申请。医学院几乎没有提供背景和培训，以帮助未来的医生应对人群中出现的酒精滥用、滥用和依赖。为了满足这一需求，我们目前正在完成1R44AA016724-01A1：医学生酒精滥用和依赖教育，这是一个SBIR快速通道(I/II阶段)项目，旨在创建一个在线课程，教育医学生有关酒精滥用和使用障碍患者的背景、适当评估和治疗选择。该产品结合了案例研究和互动学习，教授酒精滥用的筛查和评估，以及正确的治疗决策，以帮助滥用酒精的患者。这个SBIR项目的第一阶段：1)制定了课程计划，使接受培训的医生具备有效筛查、评估和干预的知识和技能；2)开发了一个模块，“酒精使用、误用和患者护理”；3)显示(n=32)测试前/后知识显著增加(p&lt；0.001)，态度、自我效能和预期行为方面的统计显著增加(p&lt；0.05)。第二阶段正在完成我们的基于计算机的培训课程，并已计划利用基于远程互联网聊天的现场标准化患者(SP)组件来评估与酒精使用评估相关的临床技能。我们的实施反映了SPS在STEP 2(CS)美国医生执照考试(USMLE)中的使用。该补编要求提供资金，以扩大第二阶段项目，创建并纳入一个额外的教育组成部分，基于一个用于培训目的的新的、远程的现场标准化患者。SP体验相当于课程中的一个附加模块，共产生8个模块。在新的模块中，学生将有机会通过与远程现场SP演员进行互联网聊天来排练其他模块中介绍的临床技能。关于学生表现的反馈将使用基于典型的欧安组织考试核对表和利克特量表的标准化衡量标准来提供。由于补充剂增强了技能培训，它显著提高了在任何医学院的1至4年级向学生提供经济高效的培训体验的潜力。它还提供了一个稳定和最先进的框架，课程主任和助理主任可以在此基础上进一步建立和完善患者评估和护理技能。研究、人类受试者的使用和计划的评估在最初的应用中保持不变。为了与ARRA保持一致，资金将用于雇用更多的工作人员，并向顾问支付增加模块的费用。 与公共健康相关：饮酒，特别是滥用，仍然是一个普遍的公共和社会健康问题。大约6%的美国人遭受酒精滥用或依赖，而更多的人面临这些疾病的风险(SAMHSA 2005)。然而，成瘾作为一种疾病并没有被很好地理解，因为并不是所有人都同样容易患上成瘾疾病。尽管如此，上瘾的破坏性是显而易见的。误用酒精经常被医生忽视，他们中的许多人没有做好充分准备来充分处理滥用酒精的患者。我们选择将教育材料的重点放在酗酒和依赖上，因为这个主题具有巨大的教育潜力。话题不仅可以影响对成瘾的知识、态度、信心和理解，还可以打破刻板印象，传授从同情到严格遵守规则的全方位治病方法。学生可以从这个主题中学到很多东西，并应用于更好地保护患者的健康。

DESCRIPTION (provided by applicant): This is a competitive revision application in response to NOT-OD-09-058 "NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications". Medical schools provide little background and training to prepare future physicians to deal with alcohol misuse, abuse and dependence seen in the population. To address this need we are current completing 1R44AA016724-01A1: Medical Student Education on Alcohol Abuse and Dependence, an SBIR Fast-Track (Phase I/II) project to create an online curriculum to educate medical students on the background, proper assessment, and treatment options for patients with alcohol misuse and use disorders. The product combines case studies and interactive learning to teach screening and assessment for alcohol misuse and proper treatment decision making to help patients who misuse alcohol. Phase I of this SBIR project: 1) developed a curriculum plan to cost-effectively prepare physicians-in-training with the knowledge and skills to effectively screen, assess, and intervene, 2) developed one module, "Alcohol Use, Misuse, and Patient Care" and 3) demonstrated (n=32) a significant increase in knowledge pre/post test, (p<0.001), and statistically significant increase in attitudes, self-efficacy, and intended behavior (p<0.05). Phase II is completing our computer-based training curriculum and already planned to utilize a remote Internet-chat based live Standardized Patient (SP) component to assess clinical skills related to alcohol use assessment. Our implementation mirrors the use of SPs in the Step 2 (CS) US Medical Licensure Exam (USMLE). The supplement requests funding to expand the Phase II project by creating and incorporating an additional educational component based around a novel, remote live Standardized Patient for training purposes. The SP experience will be the equivalent of an additional module for the curriculum, yielding a total of 8 modules. In the new module students will have the opportunity to rehearse the clinical skills presented in the other modules by using Internet chat with a remote live SP actor. Feedback regarding the student's performance will be provided using standardized measures based on typical OSCE exam checklists and Likert scales. Because the supplement enhances skills training, it significantly enhances the potential to deliver a cost-effective training experience to students throughout years 1 to 4 of any medical school. It also provides a stable and state of the art framework upon which course directors and clerkship directors can further build and refine patient assessment and care skills. The study, use of human subjects, and planned assessments remain unchanged in the original application. In keeping with ARRA, funds will be used to hire additional staff and pay consultants to add the module. PUBLIC HEALTH RELEVANCE: Alcohol use, and especially abuse, continues to be a widespread public and social health problem. Approximately 6% of Americans suffer from alcohol abuse or dependence, while many more are at-risk for these disorders (SAMHSA 2005). However, addiction as a disease is not well understood since not all of us are equally liable to suffer from the diseases of addiction. Nonetheless the destructiveness of addiction is apparent to all. Misuse of alcohol is often overlooked by physicians, many of whom are not well prepared to adequately deal with patients who abuse alcohol. We chose to focus our educational materials on alcohol abuse and dependence because of the tremendous education potential of this topic. The topic can not only effect knowledge, attitude, confidence and understanding of addiction, but can also break stereotypes and teach a full range of doctoring from compassion to strict rule-following. There is much that a student can learn from this topic and apply to better the health of their patients.