18 Feb Online Training Improves Doctors’ Ability to Treat Substance Abuse
In many cases, non-specialized doctors known commonly as residents are the first medical professionals to encounter people affected by undiagnosed or untreated substance problems. However, for a number of reasons, residents may lack the skill or confidence to properly diagnose such problems or follow up a diagnosis with effective treatment recommendations. In a study published in October 2014 in the journal Academic Medicine, a team of American researchers assessed the potential effectiveness of a brief, online-based training regimen in improving the skills of residents who work with substance-affected patients.
Broadly speaking, there are two forms of diagnosable substance problems: substance abuse and substance addiction. People affected by substance abuse do not have a physical need to consume alcohol or a given drug or medication, while people affected by substance addiction do have such a need. Despite these distinguishing characteristics, it’s not uncommon for a person who meets the criteria for a substance abuse diagnosis to have significant symptoms of substance addiction. Conversely, people diagnosed with addiction often have significant symptoms that point toward the presence of non-addicted abuse. In some cases, doctors have no real way to separate addiction-related symptoms from abuse-related symptoms. In order to accurately reflect these facts, the American Psychiatric Association no longer maintains individual definitions for substance abuse or substance addiction (i.e., substance dependence). Instead, the organization directs doctors to consider both conditions jointly as connected aspects of an illness known as substance use disorder. There are subtypes of this illness for all substances associated with abuse- and addiction-related issues.
Residents and Substance Treatment
Instead of interacting with an addiction specialist, many people affected by substance use disorder first encounter a resident working in an emergency room or other department of a general hospital. Residents are post-graduate, licensed doctors completing additional coursework in a field of medical specialization. Unfortunately, despite the fact that these doctors have a very high chance of working with patients dealing with serious substance problems, they often receive only basic training on how to diagnose and treat such patients. According to the results of a study published in 2013 in the journal Substance Abuse, more than 85 percent of residents may feel unprepared to make an accurate substance use disorder diagnosis. In addition, over half of all residents may feel unprepared to create an appropriate treatment plan for patients already diagnosed with substance problems.
Usefulness of Online Training
In the study published in Academic Medicine, researchers from Drexel University, the University of Pennsylvania, West Chester University and the National Institute on Drug Abuse used a 2011-2012 pilot project involving hospital residents and students still in medical school to explore the usefulness of fairly brief online training sessions in increasing knowledge of the skills that non-specialist doctors need to diagnose and treat substance use disorder. A total of 129 residents and 370 medical school students in the Philadelphia area took part in this project. Each participant took a multimedia online course that emphasized self-guided learning of the principles of substance problem diagnosis and treatment. In addition, each participant followed up on this course through small-scale, in-person meetings with the course administrators. The specific material included in the online training was more extensive for the residents than for the medical students and featured patient interviews designed to test their real-world abilities.
The researchers concluded that, compared to a group of participating residents and medical students who didn’t receive the online training or participate in a follow-up meeting, the residents who did displayed an increased level of confidence in their ability to work with people affected by serious substance problems. In addition, compared to the residents who did not receive the training or the follow-up, the residents who did performed better on practical tests designed to evaluate their ability to screen for substance problems and pursue counseling in people previously diagnosed with such problems. The medical school students did not derive any noticeable benefit from their participation in the training and follow-up meeting.
The study’s authors believe that their pilot project demonstrates the usefulness of fairly short online training as a means of improving non-specialist doctors’ ability to recognize and treat serious substance problems. In turn, the improvements provided by this training may very well translate into improved care for the many people who never seek specialized treatment for their substance-related issues.
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