260888 When less is more: Optimizing SBIRT/MI training for primary care medical residents

Tuesday, October 30, 2012

Jonathan Agley, PhD, MPH , School of Public Health, Indiana University, Bloomington, Indiana University, Bloomington, IN
Richard Goldsworthy, MSEd, PhD , Academic Edge, Inc., Bloomington, IN
Ruth Gassman, PhD , School of Public Health, Indiana University, Bloomington, Indiana Prevention Resource Center, Bloomington, IN
Joseph Bartholomew, MSW, LCAC, CHES , Coordinator, SBIRT Program, Wishard Health Services, Indianapolis, IN
David Crabb, MD , Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
Julie Vannerson, MD , Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
Screening, brief intervention, and referral to treatment (SBIRT) has been shown to reduce substance use and related consequences in primary care settings. Indiana University School of Medicine (IUSM) trains all primary care medical residents to implement SBIRT at an adult primary care clinic. Training methods include web-based modules, face-to-face trainings, and interactive workshops. Continuous process evaluation and training modification is important to institutional adoption of new protocols. Further, time spent in training often is related to participants' satisfaction. Following six months of SBIRT training, 26.5% of medical residents trained (N=49) indicated dissatisfaction with the length of the training. These responses highlighted the need to develop a shorter training without adversely affecting learning outcomes. We therefore streamlined the curriculum by removing extraneous demonstrative materials (i.e., videos) and carefully pruning non-essential didactic information. Medical residents who received the modified training (n1=28) were compared to a random sample of those who had received the original training (n2=28). Those who participated in the modified training reported significantly higher satisfaction with training quality, materials, experience, organization, and instructor preparedness, and were more likely to recommend the training to a colleague (p < .05). Simultaneously, there were no significant reductions in reported likelihood of using SBIRT/MI techniques during clinical practice or in levels of confidence in stating medical concerns about patients' substance use patterns. These findings highlight the utility of formative evaluation and iterative curriculum development. Both our approach and the resulting training provide a model for other organizations planning similar training.

Learning Areas:
Administer health education strategies, interventions and programs

Learning Objectives:
1) Explain the importance of measuring and seeking to improve participantsí satisfaction with SBIRT and MI training. 2) Describe strategies that successfully increase participantsí satisfaction with SBIRT/MI training without decreasing stated intentions to utilize techniques or confidence in discussing substance use with patients.

Keywords: Screening, Alcohol

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as principle investigator on several multiyear, multi-institutional NIH-funded efforts to develop and evaluate how different educational tools affect SBIRT adoption and implementation and as an educational consultant on this SAMSHA supported medical resident program. I have 15 years experience as a lead researcher and a health instructional designer, and my areas of work have included alcohol use and abuse, FASD, screening and intervention, suicide-prevention, conflict resolution, STD prevention, and others.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.