Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors

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Title: Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors
Authors: Klimas, Jan
Small, Will
Ahamad, Keith
Cullen, Walter
et al.
Permanent link: http://hdl.handle.net/10197/9142
Date: 20-Sep-2017
Abstract: 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.
Funding Details: European Commission
Irish Research Council
Type of material: Journal Article
Publisher: BMC Springer
Copyright (published version): 2017 the Authors
Keywords: Addiction;Substance-related disorders;Medical education;Qualitative research
DOI: 10.1186/s13722-017-0086-9
Language: en
Status of Item: Not peer reviewed
Appears in Collections:Medicine Research Collection

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