The AAMC is actively supporting member medical schools and teaching hospitals in their efforts to advance educational practices. As part of the AAMC’s effort to assist its members’ work to counter this epidemic, nine institutions or partnering institutions have been selected to receive grants, funded in part by the Samueli Foundation or a Workforce Improvement Project grant from the Centers for Disease Control (CDC), to respond to the training and development needs of academic medical centers.
Academic medical centers were invited to apply through a competitive proposal process. The grantees will develop tools and resources to support educators in their collaborative efforts to increase faculty proficiency in the areas of pain management, opioid use disorder (OUD), substance use disorders (SUD), medication-assisted treatment (MAT), safe prescribing practices, and addressing stigma.
Samueli Foundation Awardees
Penn State College of Medicine
The Penn State College of Medicine will implement comprehensive OUD and MAT education into the Family and Community Medicine (FCM) Residency Program. Faculty leaders with experience as residency clinician educators and MAT-trained providers will work to develop a MAT curriculum for the FCM residency in consultation with partners and stakeholders. This will be done in collaboration with residency program leadership to identify the appropriate time to introduce buprenorphine waiver training into the FCM residency program activities. This grant will support the development of two FCM residency-based MAT clinics for residency experiential learning and provide outpatient opioid treatment in a comprehensive primary care setting. Program data will be collected to assess changes in FCM resident competency in OUD treatment, progress toward resident waiver training completion, growth in the number of MAT-trained faculty preceptors, and increases in the number of MAT patients in new clinics. Program outcomes will be disseminated within the medical education community through attendance at academic meetings and other scholarly publications and presentations.
Robert Larner, M.D., College of Medicine at the University of Vermont
The Opioids Education Work Group at the Larner College of Medicine was created to develop an integrated pain management curriculum across the four years of medical school and residency. The work group recognizes that practicing clinicians often experience discomfort with prescribing opioids and many faculty members are geographically scattered across the state. To bridge this gap, this grant will be used to develop interactive, online modules containing case studies and assessments that will help clinicians apply skills to real-world situations. Module objectives will be mapped to each of the ACGME core competencies and provide balanced instruction in pain management and safe opioid practices. A partnership with Champlain College, Emergent Media Center™ will be utilized to develop the interactive modules. The work group will evaluate clinician satisfaction with online content, technical sustainability, and changes in opioid prescribing practices and pain management strategies. Once the online content is piloted, assessed, and edited, the resources will be presented to GME and CME curriculum committee for approval as part of the medical education curriculum. The Vermont Department of Health will assist with disseminating modules across the state, with the goal of improving state-wide skills in pain management.
The University of Florida College of Medicine
The University of Florida (UF) College of Medicine will develop portable educational experiences and assessment tools that can be integrated into medical curricula to advance addiction medicine training and facilitate the education and training of learners at other institutions. Online educational modules, three standardized patient training and assessment cases, and pre- and post-program comprehension assessments will be developed to measure proficiency in SUDs and pain management, including treatment and prescribing practices. Clinical Addiction Medicine faculty and medical education experts will work collaboratively on the development of educational content that will be integrated within the required psychiatry clerkship at UF. Student satisfaction, student proficiency with SUDs and pain management, and standardized patient feedback on student performance will be assessed through this program. Training resources that are developed will be shared with constituents in workshops at various academic meetings. Educational materials and videos will be made available across the continuum through the UF Addiction Medicine Division.
The University of Texas at Austin Dell Medical School
In response to an identified need for addressing stigma and empowering physicians to use patient-first and recovery-centered language in addiction medicine educational curricula, Dell Medical School will develop freely available online tools for learners across the medical education continuum and interprofessional practitioners. The objectives of the Reducing Stigma Educational Tools include: designing, creating, and releasing two 20-minute learning modules for health professional learners, and disseminating this free, online content to medical schools and residency programs across the country. The grant will support a team of content experts, medical students, resident physicians, clinicians, web developers, and video producers who will review learning modules with a multidisciplinary review panel and work to offer continuing education credit through connecting with interprofessional training programs. Through this effort, they aim to reduce clinician stigma and increase empathy toward patients with OUD. Members of the development team will present their work at regional and national medical education and SUD-related meetings and amplify their message through engaging their internal and external strategic partnerships.
Vanderbilt University Medical Center
The Center for Professional Health at Vanderbilt University Medical Center will develop an innovative Opioid Train-the-Trainer program to equip residents to increase their confidence with opioid prescribing. This project team will first identify and train clinical faculty as opioid prescribing champs (OPC) using a blended learning program consisting of seven web-based, self-directed learning modules followed by a seven-hour live training program on-site. Once OPCs have completed this program, they are responsible for coordinating and implementing a one-hour training activity within their institutions for up to 10 peer faculty. Each peer faculty will then train up to 10 residents to increase their knowledge and skills in teaching and assessing prescribing competence. OPCs, peer faculty, and residents will be assessed at baseline and after point-of-care teaching at the end of the training period. Clinical faculty who serve as OPCs will be included on all related publications and presentations at workshops and local Group on Educational Affairs conferences.
Workforce Improvement Project Sub-Awardees
HonorHealth and Arizona State University
The goal of this initiative is to establish a state-wide collaborative partnership to scale education and practice in the management of patients with opioid use disorder (OUD). The Project ECHO model will be used to leverage expertise of the multidisciplinary team; share best practices to standardize evidence-based care; leverage case-based learning and guided practice to master complex cases; and apply web-based tools to monitor outcomes. A web-based, interprofessional curriculum on the management of complex patients with chronic pain and OUD will be developed and be eligible for CE/CME credit to increase the knowledge and capacity of clinicians in primary care to better diagnose, manage and treat patients with OUD.
The University of Alabama at Birmingham School of Medicine
University of Alabama at Birmingham School of Medicine and it’s interprofessional partners seeks to maximize the impact of their pilot Opioid Simulation educational resource through expansion and specialization within various content areas (emergency medicine and pediatrics) and locations (emergency, inpatient, outpatient). Investigators have made continued progress as they have held virtual focus groups and subsequent meetings with discipline-specific content experts. The modifications currently envisioned include expanded treatment options, X-waiver training, clinical scenarios including retained needles, withdrawal presentation, and immediate overdose and treatment. There is also new detailed content such as the WHO guidelines for pain management, and discipline-specific provider interactions drawn from investigator clinical experience. Through the next phase, the investigators will work with a graphic designer to format and design virtual prototypes of the modifications. Piloting the simulation with target groups of representative practitioners will occur in 2021 as social distancing guidelines permit. The investigators are excited to deploy the enhanced simulation and evaluate the simulation’s impact on participants perceptions of stigma.
Renaissance School of Medicine at Stony Brook University
The overall goal of this project is to develop a multimodal, longitudinal, and integrated Pain and Addiction Curriculum (iPAC) at the Renaissance School of Medicine at Stony Brook University (RSOM). A coordinating emphasis of this curriculum is how personal biases, both explicit and implicit, influence patient care. The iPAC curriculum will begin with establishing medical student baseline knowledge and skills about pain, substance abuse, and addiction, then build on this foundation to allow students the ability to apply and practice their developing knowledge and skills. Specifically, students will learn to recognize the impact that physician biases have on patient care and medical decision-making, especially in the assessment and care of patients with pain and/or substance use disorders, such as opioids. They will have opportunities to become aware of personal biases, which are naturally inherent in a physician’s perspective, and utilize self-reflection as a method for understanding and mitigating one’s own biases. Students will also be encouraged to express their thoughts and emotions on issues and/or experiences related to the care of patients with pain, addiction and opioid overdose. Curricular materials/activities will include the use of implicit association tests (IATs) – with several data collection points – didactic lectures/training workshops, video- and/or paper-based case scenarios for facilitated small-group discussions, objective structured clinical examinations (OSCEs)/simulations, and assessment instruments, such as standardized patient encounter checklists.
Donald and Barbara Zucker School of Medicine (ZSOM) at Hoftsra/Northwell
Zucker School of Medicine (ZSOM) at Hofstra/Northwell, along with partners, will develop and execute two one-day educational symposiums for current healthcare professionals based on the ZSOM MS3 “Opioid Epidemic” themed inter-clerkship week. Symposiums will take place in Suffolk County, one of the counties in New York State hardest hit by the opioid epidemic with opioid overdose deaths, opioid-related hospital visits, and opioid analgesic prescriptions, all exceeding state averages. The goal is to provide GME and CE offerings at no cost to attendees consistent with the Northwell Health Opioid Management Steering Committee’s system-level and community-level strategies to judiciously limit the supply of opioids, raise awareness of the risk of opioid addiction, and identify and manage a population dealing with opioid use disorder.