In the SBIR Fast-track application, we propose to create and evaluate an online skills training experience for medical students to properly assess patients in pain, minimize potential opioid misuse, and maximize pain treatment. Our curriculum will provide an awareness of the risks of the addictive substances, as well as the benefits of utilizing opioids to treat pain. A lack of clinical skill when assessing pain and addiction potential can lead to under-treatment of pain, overuse of opioids in at-risk patients, diversion, exposure to addictive substances without proper monitoring, and worsening of prior addictive disease. The project will create a novel, interactive, Web-based curriculum that incorporates a remote Standardized Patient (SP) interview into the learning experience. SPs are now a common part of medical education and success with SPs (via face-to-face interactions and a telephone interview) is now a required part of the Step 2 (CS) US Medical Licensure Exam (USMLE). The examination uses Standardized Patients in multiple case situations to train the medical students in areas of medicine which they might encounter in their practices. Our project is unique in that we will utilize remote SPs for the actual training of medical students;thus ensuring learning, practice, and rehearsal of the skills medical students will need later in their professional life. The product builds on standard tools of the Internet including chat-based communication, web collaboration, and remote interactions. The final product has the potential to deliver a cost-effective training experience to students throughout years 1 to 4 of any medical school. It will also provide a stable framework upon which course directors and clerkship directors can further build and refine patient assessment and care skills. Phase I will 1) develop a complete curriculum plan for 5-7 modules on the topic of pain and addiction, 2) complete a needs analysis to define how best to use an SP interview within a learning module, 3) finalize a prototype module including a standardized patient learning experience, case scenarios, interactive questions, didactic information, and links to additional resources, 4) create the standardized patient case for the prototype module, and 5) conduct qualitative and quantitative usability testing on the learning experience with the standardized patient as a teaching component. An expert panel incorporating medical school, standardized patient, and topic expertise will assist throughout development and evaluation and rate the success of the Phase I project. Phase II will: 1) complete the content including additional SP experiences, 2) outline a plan to create a "train the course/clerkship director" module to guide implementation, 3) evaluate the program with medical students, 4) evaluate the program and prototype with consultants and course/clerkship directors, and 5) complete and publish the completed curriculum, resources and supplementary materials on a website.
The ravages of chronic pain are easily understandable;pain is a universal phenomenon that is essential to survival if we are to avoid or attend to unpleasant stimulation. Addiction is less well understood since not all of us are equally liable to suffer from the diseases of addiction. Nonetheless the destructiveness of addiction is apparent to all. Misuse of controlled substances is also poorly understood and often unanticipated. We chose the intersection of pain and addiction/misuse as the focus of this product because it of the tremendous education potential of this topic. The topic can not only effect knowledge, attitude, confidence and understanding of each issue, but can also break stereotypes and teach a full range of doctoring from compassion to strict rule-following. It introduces the legal challenges of medicine as they relate to federal and state oversight and the need for an integrated long term approach to fully address a patient's medical issue