title: Medicine Resident Preparedness to Diagnose and Treat Substance Use Disorders: Impact of an Enhanced Curriculum.
abstract: BACKGROUND
  The authors' previous study found that despite caring for many patients with addiction, most Massachusetts General Hospital (MGH) internal medicine residents feel unprepared to treat substance use disorders (SUDs) and rate SUD instruction during training as fair or poor. This follow-up study evaluates the impact of an enhanced curriculum on resident perceptions of the quality of instruction, knowledge base, and self-perceived preparedness to diagnose and treat SUDs.
  
  
  METHODS
  Based on the findings of the earlier study, an enhanced SUD curriculum was designed and delivered to MGH medicine residents. Impact of the curriculum was evaluated using the same Web-based survey that was administered in the earlier study to compare pre- and posttest results.
  
  
  RESULTS
  The authors' earlier study found that 75% of residents felt prepared to diagnose and 37% to treat SUDs and 45% of residents rated the overall quality of SUD instruction as good or excellent. Following the curriculum intervention, 87% of residents reported feeling prepared to diagnose (P=.028) and 60% to treat (P=.002) SUDs. Three quarters of residents rated the overall quality of instruction as good or excellent (P<.001), and 98% reported residency curriculum had a positive impact on their preparedness to care for patients with a SUDs. Residents who reported receiving an adequate amount of SUD instruction were more likely to feel prepared to diagnose and treat addiction (P<.001). Thirty-one percent of residents still rated the overall amount of SUD instruction as too little. The intervention did not significantly improve answers to knowledge questions.
  
  
  CONCLUSIONS
  An enhanced SUDs curriculum for medicine residents increased self-perceived preparedness to diagnose and treat SUDs and educational quality ratings. However, there was no significant change in knowledge. Implementation of a more comprehensive curriculum and evaluation at other sites are necessary to determine the ideal SUD training model.
authors.affiliation: a Department of Medicine , Massachusetts General Hospital , Boston , Massachusetts , USA.|b Department of Medicine, Harvard Medical School , Boston , Massachusetts , USA.|c Massachusetts General Hospital Center for Community Health Improvement , Boston , Massachusetts , USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wakeman
authors.affiliation: d Mongan Institute for Health Policy , Boston , Massachusetts , USA.|e Edmond J. Safra Center for Ethics , Harvard University , Boston , Massachusetts , USA.|f Department of Health Systems, Management, and Policy, Colorado School of Public Health , University of Colorado Anschutz Medical Campus , Aurora , Colorado , USA.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Pham-Kanter
authors.affiliation: a Department of Medicine , Massachusetts General Hospital , Boston , Massachusetts , USA.|b Department of Medicine, Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Meridale V
authors.initials: MV
authors.lastname: Baggett
authors.affiliation: a Department of Medicine , Massachusetts General Hospital , Boston , Massachusetts , USA.|b Department of Medicine, Harvard Medical School , Boston , Massachusetts , USA.|d Mongan Institute for Health Policy , Boston , Massachusetts , USA.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Campbell
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D015397:Program Evaluation; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy
keywords: Resident preparedness, substance use disorder, addiction, curriculum, substance abuse, drug use