Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students

• Published in: Academic psychiatry 2023-06, Vol.47 (3), p.258-262
• Main Authors: McAfee, Nicholas W., Schumacher, Julie A., Williams, Daniel C., Madson, Michael B., Bagge, Courtney L., Konkle-Parker, Deborah, Paul, Ian A., Houston, L. Joy, Young, Kathleen M.
• Format: Article
• Language: English
• Subjects: Alcohol Abuse; Alcohol use; Attitude Measures; Attitudes; Benchmarking; Benchmarks; Check Lists; Confidence; Curricula; Drinking; Drug use; Educational Research; Effect Size; Evidence Based Practice; Feedback; Fidelity; In Brief Report; Interpersonal Competence; Intervention; Interviews; Knowledge; Measurement Techniques; Medical Education; Medical students; Medicine; Medicine & Public Health; Multiple Choice Tests; Outcome Measures; Psychiatry; Ratings & rankings; Referral; Resistance (Psychology); Skills; Student Evaluation; Student Satisfaction; Substance use disorder; Training
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-023-01752-2

Objective Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying and addressing alcohol use in non-specialty settings. Many medical schools teach SBIRT, but most published evaluations of these efforts exclude rigorous skill assessments and teaching methods. Methods During the 2017–2018 academic year, 146 third-year medical students received classroom-based learning on SBIRT and motivational interviewing (MI) and at least two SBIRT practices with feedback as part of a 4-week psychiatry clerkship. The objective of this curriculum was to improve SBIRT knowledge, attitudes, and confidence and enable learners to skillfully deliver SBIRT. Outcomes evaluated included satisfaction, knowledge, attitudes and confidence, and clinical skill in delivering SBIRT to a standardized patient (rated by the actor, as well as an expert). Results Results indicated acceptable satisfaction at post-curriculum and significant improvements in attitudes and knowledge from pre- to post-curriculum. On the clinical skills exam, all students were rated as having mastered at least 80% of SBIRT elements by standardized patients and 91.8% were rated at this level by a faculty expert. Student attitudes and knowledge were unrelated to expert ratings, and standardized patient ratings had limited associations with expert ratings. Conclusions These results suggest curriculum objectives were achieved and provide unique contributions to the SBIRT curricular outcome research for healthcare trainees. Other findings included that trainee knowledge and confidence may not relate to skill, and standardized patient feedback provides different information on SBIRT and MI skill than expert ratings.