Now showing 1 - 6 of 6
  • Publication
    Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors
    BackgroundAlthough progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships.MethodsWe interviewed trainees and faculty from clinical and research training programmes in addiction medicine at St Paul¿s Hospital in Vancouver, Canada (N = 26) about barriers and facilitators to implementation of physician training in addiction medicine. We included medical students, residents, fellows and supervising physicians from a variety of specialities. We analysed interview transcripts thematically by using NVivo software.ResultsWe identified six domains relating to training implementation: (1) organisational, (2) structural, (3) teacher, (4) learner, (5) patient and (6) community related variables either hindered or fostered addiction medicine education, depending on context. Human resources, variety of rotations, peer support and mentoring fostered implementation of addiction training. Money, time and space limitations hindered implementation. Participant accounts underscored how faculty and staff facilitated the implementation of both the clinical and the research training.ConclusionsImplementation of addiction medicine fellowships appears feasible, although a number of barriers exist. Research into factors within the local/practice environment that shape delivery of education to ensure consistent and quality education scale-up is a priority.
    Scopus© Citations 6  480
  • Publication
    What are the training needs of early career professionals in addiction medicine? A BEME scoping review protocol
    Background: Substance use disorders (SUD) represent a significant social and economic burden globally. Accurate diagnosis and treatment by early career professionals in addiction medicine (ECPAM) fails, in part, due to a lack of training programs targeting this career stage. Prior research has highlighted the need to assess the specific training needs of early career professionals working in this area. Aim: To conduct a scoping review of the literature on the self-reported training needs of ECPAM worldwide. Methods: Medical and education databases will be searched for studies reporting perceived training needs of early career professionals (having completed their training within a five year period at the time of assessment) in addiction medicine. Retrieved citations will be screened and full text articles reviewed for eligibility by two independent reviewers. A third reviewer will arbitrate where there was disagreement. Two reviewers will independently extract data from included studies and conduct a quality appraisal assessment. Importance: Overall, the evidence on the training needs from this review will inform efforts to optimise ECPAM education internationally. Training needs assessment of early career professionals working in the field of addiction medicine is a priority.
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  • Publication
    In-hospital training in addiction medicine: A mixed-methods study of health care provider benefits and differences
    Background: Hospital-based clinical addiction medicine training can improve knowledge of clinical care for substance-using populations. However, application of structured, self-assessment tools to evaluate differences in knowledge gained by learners who participate in such training has not yet been addressed. Methods: Participants (n = 142) of an elective with the hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, responded to an online self-evaluation survey before and immediately after the structured elective. Areas covered included substance use screening, history taking, signs and symptoms examination, withdrawal treatment, relapse prevention, nicotine use disorders, opioid use disorders, safe prescribing, and the biology of substance use disorders. A purposefully selected sample of 18 trainees were invited to participate in qualitative interviews that elicited feedback on the rotation. Results: Of 168 invited trainees, 142 (84.5%) completed both pre- and post-rotation self-assessments between May 2015 and May 2017. Follow-up participants included medical students, residents, addiction medicine fellows, and family physicians in practice. Self-assessed knowledge of addiction medicine increased significantly post-rotation (mean difference in scores = 11.87 out of the maximum possible 63 points, standard deviation = 17.00; P < .0001). Medical students were found to have the most significant improvement in addiction knowledge (estimated mean difference = 4.43, 95% confidence interval = 0.76, 8.09; P = .018). Illustrative quotes describe the dynamics involved in the learning process among trainees. Conclusions: Completion of a hospital-based clinical elective was associated with improved knowledge of addiction medicine. Medical students appear to benefit more from the addiction elective with a hospital-based AMCT than other types of learners.
    Scopus© Citations 8  288
  • Publication
    Clinician-Scientist Training in Addiction Medicine: A Novel Programme in Canadian Setting
    (Lippincott, Williams & Wilkins, 2017-10) ; ; ;
    Medical education has long been the missing element in the response to the global addiction problem. Instead of treating addiction as a disease, governments have focused on drug prohibition and law enforcement. This approach has failed by many measures, and, as a result, millions of people have suffered. Addiction science has increasingly identified a range of evidence-based approaches to treat substance-use disorders, particularly through early identification and treatment. However, most interventions are underused. Better physician education can improve accurate use of evidence-based treatments.
      175Scopus© Citations 2
  • Publication
    Core Addiction Medicine Competencies for Doctors, An International Consultation on Training
    BACKGROUND:Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education.METHODS:We interviewed 13 members of the International Society of Addiction Medicine (ISAM), from 12 different countries (37% response rate), over Skype, email survey or in-person - at the annual conference. We content-analysed the interview transcripts, using constant comparison methodology.RESULTS:We identified recommendations related to the core set of the addiction medicine competencies at three educational levels: (i) undergraduate (ii) postgraduate and (iii) continued medical education (CME). The participants described broad ideas, such as knowledge / skills / attitudes towards addiction to be obtained at undergraduate level, or knowledge of addiction treatment to be acquired at graduate level, as well as specific recommendations, including the need to tailor curriculum to national settings and different specialties.CONCLUSIONS:While it is unclear whether a global curriculum is needed, a consensus on a core set of principles for progression of knowledge, attitude and skills in addiction medicine to be developed at each educational level amongst medical graduates would likely have substantial value.
    Scopus© Citations 19  172