(86) Outcomes of a Robust Addiction Medicine Curriculum in Undergraduate Medical Education

Introduction/

Background:
In January 2018, the Michigan Department of Health and Human Services convened a meeting of the Deans of the seven medical schools to discuss opioid-related training in undergraduate medical education (UME). At that time six of the seven medical schools in Michigan did not have board-certified addiction physicians on their core faculty.

UME curriculum is critical to teaching and training of physicians. It empowers their ability to deliver quality and effective addiction treatment. A current challenge is that the number of curricular hours devoted to addiction medicine training is just a fraction of the time dedicated to other chronic diseases. To bridge this gap, MI CARES set out to recruit and retain a physician(s) from each of the seven medical schools to become board-certified in addiction medicine. This collaboration has had significant implications. There is now a board-eligible or a board-certified addiction medicine specialist on core faculty at each university.

In early 2020, medical students at Michigan State University College of Human Medicine (MSU-CHM) teamed up to advocate for an elective in addiction medicine. This effort signaled an unmet need in the current curriculum. Implementing addiction medicine curriculum during medical school can boost students' confidence in their ability to screen, manage, and treat people with substance use disorders.

Methods:
In May of 2021, during the COVID-19 pandemic, MSU launched a 4-week addiction medicine 75.5-hour elective. To reduce Zoom fatigue amongst students and faculty, the course used active learning, including problem-based learning (PBL), team-based learning (TBL), and peer instruction (PI). An advisory committee of college leadership, medical students, and staff met bi-monthly to discuss implementation, content, and intersession approval. The curriculum was made available as asynchronous online modules combined with guided didactics for small groups, including student and faculty resources, and large group meetings with expert and patient panels. Online asynchronous modules provided background didactics with advanced addiction topics as PBLs for TBL.

Results:
As part of the course requirements, students were asked to complete pre-post self-reported attitudes survey, adopted from the substance abuse attitudes survey (saas). The statements were closed-ended and consisted of Likert scale responses. The survey included statements regarding permissiveness, treatment intervention, treatment optimism and non-moralism. Students were surveyed prior to the first day of class, 3-months and 6-months later. When asked if substance use disorder is a treatable disease in the pre intersession survey, 61% of students agreed and 31% strongly agreed; in the post intersession survey, 28% agreed and 67% strongly agreed; in the 6-month follow-up, 21% agree and 79% strongly agreed. The pre-intersession survey indicated that 64% agreed and 33% strongly agreed that alcohol use disorder is a treatable disease; in the post survey 28% of students agreed and 67% strongly agreed; in the 6-month follow-up, 21% agree and 79% strongly agreed. The survey asked how much they agreed that a person with a substance use disorder is unpleasant to work with as patients. The pre-survey showed that 57% strongly disagreed and 43% strongly disagreed; in the post survey, 61% strongly disagree, 31% disagree, and 8% are neutral; in the 6-month follow-up, 64% strongly disagree, 21% disagree and 14% are neutral.

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