SUPPLEMENT: Screening Brief Intervention and Referral to Treatment (SBIRT) Continuation

This project addresses a critical gap in osteopathic medical education: preparedness to treat patients with substance use disorders (SUDs) to address the rising toll of opioid overdoses in the United States and the recognition that graduates of medical schools often lack training in SUD care. The authors note that osteopathic training has lagged behind allopathic programs in this domain and that only recently (2019) did the American Osteopathic Association approve Board Certification in Addiction Medicine. Given the sparse literature on substance use education for osteopathic students and trainees, the research team developed and implemented an educational curriculum intended to expand competence in screening, brief intervention, and referral to treatment (SBIRT) and related assessment and treatment topics.

The study evaluated the Physician Undergraduate and Resident Substance Use Education (PURSUE) curriculum, a set of three online modules covering SBIRT, substance use assessments, and treatment approaches for SUDs. The evaluation used a voluntary, anonymous online survey administered as a pretest and posttest. Participants included third- and fourth-year osteopathic medical students and family medicine residents: 115 students and 29 residents completed the survey. After completing the educational modules, participants finished a posttest assessing knowledge, attitudes, and responses to clinical case scenarios featuring patients at varying risk levels assessed via SBIRT.

Results demonstrated measurable learning from the modules. Average scores increased between pretest and posttest, with an overall mean improvement of 6.5 percent, a difference determined to be statistically significant (p < 0.01). These findings suggest that the online modules effectively improved participant knowledge and attitudes about SUDs and the application of SBIRT in clinical scenarios. The team also identified disparities in performance tied to participants' socioeconomic background: learners who reported growing up in underprivileged circumstances performed worse than those who did not report such backgrounds. This observation highlights potential inequities in readiness to learn or prior exposure to relevant material that may warrant targeted support within educational programs.

The investigators concluded that integrating focused educational modules on SUDs and SBIRT into medical school curricula and residency training can enhance clinician preparedness to address substance use in primary care and other settings. By expanding the number of healthcare workers proficient in SBIRT and SUD treatment, the project aims to improve access to quality care for high-need populations most affected by substance use disorders. The study's design online, modular, and capable of reaching both undergraduate medical students and residents suggests a scalable approach for medical education. Innovations in curriculum like this program have the potential to close gaps between osteopathic and allopathic training in addiction medicine, equipping future clinicians with the tools needed to respond to ongoing public health challenges related to substance use.