Standardized Patients as Drug Abuse Treatment Clients

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DESCRIPTION (provided by applicant): Key aspects of training and supervision for drug abuse treatment providers include experiential ("hands on") learning as well as feedback about performance. In other areas of health care, standardized patients (SPs) play important roles in these aspects of clinician education and monitoring. Moreover, there is a growing literature on use of SPs for training and evaluating primary care providers with regard to the detection of substance abuse problems among their patients and the provision of brief interventions. On the other hand, little information is available about use of SPs for training and supervision of community drug abuse treatment providers. Standardized patients (also known as simulated patients) are actors trained to portray health care consumers with specific conditions. The National Board of Medical Examiners (NBME) will include SPs as a regular part of medical student testing by the academic year 2002-2003. The Educational Commission for Foreign Medical Graduates (ECFMG) has used SPs for several years to test applicants' clinical skills. Most medical schools (and many other health professional education programs) use SPs to educate trainees and to assess the quality of the trainees' actual performances. To the applicants' knowledge, this approach has been used infrequently (if at all) in community drug abuse treatment settings. Indeed, it remains to be seen if use of SPs with drug abuse treatment providers will be feasible. This pilot project is designed to answer fundamental questions about feasibility of the standardized patient methodology for training and supervision of community drug abuse treatment providers. The project will determine whether or not SPs can believably portray public sector drug abuse treatment clients. In addition, the study will assess the extent to which SPs can provide useful feedback regarding drug abuse treatment provider performance. The study takes advantages of Oregon Health & Science University's longstanding work with SPs. Conveniently, the University operates the Behavioral Health Clinic where providers have received training in American Society of Addiction Medicine (ASAM) Patient Placement Criteria, motivational interviewing, and cognitive behavioral treatment approaches for clients with substance abuse and mental health problems. The proposed study will examine the feasibility and utility of SPs in this environment.