Step2 CS Training in Alcohol Addiction and the Medical Consequences of Alcohol

本项目将创建一个网站WebOSCE.com，为医学生提供一个独特的培训机会：1)准备USMLE(R)第二步CS(临床技能)考试，2)学习和练习必要的临床技能，以便与有风险或有酒精使用问题的患者互动。意义：酒精使用是一个广泛的公共、社会和个人健康问题，但酒精使用的筛查是直接的，干预是经济有效的，并且存在有效的治疗选择。许多医学院的课程不够完善，没有让学生为酒精使用障碍患者的适当评估、干预和后续治疗做好准备。相反，学生往往会形成一些方法和态度，实际上可能会阻碍未来发展他们在临床护理病人方面所需技能的努力。这一建议利用了步骤2 CS测试准备的高度动机(以及实际开发和展示临床技能的需要)来解决这一弱点。[[可在培训(实习/实习/研究金)或实践(继续专业发展、专业认证和保持认证)的后期阶段采用网络欧安组织的办法)。在第三阶段，该方法也可应用于其他卫生专业培训人员，并最终适用于我们用户感兴趣的其他主题。]]创新：WebOSCE.com培训体验将通过基于网络的界面进行，该界面包括两个组件：模拟电子病历(SEMR)和远程(基于网络)现场(实时真人)标准化患者(RLSP)访谈，通过互联网聊天进行。这种sEMR/RLSP混合体允许学习者查询sEMR和RLSP参与者，从sEMR请求附加数据(病史、会诊、实验室、体检结果)，建立鉴别诊断，并向RLSP传达诊断选择，包括治疗计划。创新表现为：1)专注于临床技能和实现临床能力，2)通过测试以满足通常被忽视的教育需求的动机，3)sEMR/RLSP混合，以及4)量身定制的培训和具体反馈，以指导改进。调查人员：调查人员和公司拥有为医学生和其他健康提供者开发、部署和支持基于网络的培训的专业知识，这些培训涉及几个成瘾主题，包括酒精。方法：通过使用酒精滥用患者或有酒精滥用风险的患者的例子，该项目努力提高对美国医学院协会(AAMC)核心能力的熟练程度，包括应用科学知识、患者参与和沟通以及与患者护理相关的目标。第一阶段将修改和加强现有的RLSP案例。为了提供可扩展且经济高效的解决方案，第一阶段还将调整我们现有的基于Drupal的软件，以支持新的同行教育和评分系统，该系统1)向学生提供sEMR/RLSP体验，2)帮助评估学生的表现，3)培训学生，使他们能够相互扮演RLSP的角色，以及4)与学习者安排RLSP。 公共卫生相关性：酒精使用障碍在美国仍然是一个日益严重的问题；52%的美国人定期饮酒(SAMHSA，2010)，其中约6%的使用者符合酒精滥用或依赖的标准(SAMHSA，2005)，占美国总人口的3%。医生和其他医疗保健提供者处于独特的地位，可以建议和治疗那些滥用酒精的人，并减轻酒精使用的医疗后果；不幸的是，未来的医生和其他医疗保健提供者往往没有获得与患者互动的技能，以评估那些酒精使用障碍的人，并提供咨询和治疗选择。该项目为培训需求提供了一种独特而新颖的解决方案，它利用了与准备USMLE第二步CS(临床技能)考试相关的共同需求和高度焦虑，这是美国医生执照所需的。

DESCRIPTION (provided by applicant): Step2 CS Training in Alcohol Addiction and the Medical Consequences of Alcohol This project will create a website, WebOSCE.com, to provide a unique training opportunity for medical students to: 1) prepare for the USMLE(R) Step 2 CS (Clinical Skills) examination, and 2) learn and practice necessary clinical skills to interact with patients at risk or with an alcohol use problem. Significance: Alcohol use is a widespread public, social, and personal health problem, yet screening for alcohol use is straightforward, intervening is cost-effective, and effective treatment options exist. Many medical school curricula are inadequate and do not prepare students for proper assessment, intervention, and follow-up treatment of those with alcohol use disorders. Instead, students often develop approaches and attitudes that may, in fact, hinder future efforts to develop the skills they need in their clinical care of patients. This proposal utilizes the high motivation attached to Step 2 CS test preparation (and the need to actually develop and demonstrate clinical skills) to address this weakness. [[The WebOSCE approach can be applied during later states of training (internship/residency/fellowship) or practice (continuing professional development, specialty certification, and maintenance of certification). The approach can also be applied to other health professional trainees and eventually to other topics of interest to our users during Phase III.]] Innovation: The WebOSCE.com training experience will occur via a web-based interface including two components: a simulated Electronic Medical Record (sEMR) and a Remote (web-based) Live (real person in real time) Standardized Patient (RLSP) interview which occurs via Internet chat. This sEMR/RLSP hybrid allows the learner to query the sEMR and RLSP actor, request additional data from the sEMR (history, consults, laboratories, physical findings), build a differential diagnosis, and convey diagnostics choices, including treatment plans, to the RLSP. Innovation is demonstrated via: 1) focus on clinical skills and achieving clinical competency, 2) motivation of passing a test to address an educational need that is often ignored, 3) the sEMR/RLSP hybrid, and 4) tailored training and specific feedback to guide improvement. Investigators: The investigators and company have expertise developing, deploying, and supporting web- based training for medical students and other health providers on several addiction topics, including alcohol. Approach: Using examples of patients with or at risk for alcohol misuse, the project strives to improve proficiency in Association of American Medical Colleges (AAMC) core competencies including the application of scientific knowledge, patient engagement and communication, and patient care-related objectives. Phase I will modify and enhance existing RLSP cases. To provide a scalable and cost-effective solution, Phase I will also adapt our existing Drupal-based software to support a novel peer-education and rating system that 1) delivers an sEMR/RLSP experience to students, 2) helps rate student's performance, 3) trains students so they can perform the role of RLSP for each other, and 4) schedules RLSPs with learners. PUBLIC HEALTH RELEVANCE: Alcohol use disorders continue to be a growing problem in the United States; 52% of Americans consume alcohol on a regular basis (SAMHSA, 2010) and approximately 6% of those users meet the criteria for alcohol abuse or dependence (SAMHSA, 2005), or 3% of the total U.S. population. Physicians, and other health care providers, are in a unique position to counsel and treat those who abuse alcohol and lessen the medical consequences of alcohol use; unfortunately future physicians and other health care providers are often not given the skills to interact with patients to assess those with alcohol use disorders, and provide counseling and treatment options. This project offers a unique and novel solution to the training needs by taking advantage of the common need, and high anxiety, associated with preparation for the USMLE " Step 2 CS (Clinical Skills) examination which is required for medical licensure in the United States.