Materials should NOT be shared with those that are not registered for the conference. Poster abstracts are not proofed for spelling and/or grammar errors.
Interprofessional Training in Addiction Psychiatry: The Time is Now
Kelly Gassman, MPAS, PA-C
University of Nebraska Medical Center Department of Psychiatry
- Explain the role of interdisciplinary education in reducing the stigma surrounding substance use disorders.
- Explain the role of interdisciplinary education in increasing access to providers capable of diagnosing and treating addiction.
Introduction: Substance use disorders (SUDs) are common and treatable medical conditions with increasing prevalence nationwide. Physician assistant and nurse practitioner students (PA/NP) students generally receive inadequate training on management of addiction; resultantly, students are poorly prepared for real-world practice since patients with SUDs are encountered across all healthcare settings. Research shows that healthcare providers generally hold stigmatizing attitudes towards patients with SUDs. This correlates with providers having little interest in addressing these conditions. However, recent studies suggest that exposure to patients with addiction and having clinical role models for this population can decrease stigma. SUDs commonly co-occur with other psychiatric disorders, making the psychiatry rotation an opportune time to provide hands-on training for diagnosis and treatment of SUDs as part of an interdisciplinary team. Such training can lead to increased access to providers competent to treat SUDs.
Methods: The University of Nebraska Medical Center Department of Psychiatry Addiction Psychiatry Consultation-Liaison (APCL) Service is an interdisciplinary team providing consultations to patients with substance use who are medically admitted to our hospital. APCL is a teaching service with learners across a multitude of disciplines including medical and PA/NP students, residents, and fellows. Emphasis is placed on interprofessional training as APCL is the only supervised exposure these students have to addiction psychiatry during their program. Students spend one week with APCL during their general psychiatry clerkship or four-weeks as an addiction psychiatry elective. Students become integral members of the team. Their responsibilities include interviewing and examining new and follow-up patients, presenting clinical cases, communicating with interdisciplinary members of the healthcare team, and documenting patient evaluations using clinically accurate addiction terminology. Students receive a comprehensive orientation to the service including teaching on the components of the psychiatric interview and how to ask questions in a non-stigmatizing, clinically accurate manner to maximize therapeutic rapport. Students learn about multimodal treatments including FDA approved pharmacotherapy for SUDs. Special emphasis is placed on the role that healthcare workers have in propagating or reducing stigma. Empowered with the knowledge that pejorative language jeopardizes patient care, students are taught skills to reverse stigma. Expert physician faculty directly supervise students and provide formative and summative feedback through encouragement, gentle correction, and written evaluation.
Outcomes and Significance: From June 2020 to June 2021, APCL hosted 11 PA/NP students for rotations lasting one to four weeks. Nearly all learners report changes in their perception of patients with SUDs by the end of their APCL rotation, resulting in reduction of healthcare provider stigma. Students also report that this interdisciplinary training has helped them view SUDs as medical in nature and has increased their comfort in providing evidence-based treatments themselves in the future. Learner feedback demonstrates that one to four weeks on an APCL service is an effective interdisciplinary training experience that can increase access to providers capable of treating SUDs and decrease stigma associated with these conditions.