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

描述（由申请人提供）：Step2酒精成瘾和酒精的医疗后果CS培训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）步骤2 CS（临床技能）考试，和2）学习和实践必要的临床技能，与有风险或酒精使用问题的患者互动。重要性：酒精使用是一个普遍的公共，社会和个人健康问题，但酒精使用的筛查是简单的，干预是具有成本效益的，有效的治疗方案存在。许多医学院的课程是不够的，不准备学生适当的评估，干预和后续治疗的酒精使用障碍。相反，学生们往往会形成一些方法和态度，事实上，这些方法和态度可能会阻碍他们未来在临床护理患者时培养所需技能的努力。该提案利用了第2步CS考试准备的高动机（以及实际开发和展示临床技能的需求）来解决这一弱点。[[The WebOSCE方法可以在培训（实习/居住/奖学金）或实践（持续专业发展，专业认证和认证维护）的后期状态中应用。该方法也可应用于其他卫生专业受训人员，并最终应用于第三阶段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（真实的人在真实的时间）标准化患者（RLSP）访谈，该访谈通过互联网聊天进行。这种sEMR/RLSP混合允许学习者查询sEMR和RLSP参与者，从sEMR请求额外的数据（历史，咨询，实验室，物理发现），建立鉴别诊断，并将诊断选择（包括治疗计划）传达给RLSP。创新体现在：1）关注临床技能和实现临床能力，2）通过测试以解决经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。研究者：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，这些培训涉及包括酒精在内的几个成瘾主题。方法：该项目以酗酒或有酗酒风险的患者为例，努力提高美国医学院协会（AAMC）核心能力的熟练程度，包括科学知识的应用、患者参与和沟通以及患者护理相关目标。第一阶段将修改和加强现有的退休金计划。为了提供一个可扩展和具有成本效益的解决方案，第一阶段还将调整我们现有的基于Drupal的软件，以支持一个新的同伴教育和评级系统，1）为学生提供sEMR/RLSP体验，2）帮助评价学生的表现，3）培训学生，使他们能够为彼此扮演RLSP的角色，4）与学习者一起安排RLSP。 公共卫生相关性：在美国，酒精使用障碍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%。医生和其他卫生保健提供者，在咨询和治疗那些滥用酒精和减少酒精使用的医疗后果的独特地位;不幸的是，未来的医生和其他卫生保健提供者往往没有与患者互动的技能，以评估那些与酒精使用障碍，并提供咨询和治疗方案。该项目提供了一个独特的和新颖的解决方案，通过利用共同的需要，培训需求，和高焦虑，与准备USMLE“步骤2 CS（临床技能）考试，这是在美国的医疗执照所需的优势.

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.