Medical Student Skills Training on Pain and Addiction Assessment

描述(由申请人提供)：在SBIR快速通道申请中，我们建议为医学生创建和评估在线技能培训体验，以正确评估疼痛患者，最大限度地减少潜在的阿片类药物滥用，并最大限度地提高疼痛治疗效果。我们的课程将提供对成瘾物质的风险的认识，以及使用阿片类药物治疗疼痛的好处。在评估疼痛和成瘾潜力时缺乏临床技能可能会导致疼痛治疗不足、高危患者过度使用阿片类药物、转移注意力、在没有适当监测的情况下接触成瘾物质，以及先前成瘾疾病的恶化。该项目将创建一种新颖的、交互式的、基于Web的课程，将远程标准化患者(SP)面谈纳入学习体验。SPS现在是医学教育的常见部分，SPS的成功(通过面对面的互动和电话面试)现在是第二步(CS)美国医生执照考试(USMLE)的必备部分。该考试使用多病例情况下的标准化患者来培训医学生在他们在实践中可能遇到的医学领域。我们的项目的独特之处在于，我们将利用远程SPS对医学生进行实际培训；从而确保学习、练习和排练医学生在以后的职业生活中将需要的技能。该产品建立在互联网的标准工具之上，包括基于聊天的通信、网络协作和远程交互。最终产品有可能为任何医学院的1至4年级的学生提供具有成本效益的培训体验。它还将提供一个稳定的框架，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。第一阶段将1)制定关于疼痛和成瘾主题的5-7个模块的完整课程计划，2)完成需求分析，以确定如何在学习模块中最好地使用SP访谈，3)最终确定原型模块，包括标准化患者学习体验、案例场景、互动问题、教学信息和到其他资源的链接，4)为原型模块创建标准化患者案例，以及5)以标准化患者为教学组件对学习体验进行定性和定量的可用性测试。一个由医学院、标准化患者和专题专家组成的专家小组将在整个开发和评估过程中提供帮助，并对第一阶段项目的成功程度进行评级。第二阶段将：1)完成内容，包括额外的SP经验；2)概述一项计划，创建“培训课程/助理主任”模块以指导实施；3)与医学生一起评估计划；4)与顾问和课程/助理主任一起评估计划和原型；5)完成并在网站上发布完成的课程、资源和补充材料。与公共卫生相关：慢性疼痛的破坏性是很容易理解的；如果我们要避免或注意到令人不快的刺激，疼痛是一种普遍现象，对生存至关重要。人们对成瘾的了解较少，因为并非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。滥用受管制物质的情况也鲜为人知，而且往往出乎意料。我们选择痛苦和上瘾/滥用的交集作为这款产品的重点，是因为它具有巨大的教育潜力。话题不仅可以影响对每个问题的知识、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医术。它引入了医学的法律挑战，因为它们涉及到联邦和州的监督，以及需要一个综合的长期方法来充分解决患者的医疗问题

DESCRIPTION (provided by applicant): In the SBIR Fast-track application, we propose to create and evaluate an online skills training experience for medical students to properly assess patients in pain, minimize potential opioid misuse, and maximize pain treatment. Our curriculum will provide an awareness of the risks of the addictive substances, as well as the benefits of utilizing opioids to treat pain. A lack of clinical skill when assessing pain and addiction potential can lead to under-treatment of pain, overuse of opioids in at-risk patients, diversion, exposure to addictive substances without proper monitoring, and worsening of prior addictive disease. The project will create a novel, interactive, Web-based curriculum that incorporates a remote Standardized Patient (SP) interview into the learning experience. SPs are now a common part of medical education and success with SPs (via face-to-face interactions and a telephone interview) is now a required part of the Step 2 (CS) US Medical Licensure Exam (USMLE). The examination uses Standardized Patients in multiple case situations to train the medical students in areas of medicine which they might encounter in their practices. Our project is unique in that we will utilize remote SPs for the actual training of medical students; thus ensuring learning, practice, and rehearsal of the skills medical students will need later in their professional life. The product builds on standard tools of the Internet including chat-based communication, web collaboration, and remote interactions. The final product has the potential to deliver a cost-effective training experience to students throughout years 1 to 4 of any medical school. It will also provide a stable framework upon which course directors and clerkship directors can further build and refine patient assessment and care skills. Phase I will 1) develop a complete curriculum plan for 5-7 modules on the topic of pain and addiction, 2) complete a needs analysis to define how best to use an SP interview within a learning module, 3) finalize a prototype module including a standardized patient learning experience, case scenarios, interactive questions, didactic information, and links to additional resources, 4) create the standardized patient case for the prototype module, and 5) conduct qualitative and quantitative usability testing on the learning experience with the standardized patient as a teaching component. An expert panel incorporating medical school, standardized patient, and topic expertise will assist throughout development and evaluation and rate the success of the Phase I project. Phase II will: 1) complete the content including additional SP experiences, 2) outline a plan to create a "train the course/clerkship director" module to guide implementation, 3) evaluate the program with medical students, 4) evaluate the program and prototype with consultants and course/clerkship directors, and 5) complete and publish the completed curriculum, resources and supplementary materials on a website. PUBLIC HEALTH RELEVANCE: The ravages of chronic pain are easily understandable; pain is a universal phenomenon that is essential to survival if we are to avoid or attend to unpleasant stimulation. Addiction is less 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 controlled substances is also poorly understood and often unanticipated. We chose the intersection of pain and addiction/misuse as the focus of this product because it of the tremendous education potential of this topic. The topic can not only effect knowledge, attitude, confidence and understanding of each issue, but can also break stereotypes and teach a full range of doctoring from compassion to strict rule-following. It introduces the legal challenges of medicine as they relate to federal and state oversight and the need for an integrated long term approach to fully address a patient's medical issue