Standardized Patient Simulation Using SBIRT (Screening, Brief Intervention, and Referral for Treatment) as a Tool for Interprofessional Learning.

Introduction: Substance misuse is a critical social and health care issue, and learning how to effectively screen for misuse and perform a brief intervention is useful for all health care professions. As an intercollegiate, interprofessional group, we developed a mechanism for delivering interprofessional education (IPE) using SBIRT (screening, brief intervention, and referral for treatment) as a tool to identify potential substance misuse. Methods: A total of 1,255 students from nursing, pharmacy, medicine, physician assistant, social work, dietetics, and occupational therapy programs participated in the training and evaluation of this IPE experience over 2 academic years. The training incorporated asynchronous SBIRT training, in-person student role-plays, and a standardized patient (SP) interaction. Results: A significant majority of participants indicated that this IPE experience enhanced their interprofessional skills (91%), was useful for interprofessional development (79%), was relevant to their career (92%), and would benefit their clients (93%). Faculty debrief sessions supported the efficacy of SBIRT as a platform for IPE. Discussion: Students believed that utilizing SBIRT as an interprofessional learning experience enhanced their overall educational experience and assisted with developing interprofessional relationships and that team-based care would lead to improved patient outcomes. Faculty found this learning activity to be effective in developing student insight regarding future professional peers and patient interview skill development through role-plays with peers and SPs.

Ethnicity/race, use of pharmacotherapy, scope of physician-ordered cholesterol screening, and provision of diet/nutrition or exercise counseling during US office-based visits by patients with hyperlipidemia.

BACKGROUND: Elevation of serum cholesterol, or hyperlipidemia, is recognized as one of the major modifiable risk factors in the development of atherosclerosis and cardiovascular disease. On a US population basis, there has been a downward trend in total- and LDL-cholesterol levels, and an increase in cholesterol screening. Nevertheless, previous research suggests that there remain racial/ethnic disparities in the access to and quality of care for hyperlipidemia. OBJECTIVE: The aim of this study was to examine the extent of racial/ethnic disparities in the provision of pharmacotherapy, cholesterol screening and diet/nutrition or exercise counseling during US office-based physician-patient encounters (visits) by patients with hyperlipidemia. METHODS: We examined data from the 2005 US National Ambulatory Medical Care Survey for office-based visits for hyperlipidemia for patients aged > or =20 years in terms of prescribing for hyperlipidemia, and the ordering/provision of cholesterol testing, diet/nutrition counseling, and exercise counseling. RESULTS: Use of pharmacotherapy for hyperlipidemia varied by ethnicity/race (chi2, p < 0.05). Physician-ordered/provided cholesterol screening occurred in 44.2% of all office-based visits; 46.5% for Whites, 35.4% for Blacks, and 30.3% for Hispanics (chi2, p < 0.05). Diet/nutrition counseling was ordered/provided in 39.7% of office-based visits; 40.4% for Whites, 32.6% for Blacks, and 39.0% for Hispanics (chi2, p < 0.05). Exercise counseling was ordered/provided in 32.1% of office-based visits; 32.7% for Whites, 27.2% for Blacks, and 30.6% for Hispanics (chi2, p < 0.05). CONCLUSIONS: These findings reveal a disparity in use of pharmacotherapy for hyperlipidemia, physician-ordered/provided cholesterol screening, diet/nutrition counseling, and exercise counseling by ethnicity/race. Further research is required to discern, in greater detail, reasons for the observed differences reported, and to ensure equitable access to established standards of care.