The 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 a national webinar and encouraged to submit it to MedEdPORTAL for peer-reviewed publication.
2019 Award Winners
Duke University School of Medicine developed a substance use disorder (SUD) course that brought together students and faculty from different health professions, engaged students in their learning, explored their beliefs about SUDs and health care roles, and extended learning to the clinical setting. In doing so, they developed a course that directly responded to the need for interprofessional education that prepares students for collaborative care and achieves educational outcomes affecting students’ behaviors and patients’ care. As corroborated by validated assessment measures demonstrating statistically significant changes, students’ understanding and attitudes toward patients with SUDs and collaborative care were enriched by theory-based intentional course design, which continuously involved students in active learning with faculty facilitation. Students performed behavior change counseling in the clinical setting, with over 90% of counseled patients expressing a willingness for follow-up SUD care. Course findings demonstrate how to advance students’ learning from satisfaction and self-declared learning to changes in their behavior and patient outcomes.
HonorHealth developed a network-wide Opioid Stewardship Taskforce (OST) encompassing five hospitals, a medical group with over 250 clinicians, and seven GME programs with 66 residents. A modular curriculum with two broad arms was developed and includes a comprehensive quality improvement initiative as well as a series of in-person materials, online videos, and simulation workshops under their Opioid Education program. Design thinking, state level data, and an environmental scan were used to inform and plan the formation of the OST with a focus on ambulatory clinics. This effort was designed to improve understanding of clinicians on opioids, increase awareness of principles of opioid stewardship, and provide resources to aid in care for patients with a substance use disorder patients. Participants were assessed in their familiarity with Arizona opioid-prescribing policy, perceived physician confidence in recognizing and properly escalating opioid use disorder, including medication assisted treatment options.
University of Chicago Pritzker School of Medicine
To address a gap in students’ exposure to addiction medicine, while also improving the hospital’s response to the opioid epidemic, the University of Chicago Pritzker School of Medicine created The O.P.I.A.T.E. (Outpatient Principles in Addiction Training and Education) Initiative. Through O.P.I.A.T.E., first-year medical students (MS1’s) in the emergency medicine elective learn about the opioid epidemic, harm reduction, recognition and response to overdose, and naloxone distribution. Following didactic training, MS1’s screen patients in the emergency department to identify those at risk for experiencing or witnessing opioid overdose. Through this process, students gain early clinical exposure to the opioid epidemic, addiction medicine, discussing sensitive topics, and filling a value-added role that improves patient care. To date, 30 first-year medical students participated in lectures and completed ED screening, identifying 59 patients eligible to receive naloxone.
University of Kansas School of Medicine
The Family Medicine Opioid Stewardship and Recovery Curriculum at the University of Kansas School of Medicine is comprised of two interacting components— Family Medicine Recovery Clinic (FMRC) and Opioid Class & Panel Management (OCPM). FMRC is an interprofessional (IP) teaching clinic housed within the academic family medicine practice, operating on one half-day weekly, serving patients with substance use disorders. Core family medicine faculty, all buprenorphine-waivered, supervise IP learner teams—family medicine PGY-1s, third-year medical students (M3s) on their family medicine clerkship, fourth-year pharmacy students (P4s), and social work and psychology interns. OCPM is a flipped classroom session attended by the same IP learner teams participating in FMRC. In OCPM, teams are assigned a clinic patient, whose charts they review. They appraise the quality of opioid stewardship for that patient, locate any gaps in guideline-directed care, and pen a recommendation statement for the PCP. The Substance Abuse Attitudes Scale was used to evaluate the M3 learner experience with FMRC. To date, 300 M3s, 100 P4s, and several social work and psychology students have participated in FMRC. Twenty family medicine residents have been waiver-trained through FMRC.
2018 Award Winners
University of Massachusetts Medical School
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.
Warren Alpert Medical School of Brown University
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.
University of Michigan Medical School
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.
Uniformed Services University of the Health Sciences
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.