Preceptors' preparedness to teach about substance and opioid use disorder: a qualitative study.

STUDY AIM: Little is known about preceptors' comfort and readiness to teach clinical students about the care of patients with substance and opioid use disorder (SUD/OUD). This study explores preceptors' views about caring for such patients, and their preparedness to teach about SUD/OUD management, to improve graduate competencies. METHODS: Participants were recruited by convenience and snowball sampling. Semi-structured interviews were conducted with physician, physician assistant, and nurse practitioner preceptors who taught medical and physician assistant students. Interviews were conducted via Zoom® videoconferencing. Transcripts were generated and independently analyzed for themes by 4 experienced coders using constant comparison and a grounded theory approach. RESULTS: Fifteen interviews were conducted to theme saturation. We identified 3 major themes and 10 subthemes supported by exemplar quotes. The major themes were: education about SUD/OUD in primary care (subthemes include need for longitudinal curriculum, redefining 'success' in treatment, and precepting challenges), treatment of SUD/OUD in primary care (need for systemic support and care continuity), and medication-assisted therapy (MAT) training as a tool for teaching (preceptors' own training, and need for clinical students to be trained). CONCLUSIONS: Preceptors agreed that treatment of SUD/OUD belongs in primary care and students should learn about SUD/OUD from the start of their medical education. Data analysis enabled the construction of an emerging conceptual framework reflecting a diversity of experiences and opinions of preceptor comfort and preparedness to teach about SUD/OUD, associated with various barriers and motivators. This framework can guide future strategies to address facilitators and obstacles to advance and promote preceptor preparedness to teach students about the care and management of patients with SUD/OUD.

Addressing the Opioid Crisis: Medication-Assisted Therapy Waiver Training for Students.

PURPOSE: Physician assistant (PA) graduates should be prepared to care for patients with substance use disorders. Medication-assisted therapy (MAT) allows PA graduates to provide that care by becoming licensed to prescribe buprenorphine. However, it is unclear how feasible and effective it is to implement online MAT waiver training during PA school. This study examined student knowledge and attitudes after training to assess its impact and perceived value. METHODS: We conducted a 15-question survey after one class of students completed training during clinical rotations. Students self-reported pre/post change in awareness, knowledge, interest, comfort and confidence, perceived usefulness to practice, and assessed quality using 5-point Likert scale (higher scores = more positive) and narrative responses. Data analysis was performed using the Wilcoxon signed rank test and descriptive statistics. Free text comments were analyzed for themes using constant comparison. RESULTS: Fifty-five (100%) students completed training within 6 weeks. The survey response rate was 49/55 (89%). Pre-to-post score changes were significant (p < .05) from +0.39 to +1.35 with the greatest changes seen in knowledge (+1.35), comfort (+1.14), awareness (+1.06), and confidence (+1.08); the lowest change was in interest (score change +0.39). Students reported being satisfied with content organization and quality (mean 3.82) and recommended training to colleagues (3.98); 82% reported they would have preferred 3 months to complete training; 46% would have preferred training prior to the start of clinical rotations. Major themes indicated a desire for better preparation and flexibility of platform, with ambivalence about relevance to practice. CONCLUSION: Online MAT waiver training is feasible and effective. However, students may not be convinced of its relevance to future practice. Faculty should offer adequate preparation and optimize integration into existing curricula.

Evaluating Interprofessional Team Performance: A Faculty Rater Tool.

INTRODUCTION: Reliable team assessment has become a priority because of growing emphasis on interprofessional education and team-based care. Objective rating scales are needed to evaluate interprofessional student teams and individuals and provide real-time feedback. METHODS: In response to a need for behavioral rating scales, we modified the McMaster-Ottawa Scale from a 9-point to a 3-point scale and added descriptive behavioral anchors to define three levels of competency (i.e., below, at, and above expected). This modification is intended to provide consistent rating of individuals and teams in patient settings. We then developed a demonstration video using actors representing four professions to demonstrate the three levels of performance within the team. Our faculty rater tool, consisting of the modified scale and video, is designed to provide standardized ratings in interprofessional educational settings that involve patient care. RESULTS: We conducted training sessions with 40 faculty members from seven professions (medicine, dentistry, occupational therapy, nursing, pharmacy, physician assistant, and psychology) over a 2-year period. Immediately after each training session, two trained faculty observers rated interprofessional student teams as they conducted history and assessments on standardized patients. Observer scores were compared with one another and with standard expert ratings of the same teams. Trained observer ratings were consistent across the pairs. The observer training can be conducted within 60-90 minutes with the tool. DISCUSSION: Results of our implementation of the faculty rater tool confirm that the modified McMaster-Ottawa Scale is feasible to administer in clinical settings and that the demonstration video can be easily adopted for standardizing observer ratings.