4 minute read

Every week I receive solicitations in my physical mailbox for clinical trainings on a variety of topics like trauma-informed care, grief counseling, mindfulness, and more. They never stop coming! I wonder who sent these companies my address.

These trainings are usually live or recorded webinars with handouts, sometimes with a well-known expert involved. And if you register now, they will knock 70% off the price!

Truly, there has never been a better time for clinicians to access advanced training. That is one benefit of the internet. Also, the evidence base behind these training events is often solid and the instructors are top-shelf quality.

The next step in our workforce evolution is to make core advanced training widely accessible in a central location. The training should be asynchronous, competency-based, and engaging. To illustrate, I’ll share my experience in co-developing the STFM (Society of Teachers of Family Medicine) Addiction Medicine Curriculum.

I met the co-developer, Randi Sokols, through the STFM Addiction Collaborative. Randi is board-certified in family medicine and addiction medicine with an MPH and MMedEd. I am a medical family therapist with experience designing large training programs in substance use treatment. We both recognized the lack of a central curriculum for medical residents to develop an addiction medicine knowledge base. So, we concocted a plan.

 Here is the general process we went through to develop and test our curriculum.

1. Develop learning objectives
2. Design the overall curriculum and specific modules
3. Recruit experts in the field to write module content
4. Find funding to produce modules
5. Hire instructional designers
6. Pick a learner management system to host the modules
7. Test the modules with a pilot group of learners and instructors
8. Disseminate the modules through professional networks

We ran a pilot test with residents and faculty from 25 family medicine residency programs. Residents were exposed to the modules and the faculty were exposed to the instructor materials plus a monthly faculty development meeting. We learned a lot during the pilot test. Here is a 2023 article by Family Medicine that describes our method. The findings show that the modules were engaging and effective.

Health professionals need access to free, high-quality, and engaging clinical training.

Funding was crucial and went entirely toward the instructional designers. We received a seed grant from STFM and then additional funding from a federal grant. We could have used more though; the instructional designers were generous with their time and did more than what we could pay them to do.

The curriculum includes 12 addiction medicine modules with interactive content, handouts, videos, supplemental resources, and assessments. Each one takes ~1- 1.5 hours to complete. Topics include:

• Screening, Brief Intervention, and Referral to Treatment (SBIRT)
• Addiction as a Chronic Disease
• Taking a Substance Use Disorder (SUD) History
• Safe Prescribing of Opiates
• Urine Drug Screening
• Tobacco Use Disorder
• Opioid Use Disorder (OUD)
• Inpatient Management of OUD
• OUD and Pregnancy
• Alcohol Use Disorder (AUD)
• Inpatient Management of AUD
• Health Equity and Vulnerable Populations

The modules were designed to be pragmatic, highly engaging, and focused on evidence-based clinical practice. Randi recorded demonstration videos and narration for each module. Production took significant time because of the visual and audio elements that were synchronized. All the modules are hosted on a public version of Canvas.

Currently, I use the modules in my behavioral health courses here at Arizona State University. My students represent multiple disciplines like social work, applied behavior analysis, nursing, and professional counseling.

Our curriculum is appropriate for any health professional that wants to build upon their foundational helping or clinical skills. There is some dosing content for prescribers, but even that information is good for non-prescribing professionals to know.

The arrival of our curriculum is timely. Substance use problems are prevalent throughout the country. Professionals need access to free, high-quality, and engaging training.

What other clinical topics need to be covered? One idea is curricula for peer navigators and community health workers. The healthcare system is overwhelmed with patient demand for behavioral health services; organizations need trained professionals who extend the care team, increase treatment engagement, and reduce the workload of clinicians. But there is no central curriculum for these disciplines.

Another idea: AI-facilitated patient-provider communication skill training. Chatbots like ChatGPT and Google Bard have tremendous potential for acting as patients and allowing learners to practice communication skills. A chatbot could easily supplement traditional didactics.

Imagine a free chatbot that any professional can use to develop sophisticated skills like motivational interviewing. Learners could use the platform repeatedly to gain proficiency. Perhaps the chatbot could even monitor performance and give coaching feedback.