The 2018 AAMC Curricular Innovation Awards highlight the innovative ways AAMC member institutions are working to advance the education of students, residents, and practicing physicians about opioids, substance use disorder, and pain management. The awards, in partnership with the Samueli Foundation, recognize the leadership of medical education programs at the undergraduate, graduate, and continuing education levels that provide innovative pain, substance use, and addiction training, including nonpharmacological approaches to patient care. Awardees received $2,500 each and will be invited to present their work during the AAMC National Workshop to Advance Medical Education to Combat Opioid Misuse: Working Together Across the Continuum.
Awardees were also invited to submit their curricular innovations for publication on MedEdPORTAL, a peer-reviewed, open-access journal that promotes educational scholarship and dissemination of teaching and assessment resources in the health professions.
Since 2016, the University of Massachusetts Medical School has incorporated the “Opioid Safe- prescribing Training Immersion” (OSTI) into the required medical and graduate nursing curricula, thereby ensuring all graduating prescribers benefit from the training. OSTI learning objectives are focused on competencies including prevention, identification, and management of substance use disorders. The sessions include independent work, standardized patient encounters, mini-didactics, patient and family member panels, reflection, and discussion. Learner assessment and evaluation enhance feedback and contribute to continuous curriculum improvement. Following initial implementation with students, OSTI training has been adapted to include residents and practicing providers. To date, the school has trained more than 800 interprofessional learners from across the educational and professional continuum.
The Warren Alpert Medical School of Brown University (AMS) integrates training to first through fourth-year medical students about use and misuse of opioids, along with pain management. Aspects of the learning objectives include comparing and contrasting non-pharmacologic and pharmacologic treatment methods as well as screening, behavioral intervention and referral for treatment (SBIRT). Throughout the four years, students learn through the use of motivational interviewing, work-through case studies, and interprofessional workshops. The number of SBIRTs completed by first and second-year students is tracked, and in the past three years has resulted in approximately 5,000 screenings by AMS medical students. AMS students completing their residency in Rhode Island are also eligible to receive a Drug Enforcement Agency X number to prescribe medication assisted treatment beginning in the second year of residency, upon completion of the curriculum, as part of a partnership with the Rhode Island Department of Health.
The curricular innovation at University of Michigan Medical School was designed based on research that showed a significant discrepancy between post-operative opioid prescribing practices and patient consumption of those prescribed opioids. The curriculum educates students, residents, surgical faculty, and nurses on appropriate post-operative pain management and prescribing, and counsels patients on appropriate opioid use. With the use of data collection and patient feedback, Michigan established standardized prescribing guidelines for over a dozen common operations. The program also includes counseling of patients on pain management, encouraging non-pharmacologic approaches, discussing the risk of addiction, and proper disposal of opioids, and the recommended guidelines and counseling materials are available online. It is estimated that the introduction of the short teaching sessions and video lectures has prevented more than 40,000 excess pills from entering the community.
The Uniformed Services University of the Health Sciences (USUHS) teaches battlefield acupuncture (BFA) to senior medical students as an intervention that can be used to alleviate both acute and chronic pain, while simultaneously avoiding the risk of drug-drug interactions or narcotic insensitivity. Developed post 9/11, BFA is a form of auricular acupuncture that can be used to treat many types of pain in a variety of settings. Training can be completed in a four-hour setting for physicians or a two-phased program for medical students. Students are assessed on their ability to evaluate and counsel a prospective patient, and on their ability to accurately identify, select, and needle the appropriate ear points. To date, more than 6,000 Department of Defense and Veteran’s Affairs health care providers have been trained and more than 300 medical students have been introduced to this technique. Patient response has been exceedingly positive, with many reporting significant pain reduction within minutes to seconds.