Medical Student Education on Alcohol Abuse and Dependence

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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.