title: Implementing Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) Education in a Pediatric Residency Curriculum.
abstract: BACKGROUND
  Screening, brief intervention, and referral to treatment (SBIRT) is recommended as part of routine health care for adolescents as well as adults. In an effort to promote universal SBIRT, the Substance Abuse and Mental Health Services Administration awarded funding to residency programs to develop and implement SBIRT education and training. Our project focused on creating scientifically based, developmentally appropriate strategies and teaching materials for the adolescent age range. This paper describes curriculum development and implementation and presents evaluation data.
  
  
  METHODS
  Pediatric and child psychiatry residents were trained. The training consisted of 4 activities: (1) case-based teaching modules, (2) role-play of motivational interviewing and brief interventions, (3) mock interviews with trained adolescents, and (4) supervised "hands-on" screening and brief interventions. Main outcome measures included trainee satisfaction, and SBIRT knowledge, perceived self-efficacy, and self- and observer report of use of the SBIRT algorithm.
  
  
  RESULTS
  Among 150 total participants completing the SBIRT training modules, nearly all (92.3%) were satisfied/very satisfied with the training modules. Knowledge accuracy immediately post training was high, but declined significantly by the end of the first residency year, with little change across subsequent years of residency. Confidence ratings also declined over time. Use of the SBIRT algorithm during the Adolescent Medicine rotation was high according to trainee self- and faculty observer report.
  
  
  CONCLUSIONS
  We found evidence of training satisfaction, increased confidence in talking to adolescents about substance use, and widespread use of recommended practices immediately following training. Use of a highly structured algorithm to guide practice, and simple, highly structured brief interventions was a successful training approach, as residents self-reported accurate use of the SBIRT algorithm immediately after training. Knowledge and self-confidence declined over time. It is possible that "booster" sessions and ongoing opportunities to review materials could help residents retain knowledge and skills.
authors.affiliation: a Department of Pediatrics , Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schram
authors.forename: Sion K
authors.initials: SK
authors.lastname: Harris
authors.forename: Shari
authors.initials: S
authors.lastname: Van Hook
authors.forename: Sara
authors.initials: S
authors.lastname: Forman
authors.forename: Enrico
authors.initials: E
authors.lastname: Mezzacappa
authors.forename: Roman
authors.initials: R
authors.lastname: Pavlyuk
authors.forename: Sharon
authors.initials: S
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002665:Child Psychiatry / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008403:Mass Screening; D010372:Pediatrics / Q000193:education*; D011614:Psychotherapy, Brief / Q000193:education*; D012017:Referral and Consultation; D020377:Self Efficacy; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy
keywords: SBIRT training; adolescent substance abuse; brief intervention; residents