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。我们的课程将提供成瘾物质的风险意识，以及利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导致疼痛治疗不足，高危患者过度使用阿片类药物，转移治疗，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、基于网络的课程，将远程标准化患者（SP）访谈纳入学习体验。SPs现在是医学教育的一个常见部分，成功的SPs（通过面对面的互动和电话面试）现在是第2步（CS）美国医疗执照考试（USMLE）的必要部分。考试采用标准化病人在多种情况下的情况，以培养医学生的医学领域，他们可能会遇到他们的做法。我们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；从而确保医学生在以后的职业生涯中所需要的技能的学习、实践和演练。该产品建立在Internet的标准工具之上，包括基于聊天的通信、web协作和远程交互。最终产品有可能为任何医学院一至四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，在此基础上，课程主任和见习主任可以进一步建立和完善患者评估和护理技能。第一阶段将1)为疼痛和成瘾主题的5-7个模块制定完整的课程计划，2)完成需求分析，以定义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，包括标准化的患者学习经验，案例场景，互动问题，教学信息和附加资源链接，4)为原型模块创建标准化的患者案例。5)以标准化患者为教学组件，对学习体验进行定性和定量可用性测试。一个由医学院、标准化患者和专题专家组成的专家小组将协助整个开发和评估并评估第一阶段项目的成功程度。第二阶段将：1)完成包括额外SP经验在内的内容，2)概述创建“培训课程/实习主任”模块以指导实施的计划，3)与医学生一起评估项目，4)与顾问和课程/实习主任一起评估项目和原型，5)完成并在网站上发布完成的课程、资源和补充材料。公共卫生相关性：慢性疼痛的危害很容易理解；疼痛是一种普遍现象，如果我们要避免或处理不愉快的刺激，它对生存至关重要。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，成瘾的破坏性是显而易见的。人们对管制药物的滥用也知之甚少，而且往往是没有预料到的。我们选择疼痛和成瘾/滥用的交叉点作为这个产品的重点，因为这个话题具有巨大的教育潜力。这个话题不仅可以影响知识、态度、信心和对每个问题的理解，还可以打破刻板印象，教授从同情到严格遵守规则的全方位的医生。它介绍了医学的法律挑战，因为它们涉及联邦和州的监督，以及需要一个综合的长期方法来充分解决病人的医疗问题

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