DOCUMENT RESUME

FD 332 565 HE 024 475

TITLE Project Descriptions: Model Curricula for Alcohol andOther Drug Abuse Physician and Nurse Education.

INSTITUTION National Inst. on Alcohol Abuse and Alcoholism(DHHS), Rockville, Md.; National Inst. on Drug Abuse(DHHS/PHS), Rockville, Md.

REPURT NO RPO-736PUB DATE Nov 89NOTE 47p.; For related documents, see HE 024 476-411.PUB TYPE Reports - Descriptive (141)

EDRS PRICE MF01/PCO2 Plus Postage.DESCRIPTORS *Alcohol Abuse; Course Descriptions; Curriculum

Design; *Drug Abuse; *Drug Education; Family Practice(Medicine); *Graduate Medical Education; HigherEducation; Internal Medicine; "Medical Education;*Nursing Educatn; Pediatrics

ABSTRACT

Brief descriptions are presented of 12 modelcurriculum projects which are part of a program to develop anddemonstrate effective models for integrating alcohol and other drugabuse teaching into the medical and nurse education curriculum. Themodels are based upon discipline-specific knowledge and skillobjectives and address undergraduate, graduate, residency, andfaculty training needs within physician and nurse education. The 12curricula projects include the following: Brown University School ofMedicine Center for Alcohol and Addiction Studies: ProjectADEPTBrown University Alcohol and Drug Education for PhysicianTraining in Primary Care"; "Society of Teachers of FamilyMedicine--Project to Develop, Implement, and Evaluate a Model Programan Curriculum in Alcohol and Drug Abuse in Family Medicine"; "TheJohns Hopkins Hospital" Specialty Specific Model; Develop, Implement,and Evaluate a Model Program and Curriculum in Alcohol and Other DrugAbuse for Pediatric Faculty, Residents, and Medical Students"; "TheJohns Hopkins University School of Medicine: Development,Implementation and Evaluation of a Model Program and Curriculum inAlcohol and Cther Drug Abuse Education for Medical Students,Residents, and Faculty In Internal Medicine"; "Medical College ofVirginia Program for Alcohol and Other Drug Abuse Education,Research, and Treatment"; "Vanderbilt University: Vanderbilt'sIntegrated Curriculum on Alcohol and Drugs"; "University of Alabamaat Birmingham Medical Education Facility: Curriculum for ClinicalCompetency in Substance Abuse Medicine for Primary Care Physicians";"University of Virginia School of Medicine: Project SAGE (SubstanceAbuse General Education)"; "University of North Dakota School ofMedicine: PEPSA, University of North Dakota Physician EducationProject on Substance Abuse"; "New York University Division ofNursing: NIAA-NIDA Alcohol and Other Drug Curriculum DevelopmentProject for Nursing"; "The Ohio State University College of Nursing:Project CANDIDCurriculum for Addictions Nursing: Directions forIntegrated Design (Tentative)"; "University of Connecticut School ofNursing: Project NEADA--Nursing Education Alcohol and Drug Abuse."Each description includes a list of those who worked on developingthe project as well as information on purpose, approach, andmaterials. (JB)

National Institute on Alcohol Abuse and AlcoholismNational Institute on Drug Abuse

Project Descriptions

Model Curricula forAlcohol and Other Drug AbusePhysician and Nurse Education

November 1989

14)u B. DEPARTMENT OF ECluCATION

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tiM EDUCATIONAL RESOURCES INFORMATIONCENTER IERICI

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.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health SIM*

Alcohol, Drug Abuse, and Mental Health Admhdotrodon

BEST COPY AVAILABLE 2

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RP0738

Preface

The National Institute an Alcohol Abuse and Al-coholism (NIAAA) and the Naticlial Institute on DrugAbuse (NIDA) are jointly sponsoring a program todevelop and demonbcrate effective models for integrat-ing alcohol and other drug abuse teaching into the medi-cal and nurse education curricula. The model curriculaare based upon discipline-specific knowledge and sIdllobjectives and address undergraduate, graduate,residency, and faculty training needs. Within medicine,curriculum models are being developed for the follow-ing specialties: General Internal Medicine, FamilyMedicine, Psychiatty, Pediatrics, and 013/GYN. Withinnursing, curriculum models are being developed for

UI

undergraduate core courses and for graduate nursingspeciakies.

Each project includes the follGwing components: (1)use of a faculty wvarldng committee to assess alcohol andother drug abtre instructional needs and develop cur-riculum objectives, (2) development of curriculummaterials and pilot testing of a selected segment of thecurriculum, and (3) a 14-month implementation andevaluatian phase.

Descriptions of the 12 model curriculum projects arepresented in this publication. Additional informationmay be obtained by comacting the individual projectdirectors.

Contents

Psie

Preface iii

Brown University School of Medicine Center for Alcohol and Addiction Studies 1

Society of Teachers of Family Medicine 5

The Johns Hopkins Hospital 9

The Johns Hopkins University School of Medicine 13

Medical College of Virginia 19

Vanderbilt University 23

University of Alabama at Birmingham Medical Education Facility 27

University of Virginia School of Medicine 31

University of North Dakota School of Medicine 35

New York University Division of Nursing 39

The Ohio State University College of Nursing 43

University of Connecticut School of Nursing 47

Brown University School of MedicineCenter for Alcohol and Addiction Studies

ADM-281-88-0008, 198848

Brawn University School of Medicine

Project Staff

Director

David C. Lewis, MD.Director, Brown University Center for Alcohol and

Addiction Studies; Director, Division of Alcoholism

and Substance Abuse, Roger Williams General

Hospital; Professor of Medicine ac..i Community

Health ; Donald G. Millar Professor of Alcohol and

Addiction Studies, Brown University

Coordinator

Catherine Dube, Ed.P.Doctorate in Educational Media and Technology;

Curriculum Development and Instructional Materials

Development Professional

Faculty Development

Michael Goldstein, M.D.

Assistant Psychiatrist-in-Chief, Miriam Hospital;

Proyam Director, Miriam Smoking Cessation

Program; Assistant Professor, Psychiatry and Human

Behavior, Brown University

Evaluation

William Zwick, Ph.D.Coordinator of Alcohol Services, Rhode Island

Group Health Association; Assistant Professor of

Community Health, Brown University

Working Committee

Anthony Alario, M.D.Director, Pediatric Primary Care Unit, Rhode island

Hospital; Assistant Professor, Pediatrics,

Brown University

Michele Cyr, M.D.Director, Divisionof General Internal Medicine

Inpatient and Consultation Services, Rhode Island

Hospital; Assistant Professor ofMedicine,

Brown University

Alicia Landman, M.D.

Clinical Instructor, Family Medicine,

Brown University

2

Sheldon Levy, Ph.D.Director of Behovioral ,ciences, Family Medicine

Residency Program, Memorial Hospital; Assistant

Professor, Family Medicine,Brown University

Michael Liepman, M.D.CliniJ Coordinator-, Alcohol Dependence

Treatment Program, Department of Psychiatry,

Providence VA Medical Center, Career Teacher in

Alcoholism and DrugAbuse; Assistant Professor of

Psychiatry and Human Behavior, Brown University

Suzanne Riggs, M.D.Director, Division of Adolescent Medicine,

Department ofPediatrics, Rhode Island Hospital;

Assistant Professor of Pediatrics, Brown University

Patrick Sweeny, M.D.Director ofMedical Education,Women and Infants Hospital

Robert Swift, MD., Ph.D. (Pharmacology)

Director of Division of Psychiatry, Roger Willams

General Hospital; Consultant Psychiatrist, Women

and Infants Hospital; Assistant Professor, Psychiatry

and Human Behavior, Brown University

Alan Wartenberg, MD,Medical Coordinator, Alcohol Dependence

Treatment Program, Providence VA Medical Center;

Career Teacher in Alcohol and Substance Abuse;

Instructor, Department of Medicine,

Brown L. niversity

John BrooklynMedical Student, Class of 1989,

Brown University Program in Medicine

Harry Duran, Ph.D.Doctorate in Pharmacology; Medical Student, Class

of 1989, Brown University Program in Medicine

Project Consultants

Peter Coogan, M.D., University of California, Irvine

George Comerci, M.D., University of Arizona

Herbert Kleber, M.D., Yale University

Robert Sokol, M.D., Wayne State University

Paula Stillman, M.D., University of Massachusetts

6

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Society of Teachers of Family Medicine(STFM)

ADM-281-87-00021 March 1987-March 1989

Society of Teachers of Family Medicine

Working Commit!**

Project Director

Peter G. Coggan, M.D.Department of PannlyUniversity of Califionia - Irvine

Project Coordinator

Ardis K. Davis, M.S.W.Departnitnt of Family Medicine RF-30University of Washington School of Medicine

Assistant Prided Dimdor

Rebecca Henry, Ph.D.Office of Medical Education

Research and DevelopmentMichigan State University

Project Administrator

Roger A. Sherwood, C.A.E.Society of Thachers of Family Medicine

Advisory Members

Macaran A. Baird, M.D., MS.Department of Family MedicineSUNY Health Science Center

Antonnette V. Graham, R.N., MS.W.Case Western Reserve UniversityDepartment of Family Medir: .0

Al M. Mooney, M.D.Statesboro, GA

Program Fellows

Richard L Brown, M.D., M.P.H.Jefferson Medical College

Lome Campbell, M.D.Serenity. St. Vincent Health Center

James N. Finch, M.D.Duke University Medical CenterDepartment of Community/Family Medicine

Michael F. Fleming, M.D., M.P.H.Department of Family MedicineUniversity of Wisconsin

Stephen P. Flynn, M.D., M.S.P.H.Family Practice CenterFkirview General HospitalCleveland, OH

Robert IL Rinke, MD.ICingsport Family Practice Centex

KingsPort, TN

Benjamin Goodman, M.D.**Medical Arts ClinicHickory, NC

Anton J. Kuzel, M.D.Department of Family PracticeFairfax Family Practice CenterMedical College of Virginia

Jerry Schulz, M.D.Family Practice Residency Training ProgramSt. Paul-Ramsey Medical Center

J. Paul Seale, M.D.Department of Family Practice, University of ThrasHealth Science Center

Program Consultants

Carole J. Bland, Ph.D.Department of Family Practice and Community

HealthMinneapolis, MN

Raymond C. Anderson, M.D., Cannel, NY

Upon enteritis the pogrom, Dr. Campbell was at SUNY, Buffalo.Upon entering the propam, Dr. Goodman wu at Medical College of South Carolina.

6

Society of Teachers of Family Medicine

To Develop, Implement, and Evaluate a Model Program and CurriculumIn Alcohol and Drug Abuse in Family Medicine*

Background and Pufpose

In March 1987, the Society of Teachers of FamilyMedirine was awarded a Federal contract to implementand evaluate a model program and curriculum in al-cohol and other drug abuse in family medicine. Thepurposes of the project were to:

develop selected faculty in alcohol and other drugabuse curriculum strategies in medical education;

develop selected faculty in alcohol and other drugabuse knowledge and skills;

begin a network of interested fa.nily medicinefaculty in this area;

enable selected family medicine faculty to becomemore centrally involved in faculty developmentactivities in home institutions; and

develop self-contained, exportable teachingproducts for use by others.

This faculty development program was foundedupon a model that incorporated two important com-ponents of faculty development in higher educationorganizational development and personaldevelopment into traditional curriculum developmentand instructional components. The key concepts or thisfaculty development model were:

a flexible capability to meet individual learnerneeds (and the needs of their institutions);

impact and influence on local institutiong

network-building features;

socialization to the clinical and academic fields ofalcohol and other drug abuse;

use of local and national resources in traininx

broad national impact on the specialty of familypractice; and

encouragement of interspecialty collaboration.

Approach

Ten family medicine faculty were chosen to undergoa 12-month faculty development program (figure 2) thatinclude& (a) four off-site training sessions, and (b)individual clinical training and curriculum projects at

home sites. The major characteristics of the trainingprogram for the fellows were:

a choice of alcohol and other drug abuse cur-riculum component projects that had relevance tothe kllow's own career development, experience,and expertise and to the home institution;

supervision and guidance from a group of "ex-perts" through each phase (development, pilottesting, and implementation) of the curriculumcomponent project;

an end-product from each curriculum componentproject a packapd, exportable teaching unit,preferably publishable, but at minimum, pre-sented at a national family medicine meetinig

responaility for augmentation of clinical knowl-edge and skills involved mainly individual fellowsdrawing upon local resources; and

ongoing encouragement and provision, wherepossllste, of opportunities for socialization to theclinical and academic fields of alcohol and otherdrug abuse.

The following steps were crucial to the successfulexwition of the program:

Working committee (faculty group) formationand establishment of guidelines for functioning

Selection of fellows

Determination of program objectives

Conducting a needs assessment and specificationof learning objectives

Development of instructional components

Pilot testing of selected parts of instructionalcomponents

Establishing a mechanism for sharing and cir-culating learning materials and teaching resources

Evaluation and Summary of Findings

Six evaluation elements were used to assess how wellprogram objectives were met:

I. Increase in clinical competence

/ Curriculum project performance

Society of Teachers of Family Medicine (STFM), University of Cahfornia hvine Medical Center, Building 29A. Route 81, 101The City Drive South, Orange, CA 92468; (714) 6344171.

7

Society of Teachers of Family Medidae

3. Curriculum project dissemination

4. Program impact op participants

5. Network formatiorn

6. Program impact tn institutionsThe most striking find* from the evaluatimi data

were in relation to network formation and program im-pact on participants. A strong, viable Substance AbuseWorking Group withio the Society of Teachers of Fami-ly Medicine is wobably the most objedive outcomemeasure of this program's success. This group is highlyorganized with strong leadership from the fellows.

In addition to this collaborative group, all the fellowsindicated in their evaluation of the program that it hadhad a substantial impact on them and their professionalpursuits. For some, it was not that the program createdan avenue for them to follow, but it greatly facilitatedtheir pursuit of an avenue toward which they alreadyaspired. For others, it opened up a new arca of pursuit.

Also noteworthy were findings in the area of cur-riculum project performance and curriculum projectdissemination. All 10 fellows completed their cur-riculum projects in a satisfactory (and often exemplary)manner. These were prepared in accordance withguidelines suitable for inclusion in an instructor'smanual. In addition, nine of the fellows have eitherpresented at regional or national meetings (or arescheduled to present) cc have had accepted for publi-cation work directly stemming from their curricularprojects completed in the program

The weakest feature of the program, as evidenced bythe evaluation data, was in changing fellows' own clinicalknowledge and skill acquisition. Although the data in-dicate some increase in perceived clinical competence,this could not be objectively substantiated. Recommen-dations for future programs of this nature include incor-poration of required clinical training components toaddress this weakness.

Program objectives

Foster development ofknowledge and skills in four areas

OlnicalMedical EducationAdministrationAcademic/Professional

Create network amongparticipants to outlive program

Increase faculty developmentactivities at home institutions

Promote scholarship throughpresentation and publication ofcurriculum development work

Produce a manual of pilot-testedcurriculum examples

Figure 2. Program overview

Instructional elcinents

I. Group instruction (off site)IL Individual curriculum

project (on site)III. Individual clinical training

(on and off site)IV. Resource exchange (on

and off site)

V. Socialization actiAties (onand off site)

I, IV above

I, II above

I, H, IV above

H above

Fvaluation elements

I. Increase in clinical competenceII. Curriculum project

performanceHi. Curriculum project

disseminationIV. Program impact on

participants

V. Network formation

VI. Program impact on institutions

II, ill above

ill above

8

The Johns Hopkins HospitalADM-281-86-0009, 198648

Project Staff

Director

loover Adger, Jr., M.D.

Codirector

Catherine DeAngelis, M.D.

Coordinator

Eileen M. McDonald, BS.

Evaluation

Anne Duggan, Sc.D.

Working Committee

Frank Oski, MD.Professor and ChairmanDepartment of Pediatrics

Catherine DeAngelis, M.D., M.P.H.Professor of PediatricsDeputy ChairpersonDepartment of PediatricsDirectorDivision of General Pediatncs andAdolescent Medicine

Emma J. Stokes, PhD.Special Assistant to the Dean and PresidentArting DirectorThe Johns Hopkins Alcohol ProjectActing DirectorThe Blades Center for Clinical Practice andResearch in Alcoholism

The Johns Hopkins, Hospital

10

Henry Seidel, MD.Professor of PediatricsAssociate Dean for Student AffairsJohns Hopkins University School of Medicine

Archie Golden, MD., M.P.H.Associate Professor of International HealthJohns Hopkins University School of Hygieneand Public HeakhDirector of PediatricsFrancis Scott Key Medical Center

Alain Joffe, M.D., M.P.H.Associate Professor of PediatricsDirector of Adolescent Medicine

Anne Duggan, Sc.D.Assistant Professor of PediatricsDirector, Division Research Program

Alan Rotnanoski, M.D.Assistant Professor of Psychiatry

Edward Sills, M.D.Associate Professor of PediatricsDirectorPediatric Medical Student Thaching Program

John Bland, LC.S.W.DirectorOffice of Special ProjectsMaryland Department of Health and Mental HyOene

Project Consultants

Charles Whitfield, M.D.

Richard Schwartz, M.D.

Karen Kumor, M.D.

A. Adomola Ekulona,

1 4

The Johns Hopkins Hogpital

Specialty Specific Model: Develop, implement, and Evaluate a ModelProgram and Curriculum in Alcohol and Other Drug Abuse for Pediatric

Faculty, Residents, and Medical Students*

Purpose

The overall purpose of this project was to design,implement, and evaluate a model program ard cur-riculum fw primary care pediatricians in alcohol andother drug abuse. This curriculum is based on minhnalknowledge and skills learning objectives specific topediatricians as well as generic knowledge and skillsappropriate for all primary care physicians. While ad-dressing teaching at the student, resident, and facultylevels, a major component of this curriculum is its focuson faculty development. This is considered an essentialcomponent because of the dual role of faculty, both aspotential reinforcers dour educatimml Fogram and asrole models for students, residents, and other faculty.

Model for Program and CurriculumDevelopment

To organize ow work, a model for program andcurriculum development was conceptualized that in-cludes specific steps involving assessment of the en-vironment, prioritization of competencies and'establishment of curriculum goals, and implementationof a core curriculum based on a specific instructionalplan. Fmally, the model addreues the development ofan evaluation plan to document both process and out-come of the program.

Curriculum

The primary goals of the curriadum are to improvethe performance of primary care pediatricians or medi-cal students in dealing with alcohol and other drug abuseand its related problems and to improve their skills inrecognition and intervention. The curriculum hasseveral unique features. Most importantly, it wasdesigned to be integrated into the currently existingcurriculum of the department and includes both didac-tic and experiental teaching activities. Over the courseof the academic year, more than 20 objectives-orientedpresentations devoted to specific alcohol and other drugabuse toidcs were aondusted fw medical students, resi-dents, and faculty:111e teaching activities were organ-ized around five basic topic are=

Overview of Alcohol and Other Drug AbuseIssues

Common Drop of AbuseAlcohol and Other Drug Abuse InterviewingAlcohol and Other Drug Abuse Assessment and

DiagnosisAlcohol and Other Drug Abuse Prevention and

Treatment

Materials

For uch sesrjon presented, both instructor and par-ticipant materials have been developed. Materials or-ganized for instructors typically include sessionobjectives, instructional outline, presession readingmaterials for instructor and learners, masters for slidesand handouts, preparatiai checklist, and evaluationform. Materials for the learners include structuredpatient case scenarios, fact sheets, treatment resourcelists, obsavaticm checklists, and role play scripts.

Guidelines for development, implementation, andevaluation, based on our experience conducting thesesessions, have been presented in a resource manual forinstructors. Copies of all necessary teaching and evalua-tion materials as well as a desaiption of guiding prin-ciples on curriculum development and implementationare provided.

EvaluNon

Evaluation of the curriculum occurred through aseries of both process and outcome measures. Eachcomponent of the curriculum had a corresponding eval-uation structured to assess the participant's acceptanceof materials and presentation methods as well as theeffectiveness of the session in achieving predeterminedinstructional goals. In addition, an extensive posttestinuvey Was implemented at the end of the academic year.The survey evaluated alcohol and other drug abuseknowledge, attitudes, and related clinical practice pat-terns of all residents and faculty in the department.Results of the survey indicated positive changes in allthree areas among curriculum participants.

AWUr HoçEiis HapUal, Pad Badims, Roam 3:11, 600 NW* Ware SUM 1WWWwilk MD 2120.6; (301) REMO.

11

.1 5

The Johns Hopkins University Schoolof Medicine

January 1987-October 1988

13

/ (0

The Jahns limbos Univetsity School of %Weise

Project Staff

Director

David C. Levine, M.D., KPH-, Sc.D.DirectorDiviskne of Internal Medicine andBehavioral Research 11.aining Program in Heart and

Vascular Diseases

C.odbector

Richard Moore, M.D., M.H.S.Directorl'harmaco Epidemiolog ProgramPrincipal InvestigatorPractice and Prevention Study of Alcohol AbuseDivision of Internal Medicine

Co investigators

Laura Mumford, M.D.DirectorOffice of Educadonal Development and Evaluation in

the Department of MedicineDivision of Internal Medicine

Emma Stokes, PhD.Special Assistant to the Dean and President for the

Johns Hopkins Program in Substance Abuse

Coon Unarm

Eileen McDonald, MS.CoordinatorJohns Hopkins Program in Substance Abuse

Working Committee

David C. Levine, M.D., M.P.H., Sc.D.

14

Emma Stokes, Ph.D.

Dana Rank, M.D.Assistant Professor of MedicineJohns Hopkins University School of Medicine

Laura Mustard, M.D.

Richard Moore, M.D., M.P.H.

Jolm Stobo, M.D.Chairman and Physician-in-ChiefDepartment of MedicineJohns Hopkins University School of Medicine

Man Romanoski, MD.Staff PsychiatristDirectou of Substance Abuse ProgramDepartm.nt of PsychiatryJohns Hopkins University School of Medicine

Ronan Roubenoff, MD.Active MemberInternal Medicine HousestaffJohns Hopkins Hospital

Simeon Margolis, M.D.Associate Dean for Academic AffairsProfessor a MakingJohns Hopkins University School of Meciicine

Project Consultants:

Judith Bigby, M.D., Harvard University

Martin Valaske, MD., George Washington University

Robin Barnes, MD., Harvard University

Steven Wartman, MD, Ph.D., Brown University

The lobes Hopkins University School ot Medicine

Development, implementation, and Evaluation of a Model Program andCurriculum In Alcohol and Other Drug Abuse Education for Medical

Students, Residents, and Faculty In internal Medicine*

Purpose

The major goal of this project was to develop, imple-ment, and evaluate the effectiveness of a model air-riculum in alcohol and drug abuse on the knowledge,attitudes, skills, and practice performance of medicalstudents, housestaff, and faculty in regard to screening,early diaposis, and treatment of alcohol and other drugabuse. The cenkulum was based on specific criteria andlearning objectives, and was intwated into the medicalrducation process.

After evaluation of the curriculum, those compo.nents found to be most effective in enhancing knowl-edge, skills, attitudes, and practice performance in theidentification and treatment of alcohol and other drugabuse were developed into specific modules at the un-dergraduate, ipaduate, and continuing medical educa-tion levels.

Approach and Methods

The approach to the development of the model cur-riculum was guided by learning and behavioral theory.

Particular emphasis was Oen WO (1) integration with thegeneral curriculum and linkage to other simihr complexbehavioral health problems, such as smoking andobesity control, (2) use of &ugly sole modeling withperformance feedback and (3) appropriate plot testingand ono* evaluation of the effectiveness oldie modelcurriculum. The framework for the educational pro-gram and its evaluation is &splayed in figure 3, whichcoaceptualizes three sets of factors: those that predis-pose (e4" inowledge), enable (6.11- akins), siml rein-force (e.g., feedback) desired performance behavior.

In addition to this framework, an initial educationalneeds assessment wu (=ducted through a baselineanalysis of the current prevalence of alcohol and otherdrug abuse in the patient population being cared for bythe students, !somata, and faculty, as well as howadequately this was being identified and treated. Inaddition, baselhe levels of knowledge, attitudes, skills,and reported practices were assessed for students,housestaff, and faculty. Such analyses provide importantdata to help target and refine the educational program,as well as provide a baseline assessment against whichto measure future changes (figure 4).

Figure S. The intervention and evaluation model

Predisposing factors

e.g.,.11'

KnoWedgeBeliefsAttitudes

Educationalprogram Enabling factors Bhavior

maw. &aySkle

Early idertffication and effectivetreatment of alcohol end otherdrug abuse

IminpmmImessemelo

The cuniculum Reinforcing baton

The Johns **ha Unbitten School or Mediciee, 600 North Wolfe Street, Batintote, MD 2120S; (301) 9354131.

15 18

The Johns Hopkins Unimak, School of Medicine

Baseline assessment

Postintervecton analysis

Periodic reevaluation

Figura 4: Evaluation plan

Prevalence of alcohol and otherdrug abuse

Practice patterns in diagnosis andtreatment

Prevalence

changes rates of diagnosis andVestment

rPrevalence

Ap

Percentqage of Individuals withalcohol or other drug abuseidentified and treated

Knowledge, attitudes, skiffs.repotted practice d students,housestaff, fnulty regardingalcohd and other durg abuse

Changes In levels of knowledge,attitudes, &Ms, rooted practice

Percentage of students,housestaff, faculty with desiredconvetency and perfornancelevel It knowledge, attitudes, skills,repastul pntcdce

A Working Committee was formed to take a majorresponsibilty for the planning, implenientation, and dis-semination of the model canriculum. The initial step inAte process was the identification of gene* competen-cies wetted at the medical student, housestaff, andfaculty levels in general internal median. This wasaccomplished by reviewing, modifying, and expanfinggeneric competencies developed by consensus con-ferences of the Associatkin for Medical Education andResearch in Substance Abuse and the Society ofGeneral Internal Meeficine, as well as guklerines fromthe Veterans Administration. Competencies weregrouped around five major mfydules, which provided themajor goals of the project

Early Identification and Treatment of Alcoholand Other Drug Abuse

Motivation ane Linkage of Patient Into OngoingCare

Monitoring of Patients With Alcohol and OtherDrug Abuse to Assure Sustained Maintenance

Provision of Acute Management of Alcohol andOther Drug "Ouse Including Withdrawal

Undentan4 the Natural Mum ofAlcoholismand Other Drug Abuse

These competencks were then reviewed in light ofthe current educational structure of the Department of

16

Medicine; current curriculum vis-a-vis alcohol andother drug abuse; and the aforementioned baseline as-sessment of the prevalence and practice patterns relatedto alcohol and whet drug abuse, as well as student,housestaff, and faculty knowledge, attitudes, and siTils.While there had been improvement in alcohol and otherdrug abuse education, specific needs or gaps wereidentified

At the undagraduate level, the need for a moreeffective translation of principles of alcohol andother ding abuse taught during the preclinicalyears into earlier identification and managementof these problems in patients during the clinicalyears.

At housestaff level, a need for more enhancedtewhing in regard to the prevalence of alcohol andother drug Anse problems, the inadequacy incurrent rates of diagnosis, the missed oppor-tuni&ts for provifmg effective we earlier in thecourse of an alcohol or other drug problem, andthe aced for effective %kap to counseling serv-ices and lonterm fo'l new.

At the facuky level, the need for continuing educe.don reganfmg the prevalence of alcohol and otherdrug abuse problems, improvement in earlierdiagnosis and linkage to effective treatment, andthe importance of the faculty in teaching and role

1 9

The him Hopkins lieMmity $ chool at Medici*

modeling for students and housestaff to improveidentification and effective care.

The new conic& components developed specifical-ly to supplement current teaching for medical studentsinclude, in the Introductory Clinical Skills Comie, theuse of the CAGE instrument as part of the historkaldata expected on any patient, and role playing nu-lated patient denicastration by faculty regarding ap-propbate interviewing and motivational technique&This is followed by specific patient care experiences toreinforce vpropriate skills in the Internal MaxineClerkship. Subsequent to their exposure to patients,students meet with General Internal Medicine Facultyin saga group sessions (4-5 per group) to TIMM theirclinical experience and to assure and enhance furtherdevelopment of skills in interviewin& diagnosis, andmotivating patients into care. Specific components ofthe model curriculum for residents include use of op-portunities such as existing grand or firm rounds topresent and discuss alcohol and other drug abuse; en-hanced acquakitance with and use of counseling-inter-mit/co services; and performance feedback data fromthe prevalence and practice patterns study, taking ad-vantage of this being the residents' own practice per-formance. Opportunitie.) br improvement in enhancingthe current 50 percenf. rate of diagnosis and 20 percentrate of adequate tres tment are emphasized in regard touse of screening initruinents, such as the CAGE orSMAST, Lid how to utilize these to identify substance'abuse early, when it can be effectively treated. Thecontinuing education of faculty includes the use of grandrounds, research conferences, and special seminars toemphasize alcohol and other drug abuse, as well as as...ninar series to enhance their knowledp base and skilllevel and to better prepare them as role models andteachers for tlw housestaff and students.

17

The model alcohol program for medial students waswell implemented and accepted and has been institu-tionalized as put of the ongoing curriculum. The approach has been successful in enhancing studentunderstanding of the importance of alcohol and otherdrug abuse as a medical problem; the role of the physi-cian in early identification and effective treatmen4 andimproved skills in interviewing, screening diagnosis, andpatient motivation, and linkage to long-term treatment.

Findings from the housestaff curricular program in-dicated that it was feasible to utilize and build on existingmechanisms to implement a model program at the gad-uate medical education level. All new residents are nowexposed to state-of-the-art screening and identificationand how to link patients into ongoing treatment.

The continuing education approach for faculty wasgenerally well received and well attended. Facultygained increased insight into the importance of alcoholand other drug abuse problems, bow to identify andtreat them early and effectively, and their key role inteaching medical students and housestal

Materials

The materials relevant to the development, imple-mentation, and evaluation of the model curriculum arenow available, including the specific teaching modules,an instructor's guide, state-of-the-art screening instru-ments, the evaluation approach, an implementationguide, and promotion and distillation plans. The eval-uation component is already underway, with repeatevaluation of the effect of the model curriculum onenhancing student, housestaft and faculty knowledge,attitudes, skills, and practioes related to early identifica-tion and effective treatment of substance abuse.

Medical College of VirginiaADM-281-87-0005, 198749

2119

Project Sell

Dkeeter

Sidney H. &Moll, M.D., Ph.D.ChairmanDivision of Substance Abuse MedicineProfemor .

Internal Medicine aad Psychiatry

Coordinator

Paula X Horvatich, Ph.D.Assistant ProfessorCenter for Educational Development and

Faadty ResourcesAdjunct Assistant Research FramerDepartment of Psychology

Faculty and Currkuhun Development

W. Loren Williams, Ph.D.Professor and DirectorCenter for Educational Development and

Faculty Resources

Evaluation

Judith Bradford, Ph.D.Senior Research AssociateDirectorHealth and Social Policy ResearchSurvey Research Laboratory

Julie A. Honnold, Ph.D.Associate ProfemorDepartment of Sociology and AnthropologyResearch AssociateSurrey Research Laboratory

Working Committee

Richard R. Brookman, M.D.Associate Professor of PediatricsDirector, Division of Adolescent Medicine

Medical Coast of Virginia

20

David Buchsbaum, MD.Assistant Professor of General Medicine and

Primary CareDirectorPrimmy Care Redolency Mauling

WM= L. Dewey, PhD.ProfessorDepartment of PharmacologyAssociate Provost for Research and Graduate Affairs

Marcia J. Lawton, Ph.D.Assist= ProfessorDepartment of Rehabilitation CounselingDirector of Alcohol and Drug Education/

Rehabilitaticai Program.

James S. Smeltzer, M.D.Assistant ProfessorObstetrics and GynecologyDirector, Ifigh Risk Pregnancy Oink

Albert J. %merman, MD.Professor of Maxine and PharmacologyChairmanDivision of Clinical PharmacologyExecutive Associate Dean for the School of Medicine

David I. Weber, M.D.Associate Professor of PsychiatryDirectorUndergraduate Education Program in Psychiatry and

Behavioral Sciences.

Project Consultants:

Ira Chasnoff, M.D.

Robert Morse, MD.

Rosemary Camila, Ph.D.Virginia Commonwealth University

22

Mediad Wiese ot Virginia

-MCV Program for Alcohol and Other Drug Abuse Education,Research, and Treatment*

To make instrucdonal decisicus, the finalized goalsand objectives were compared to min= courses of-fered to undergraduate medical students and residents.Because of the increased time in the curriculum thatwasmade available to alcohol and other drug *me, courseswere reorganized, content added, and information se-quenced across years.

For pilot testing, the 10-hour Substance Abuse Serieswithin the Behavioral Science Sequence fin second-yearmedical students was selected, because it represents thebulk of the undergraduate curricular offerirg. Theseries includes pharmuology of the drugs of abuse;epidemiology, prevalence, history, and cultural prece-dents for drug of abuse; prevention; characteristics ofabused drugs and of addiction; treatment ci withdrawalfor all classes of drugs; and ndes fre prescribing drugswith abuse potential.

Using the MCV standard student course evaluationforms, students rated the syllabus and the instructor'slecture content and style, the latter an indirect assess-ment of the instructor's manuaL Because this informa-tion is not very detailed, a small number of students wereinterviewed to find out what format of print materialsthey think aids their learning this information will guidesyllabus development. Fmally, student performancedata on a multiple choice examination was used to es-timate instructional effectiveness. Available studentevaluatims and test item analysis indicated that the newalcohol and other drug abuse series was successful.Student evaluations were in the "good very good"range for all items.

Tat item analysis indicated that alcohol and otherdrug abuse questions were somewhat harder than theoverall examination, but pharmacology-related ques-tions were close to the overall average in difficulty.Currdum revisions have been conducted, and funherevaluation will be undertaken when the model cur-riculum is implemented in January LW. A similar cycleof development, pilot testing. and revision will be fol-lowed for the remaining undergraduate medical coursesthat are offered on a sznalkr scale.

PurposeThe goal of this project is to develop, implement,

evaluate, and disseminate an integrated clinical re-search and clinical education program in alcohol andother drug abuse fa undergraduate medical students,residents, and faculty physicians in the primaq carespecialties. The MCV Substance Abuse Program Model(figure 5) includes the tragic:3st emphasis on (1) tm-dergraduate medical education, (2) residency training,and (3) faculty dewlaps:sent. But it also licludes twocomponents that are vital to the educaticeal progamand that reflect the institutional priorities of MCV: (4)research and (5) patient care. Therefore, a centraltheme to this project was the interrelationship amongthe five component&

ApproachA Working Committee and collaborating faculty was

formed by virtue of shared interest. At the time theproposal was being prepared, a =moo was scut to alldepartments in the School of MedicMe with the inten-tion of identifying persons interested in pursuing thecontract. The Division of Primary Care within theDepartment of Malicine was approached directly. Acore group, i.e., representatives of participating depart-

"ments and project staff, constitutes the Working Com-mittee. The first step in the planning process was todetermine curriculum priorities. In a 2-day Faculty/Resident Wakshop on Clinical Research and Curric-ulum, the Working Committee, collaborating factaky,and resident physicians or graduate students from eachparticipadng department discussed current alcohol andother drug abuse education efforts to identify where thegreatest development was needed. The results of thisdiscussion were then compared to published curriculumguides. Intadisciplinary collaboration as well as dis-cipline-specific priorities were established.

The next step was to develop curriculum goals. Rep-resentatives from each department drafted goal state-ments that reflected what the MCV graduate shouldknow and be able to do in alcohol and other drug abusemedicine. These lists were synthesized and edited, andapproval was obtained by consensus across all depart-ments. Finally, learning objectives were formallyprepared. Using pliolialisd lists of objectives, each cur-riculum goal was gl imted and, once again, approvalobtained by consensus.

Materials

Once developed in final format, the program cur-riculum, faculty development, pedant care, and re-search components and the process used to design

Medals! Coast ot Vurjnls, Einc 109, MCV Saida% Richmond, VA 232%; (804) 786-9914.

21 23

Medical Whip al Virginia

and implement the program will be made available toothers through instructor and student manuals. Themanuals will be publicized for disseminadon purposesthrough an exhibit at the 1989 annual meeting of the

Amodation of American Medical Colleges (AAMC).The exhibit will fit into the Innovations in MedicalEducation program sponsored by che AAMC Groupson Medical Education.

Figure 5. Medical Colleg of *girlie alcohol and ether drug abuse program model

FacultyDevelopment

Ob/Gyn InternalMedicine

Psychiatry Pediatrics

Undergraduate Medical Education

ResearchITTITPatient Care

Soar= Mord bun Proicom AMYL Brom thnanitay Maki and Drag Mamonas fOr Ftlintan Midribs in Prinumy Czt

n 24

Vanderbilt UniversityADM-281-87-0004, 1987-89

Vanderbilt UttiVerlitY

Project Staff

Principal Investigator

W. Anderson Spickard,Professor of Medicine _-

Chief, Division of General Internal Medicine;Medical DirectorVanderbilt's Institute for the Treatment of Addictions

Coordinator

Mary Candice Burger, Ph.D.Research InstructorDivision of General Internal MedicineResearch PsychologistVanderbilt's Institute for the Treatment of Addictions

Evaluator

Leonard Bickman, Ph.D.Professor of PsychologyDirector of the Program Evaluation LaboratoryGeo.:ze Peabody School of Vanderbilt University

Secretary

Marilp Ranalli

Working Commfttee

Donald BradyVanderbilt medical student

Peter Cartwright, M.D.Assistant Professor of Obstetrics/GynecologyDirector of Obstetrics/Gynecology ServiceNashville General Hospital

Pamela DavisDoctoral student in psychologyProgram Evaluation Laboratory

Scott DubetVanderbilt medical student

Gerald Gotterer, MD., Ph.D.Associate DeanVanderbilt Medical School

George Gray, M.D.Professor of PathologyChair, Academics Program CommitteeVanderbilt Medical School

John Greene, MD.Assnciate Professor of PediatricsDirector, Adolescent Medicine and Student Health

Joel Hardman, Ph.D.Professor and Chairman of Pharmacology

Thylor Hays, M.D.Former Assistant Professor of Medicinenow at the Weber Clinic, Ely, Illinois

Jeff Holmgren, M.D.Fellow in Psychiatrynow in private practice in Minnesota

Mark Jacokes, MD.Assistant Professor of MedicineGeneral Internal Medicine

Peter Martin, M.D.Associate Professor of PsychiatryDirector of the Division of Alcohol and Substance

Abuse in Psychiatry

Jason Morrow, M.D.Chief Resident in Medicine (1987-88)Vanderbilt University Hospital

Robert Schreiner, MD.Chief Resident in Medicine (1988-89)Vanderbilt University Hospital

Theresa SparksDoctoral student in psychologyProgram Evaluation Laboratory

Peter WilsonVanderbilt medical student

Project Consultants

William D. Lerner, M.D.University of Alabama, Birmingham

J. Thylor Hays, M.D.Weber Clinic, Illinois

John N. Chappel, M.D.University of Nevada School of Medicine

Peter Johnson, Ph.D.University of South Carolina

Vanderbilt University

Vanderblit'ti, integrated Curriculum on Alcohol and Drugs (VICAD)*

Purpose

The purpose of this project is to increase and coor-dinate training of medical students, residents, and facul-ty in alcohol and other drug abuse identification andmanagement. Four specialty departments were madethe focus of this program: Medicine, Psychiatry, Pedi-atrics, and Obstetrics/Gynecology.

Approach

The approach to trthning in alcohol and other drugabuse at Vanderbilt was based on the ultimate goal oftraining clinicians competent to identify the problem, onacknowledgment that the medical school is a hierarchi-cally organized structure in which depatments have alarge degree of autonomy, and on the desire to keep theaddition of curriculum time to a minimum by reworkingalready existing training opportunities where possible.

The following steps have been taken in the develop-ment of this project to date:

Identify a key faculty member from each depart-ment through informal contacts and meetinp withchairmen

Form Working Committee of identified facultyand representative residents and medical students

Form Executive Committee of medical schooladministrators and departmental chairmen for oc-casional functions

Begin meeting with the Working Committee

Interview Working and Executive Comnitteemembers about need for alcohol and drug trainingand knowledge of VICAD

Survey current levels of training in alcohol andother drug abuse in the medical school andresidency training programs and in departmental&and rounds

Review and distill the many curriculum guides andspecialty training guidelines for training needs atall levels of expertise

Draft a matrix of alcohol and other drug abusecompetencies needed through review above andWorking Committee discussion

Compare existing training with competenciesneeded

Determine what ncw training must be added,preparz trainees in specific competencies, anddiscuss evaluation of those interventions

Attempt to gain course time for the needed train-ing of students

Plan course materials for interventions identifiedand choose those to pilot test

Develop draft curriculum manual for instructors

Develop evaluation plan for pilot testing

Implement training experiences and evaluate ex-perience

Consult with experts on curriculum breadth andproblems

Revise curriculum

Plan evaluation strategy for implementation year

Begin to implement all training experiences andevaluation strategies

Begin development of "marketing^ proposal

The following are in progress or will be addressed inthe future:

Evaluate progress and revise implementation andevaluation plans

Consult with experts on progress and programamendments

Consolidate evaluation of training experiences

Complete rt an of curriculum guide

Complete article based on training experience

Materials

A draft curriculum guide is already available thatincludes the goals and procedures to be pursued in eacharea. Specific evaluation and assessment proceduresand supporting materials are continually beingdeveloped and added to the draft. This material and thespirit of the training was distauted to the medicalschools in the region by personal contact in the springof 1989.

Vanderbilt University, Vandetbilt Medical Center North, Ban 23106, Nashville, TN 372374 (615) 322-2543.

25

University of Alabama at BirminghamMedical Education Facility

ADM-281-87-0006, 1987-1989

University of Alabama at Birmingham Medical Education Facihty

Project Stiff

Director

William D. Lerner, M.D.DirectorUAB Substance Abuse MedicineProfessorDepartment of MedicineDivision of General and Preventive Medicine

Project Coordinator

Marjorie Barr Lerner, DA. i.W.Behavioral MedicineDivision of General and Preventive Medicine

Curriculum Coordinator

Connie L Kohler, MA.Assistant Professor of Education in MedicineSchool of MedicineCurriculum Design Specialist

Evaluation

John Boker, Ph.D.Associate Professor of Education in MedicineSchool of MedicineEvaluation Specialist

Woridng Committee

Richard Allman, M.D.Assistant ProfessorDepartment of MedicineDivision of General and Preventive MedicineGerontology specialist

Judy Ann Bigby, M.D.Assistant Professor, Department of MedicineHarvard UniversityDepartment of MedicineDivision of General Medicine and Primary :areBrigham and Women's Hospital, Boston

Ronald 0. Forbes, MD.Substance Abuse Mee mine SpecialistInsight Physicians, Ric Lasond, VADirector, Psychiatric &vicesRichmond Community HospitalRichmond, VA

Norman Huggins, MD.Assistant Professor, Department of PsychiatryMedical DirectorSubstance Abuse Programs

Howard Katz, M.D.Asilistant ProfessorDirector of Undergraduate Medical EducationDepartment of Family Medicine

Iltra Davis Knott, Ph.D.Doctorate in EvaluationProgram and Curriculum Evaluation SpecialistPresident, Evaluation Resources, Inc.Memphis, TN

David H. Knott, MD., Ph.D.Clinical DirectorMemphis Mental Health InstituteClinical Assistant Professor in Family MedicineUniversity of lInnessee Center for Health SciencesMemphis, TN

University of Alabama at Birmingham Medical Education FaWity

University of Alabama at BirminghamCurriculum for Clinical Competency in Substance Abuse Medicine for

Primary Care Physicians*

Purpose

The purpose of Cis project is to develop a com-prehensive curriculum for primary care physicianeducation and training in alcohol and other drug r.busemedicine that is bcth vertically and horizontally inte-grated. Based on identified knowledge, skill, and abilitylearning objectives, the multisegmented curriculumprovides a program that can be implemented at differinglevels of education and clinical trainin& progressingfrom the medical school curricullem to postgraduateclinical training to faculty development. The develop-mental process encompasses design and implementa-tion of the curriculum as well as evaluation andmarketing.

Approach

The curriculum was developed by a process ofreviening and evaluating existing proposals of learninggoals and objectives for competency in alcohol andother drug abuse medicine, including those of AMER-SA and SREPCIM, as well as those specific to primarycare specialties, i.e., SGIM and APA. Focusing on theareas of General Internal Medicine, Family Medicine,and Psychiatry, necessary competencies for practiceand learning objectives applicable to Fimary care prac-tice were developed and additional specialty learningobjectives were identified for the three targeted areas ofpractice. These were developed by the Internal WorkingCommittee, with members from the Departments ofMedicine, Family Medicine, and Psychiatry, includingthree junior faculty members from each departmentidentified as being interested in participating in thefaculty development phase of the project.

Corresponding to the core learning objectives, 22modules of 'instruction were initially developed to meetthese educational and training needs. Based on therecommendations of the External Working Committeeand Internal Worldng Committee, the units of instruc-tion west consolidated. To increase &agility and trans-ferability of the curriculum units to the range and varietyof levels of educational and training needs, the moduleswere combinal and condensed into 12 core curriculumunits:

A Model of Withdrawal: AlcoholThe Concept of Tolerance and Pharmacology of

AlcoholDiagnosis and Complications of AlcoholismPublic Health Model of Substance Abuse and

Introduction to Drugs of AbuseAmbulatory Care of Substance AbuseCocaine and StiwulantsTreatment of AlcoholismTreatment and Medical Aspects of IV NarcoticsDepressant DrugsChronic PainAddiction and Long-term Treatment of Narcotic

UseInhalants, Marijuana, and Hallucinogens

Two additional units of instruction were defined foreach special.v area Internal Medicine, Family Med-icine, and Psychiatry. While all members of the InternalWorking Committee participated in defining theseareas, the junior faculty membes from the particularspecialty area had primary responsilrility for the re-search, development, and implementation of these in-structional materials. These curriculum units include:

Psychiatry:

The Dual-Diagnosis PatientPsychological Effects of Drugs of Abuse

General Internal Medicine:Alcohol and Other Drug Abusr and GeriatricsAlcohol and Other Drug Abuse in the General

Medical PopulationFamily Medicine:

Alcohol and Other Drug Abuse andAdolescents

Alcohol and Other Drug Abuse and the Family

Based on the auessment of Internal and WorkingCommittee members as well as the evaluations of theprimary care residents participating in training, the var-ious units of instruction were ranked with respect to therelative importance of the curriculum component topractice. Those considered of critical importance wererated 4, while those of significance to a particular spe-cialty practice were rated 1. Evaluation of the corecurriculum units was undertaken with the administra-

University of Alabama at Birmingham, Medical Education Facility, Suite 609, University Station, Birmingham, AL 35294; (205) 934-4451

29 30

Uuivemity of Alabama at ninnies's= Medical Education Facility

tion of a pre- and posttest that addressed knowledge aswell as altitude changes, and a clinical evaluation guidespecific to evalutionand treatment of alcohol and otherdrug abuse (posttest only):.

The model was implemeted in stages beginning inNovember 1987 with one or two primary care residentsand at least one medical student in his or her third orfourth year of study participating each month in theprogram of directed clinicalpractice and didactic studybased on the core curriculum. Courses in the first andsecond years of medical school have also been based onselected units of study from these core units. Uponcompletion of the first year of curriculum implementa-tion for medical students and housestaff, the threejunior faculty members were trained using the 12 cceecurriculum units and have subsequently used the cur-riculum model in their roles as the trainers for primarycare residents, completing the monthly alcohol andother drug abuse medicine rotation under the super-vision of the Project Director. Their evaluation of themode., based on use of the curriculum materials andevaluation of factors, such as clinical applicability, ap-propriateness of specialty practice, and ease of use, hasassisted in integrating the materials across disciplinesand developing supplemental learning materials for thevarious units of instruction.

Results of the ongoing pre- and posttesting of allprimary care residents completing the clinical rotationare being compiled with individual item analysis con-

ducted to adjust the instrument accordingly. The juniorfaculty participating in the Faculty Development phaseof the project completed pre- and posttests and alsoparticipated in a structured verbal evaluation of thecurriculum materials. While initial findings were ap-plied in the development and implementation stage, theevaluative findings from the approximately 30 residentsand faculty txained with the curriculum materials will bemade available at the completion of the project.

Materials

In addition to the didactic training materialsdeveloped for the curriculum, materials have beendeveloped for use in institutions without adequate ac-cess to appropriate clinical material bo as to maintainthe project goal of a curriculum directed at clinicalcompetency rather than knowledge base alone. Thefinal product will include a full range of instructionalmaterials, supplemental clinical case material for eachunit of instruction, source material, and evaluation toolsfor use with individual units or the curriculum in total,applicable to all levels of education and training andacross primary care disciplines. In addition, an institu-tional educational research plan will be presented thataddresses not only the educational and training needsto be considered but also the clinical resources neededto effectively educate and train primary care physicians.

Figune 6. Education end training components tor clinical competency inalcohol and other drug abuse medicine

MethodFacutty developmentisPecialtY trlanin9

Individual and small grouptlidactic and clinical

Primary care resident trainingMonth4ong experienceindividual or smell groupDidactic and clinicalResearch application

Clerkship and Acting intern3- to 5-week experienceDidactic and clinicalIndividual or group

Coursework

Postgraduate

comprehensive

clinical training

MS3 and MS4 clinical experience

MS1 and MS2 educational curriculum

3031

ContentCore clinical training unitsSpecialty clinical training units

Psychiatry, Family Medicine,General Internal Medicine

Core clinical training unitsStructured and directed

clinical experience

Com clinical training units

Independent ressarch projects

CoursesOrientation to Prentice

\Basic ScienceBehavioral Medicine

University of VirginiaSchool of Medicine

ADM-281-88-0008, 1988-90

31

32

University of Virginia School of Medicine

roject Staff

Directors -Jacob A. Lohr, M.D.McLenore Birdsong Profertkor of PediatricsChair, AIMS Committee

Randolph J. Canterbury II, MD.DirectorUniversity of Virginia Institute for

Substance Almse StudiesMedical Director, Addiction Sciences CenterAssistant Professor ci Behavioral Medicine and

Psychiatry and Internal Medicine

Coordinator and Evaluator

Wei Li Fang, Ph.D.Assistant Professor of Medical Education

Working Committee

Steven N. Applegate, M.Ed., C.S.A.C.Instructor of Behavioral Medicine and PsychiatryCoordinator, Addiction Sciences Center

William P. Arnold III, M.D.Associate Professor of AnesthesiologyCochair, Impaired Physicians' Committee of the

Society for Education in Anesthesia

James H. Duffee, MD.Assistant Professor of Pediatrics and Child Psychiatry

Charles F. Gressard, Ph.D., L.P.C.Assistant Professor of Behavioral Medicine

and PsychiatryDirector of Research, Addiction Sciences Center

laMeS Krag, MD.Resident in the Department of Behavioral Mediene

and Psychiatry

Florence MelioMedical student, Class of 1989

R. Michael Morse, M.D.Associate Professor of Family Medicine

George A. Nowacek, Ph.D.Associate Professor of Medical EducationDirector Office of Medical Education

Executive Committee

Jacob A. Lohr, M.D.

Randolph J. Canterbury II, M.D.

Wei Li Fang, Ph.D.

32

William P. Arnold III, MD.

Robert M. Carey, MD.Dean of School of Medicine

knerested Faculty in Clinical Departments

Department of Behavioral Medicine and Psychiatry

John Buckman, M.D.Daniel Harrington, M.D.William R. Hobbs, MD.J. Joe Yazd, MD.

Department of Family Medicine

Richard B. Hays, MD.Steven A. Maul, M.C.Dorothy Rudolph, M.S.W.David B. Waters, Ph.D.

Department of Pediatrics

Vttlliçtm L Clarke, M.D.Richard W. Kesler, M.D.Robert J. Robeets, M.D., Ph.D.Deborah E. Smith, M.D.Wilam Wilson, M.D.

Department of Medicine

Richard A. Christcph, MD.Julia E. Connelly, MD.Eugene C. Corbett, Jr., MD.John A. Owen, Jr., M.D.

Department of Radiology

Thomas L Pope, Jr., MD.

Project Consultants:

Janine C. Edwards, Pb.D.Louisiana State University

Charles P. O'Brien, M.D., Ph.D.University Pennsylvania at Philadelphia

William Farley, M.D.Expert on impaired health professionals

Joan HedgecockAmerican Medical Student Association

William D. Lerner, M.D.University of Alabama at Birmingham

Richard H. Schwartz, M.D.Pediauician

J. Pat lbkarz, M.D.Family physician

33

University of Virginia School of Medicine

Project SAGE (Substance Abuse General Education)*

Purpose

Project SAGE proposes to educate students andresidents who, as practitioners, will recognize and ap-propriately manarp those patients with alcohol andother drug use disorders. This will be accomplishedthrough the development, implementatimi, and evalua-tion of a model educational program and curriculum inalcohol and other drug abuse. To ensure the successfuldissemination of this curriculum, a unique faculty devel-opment program will be offered to selected clinicians inthe Departments of Behavioral Medicine and Psychia-try, Family Medicine, and Pediatrics.

Approach

During the spring of l988, interested faculty mem-bers in the Departments of Behavioral Medicine andPsychiatry, Family Medicine, and Pediatrics and theOffice of Medical Education met to discuss the designof a model program and curriculum in alcohol and otherdrug abuse for primary care physician education. Thework of this group resulted in an application to NIrtkAAand NIDA and the eventual funding of Project SAGE.

These faculty members formed the Working Com-mittee. The primary responsibility of this committee isto develop, implement, and evaluate the alcohol andother drug abuse curriculum as it is integrated into theundergraduate medical curriculum and the residencytraining programs. A key element of the project is thedevelopment and offering of a unique faculty develop-

mem program that will facilitate integration of the al-cohol and other drug abuse curriculum into the teachingand learning of medical students and residents. Thus,two modod programs will be designed and offered: onefor student, residents, and one for faculty.

To accomplish the project goal, two phases have beenidentified. The first cousists of development and fieldtesting, while the second involves implementation andevaluation. Project SAGE is currently in its first phase,and initial work is focusing on the development of aphilosophy statement and project goals and objectives.Using a systems approach to curriculum design, theWorking Committee intends to idea* specific learnerobjectives as they relate to the overall goal and the needsof individual learners (i.e., medical students, residents,and faculty) in the various clinical departments. Toassist in the identification of specific learner objectives,the Workbag Committee will use the objectives outlinedby ADAMHA and the generic competencies defined byProject ADEPT at Brown University.

The Working Committee plans to accomplish thisinitial design work at two levels: within the WorkingCommittee itself and through subcommittees estab-lished in the three clinical departments. Efforts will bemade to involve au interested faculty in the developmentof the curriculum. The Working Committee recognizesthe importance of providing factual information andresources and the necessity of changing attitudes inorder to encourage faculty to incorporate alcohol andother drug abuse concepts into their teaching.

University of Virginia School of Medicine. University of Virtnia Children's Medical Center, Bco &36, Charlottesville, VA 22908 (804)924-2662

33

3 4

University of North DakotaSchool of Medicine

ADM-28148-0006, 1988-90

University of North Dakota School of Medicine

Projact Staff

Coordinator

Richard L. Davison, Ed.D.Coordinator of Special Servkes for the

University of North Dakota

Clinical Director

Keith G. Foster, MD.Director of Alcohol StudiesAssociate Professor EmeritusDepartment of Community Medicine and

Rural HealthUniversity of North Dakota School of MedicineMedical Director for the Heartview Foundation

Evaluator

Henry B. Slotnick, Ph.D.Professor of NeuroscienceMedical Education and Evaluation

Administrative Secrotary

Debra 3. MagstadtAdministrative Secretary II

Working Committee

Keith G. Foster, MD.Chairman

Richard L Davison, Ed.D.

Henry B. Slotnick, Ph.D.

Thomas K. Akers, Ph.D.Professorof Physiology

Dan Goodwin, MD.Clinical Associate ProfessorDepartment of Family Medicine

Clayton E. Jensen, M.D.Associate Professor and ChairmanDepartment of Family Medicine

Gerald Kavanaugh, M.D.Clinical Associate Professor of Internal Medicine

Reed T. Keller, M.D.Professor and ChairmanDepartment of Internal Medicine

Harvey R. Kull, Ph.D.ProfessorDepartment of Biochemistry and Molecular Biology

AI Samuelson, MD.Associate Profeasor of Neuroscience

Richard P. Starker, MD., M.P.H.Professor and ChairmanDepartment of Neuroscience

Sharon C. Wdsnack, Ph.D.Professor of NeuroscienceDirector of Preclinical CurriculumResearch Consultant.

Judy DeMersAssociate Dean of Student AffairsAdmissions and Assistant ProfessorDepartment of Family Medicine

William Goodall, M.D.Associate Dean of Clinical AffairsProfessorDepartment of Family Medicine

Dwayne 011erich, Ph.D.Associate DeanAcademic and Research AffairsProfessor of Anatomy

Projact Consultants (initial contacts only)

Rebecca C. Henry, Ph.D.Michigan State University

W. Anderson Spichard, M.D.Vanderbilt University

Peter R. Martin, M.D.Vanderrbilt University

Peter G. Coggan, MD.Univezsity of California Irvine

Alfonso J. Mooney, MD.Clinical Director-Willingsway

Univeisity of North Dakota School of Medicine

PEPSA, University of North Dakota Physician Education Project onSubstance Abuse*

Purpose

The purpose of the project is to design, implement,evaluate, and disseminate a model curriculum for pri-mary care physician training in alcohol and other drugabuse. The curriculum will be based upon the specificminimal knowledge and *ill guidelines adopted by theprimary care physician associations and societies as wellas ideal objectives developed by the University of NorthDakota Medical School faculty. The goal of this projectis the development of quality instructional componentsfor knowledge and skill mastery during the first 4 yearsof physician training in rural medical schools, with re-fined clinical skill learning experiences during the resi-dency programs.

Approach

A Working Committee representative of the BasicSciences, Internal Medicine, Family Medicine, Psychi-atry, and Clinical faculty was appointed by the Dean ofthe School of Medicine. This core group of the facultyhas taken major responaility for operational policy andas the clearinghouse for planning, development, pilottesting, implementation, evaluation, and revision of cur-ricula. Also, they are chairpersons for the subcommit-tees of the working committee and standing committeesof the medical school administrative structure. Thus,they are the core of governance within the medicalschool as well as for this project.

The subcommittee structure was adopted to enhancefaculty participation in the project and to accelerate thedevelopment of faculty ownership of the model cur-denim. The organizational involvement also reducesthe amount of travel required in a decentralized school,and smaller group meetings are more efficient and ef-fective.

The subcommittees, then, are the groups of facultythat develop, in depth, the proposed activities for con-sideration by the working committee, the policy body.

The first steps in the planning process required thedevelopment of the "ideal" curriculum, inventory ofexisting curriculum, and the recommended minimalknowledge and skill requirements of the societies and/orassociations of primary care specialty groups as well asother medical school curricula.

These three groups of data will be presented to theworking committee for discussion and ultimate adop-tion of a final list of knowledge and skills for studentscompleting the 4-year j, ysician education program.The fatuity will then, using this list, identify masterylevels by phase in the 4-year program and recommendknowledge and skill components for residency programconsideration.

The cumulative ranking of the mastery level for eachof the listed specific knowledge and skills will be pre-sented to the working committee for their considerationand final adoption. Nee, the working committee, inconsultation with department chairpersons, will priori-tize instructional modules for development during thecontract. These will be assigned to specific subcommit-tees for development into instructional modules.

The chairpersons of Family Medicine, Internal Med-icine, awl Psychiatry, in consultation with staff, willdevelop competencies for attainment in their fi,eld ofspecialty certification. These competency goals, alongwith the knowledge and skill requirements for enteringresidents, will provide the extremes for the developmentof the clinical learning experiences of the residencyProgram-

Next, one of the modules will be selected for fulldevelopment, pilot testing, and evaluation, including apre-post attitude survey and a knowledge test. Finalresults of the pilot testing and evaluations will determinethe modifications nezessary for the selected module.

The model curriculum will be implemented in phasesas determined by the working committee in consultationwith the chairpersons and their faculty. Throughout theimplementation phase, instructional materials will bedeveloped, modified, and prepared for distribution.Summative evaluation will be administered during thissame period. A longitudinal evaluation and researchplan will be designed for systematic project impactaSSCSSMCB1.

Materials

Once developed, the program, the instructional mod-ules, and methods used in development will be madeavailable to interested parties through the instructors'guides, student materials, implementation guides, theevaluation plan, and other distribution plans.

Univentity of North Dakota School of Medicine, Southwest Campus, University of North Dakota. 555 14 East Broadway, Bismark, NorthDakota 55501, (711) 224-2549.

3737

New York University Division of NursingN1A48-0008, 1989 '40

New York University Division of Nursing

Project Stiff

Director

Madeline A. Naegle, Ph.Dv. RN.

Coordinator

Janet D'Arcangelo, MA., R.N.

Research Assistant

Bonnie Johnson, MA., R.N.

Evaluadon

Sharon Weinberg, Ph.D.

Working Committee

Gean Mathwig, R.N.Professor of NursingDirector, Baccalaureate Program

Margret Wolf, Ed.D., R.N.Associate Professor of NursingDirectorMaster's Program in Advanced Nursing Science

Joanne Griffin, Ph.D., RN.Associate Professor of NursingCoordinator, Nursing Science II

Elizabeth A. Duthie, MA, R.N.Adjunct Instructor of NursingCoordinator, Nursing Science IV

Catherine Grimly, MA., R.N.Instructor of NursingCoordinator, Nursing Science III

Intro Institutional Resource Faculty

Vivian P.J. Clarke, Ed.D.Associate ProfessorChair, Department of Health Education

40

Eileen Wolkstein, PhD.Adjunct Associate ProfessorDepartment of Rehabilitation Counseling

Student Representatives

Virenia Fishfinger, BS.N., RN.Masters' student in Advanced Nursing Science

Kathleen Donahue, B.S., R.N.Masters' student in Advanced Nursing Science

Diana Lew, baccalaureate nursing student

Ruth Knecht, baccalaureate nursing student

Project Consultants

Marc Galanter, M.D.Professor, Department of PsychiatryNew York University Medical School

Richard Frances, MD.Professor, Clinical PsychiatryVice Chair and Director of Residency ThiningUniversity of Medicine and Dentistry of New Jersey

Sandra Jaffe-Johnson, Ed.D.Clinical Associate ProfessorSchool of NursingSUNY at StonybrookConsultant and Nurse Psychotherapist in

private practice

John P. Morgan, M.D.ProfessorCity College, City University of New YorkSchool of Biomedical Education

Rothlyn P. Zahourek, M.S., R.N., CS.Nurse Psycho zrapist and Consultant in AlcoholismAmherst, Massachusetts

3 I.

New York University Division of Nursing

NIAAA-NIDA Alcohol and Other Drug Curriculum Development Projectfor Nursing*

Purpose

Project goals include the development, implementa-tion, and evaluation of a model curriculum and trainingprogram in alcohol and other drug education for miss-ing. The project encompasses goals tor undergraduate(baccalaweate level) programs and gaduate programs(masters' level) that prepare practitioners in contentspecialty areas as well as for functional roles in educa-tion and administration.

Approach

A working committee was formed of baccalaureateand masters' degree program directors, student repre-sentatives, division faculty members responsible forcore courses in the caurimllum, and school faculty mem-bers with expertise in the areas of alcohol and other drugabuse. Initial steps in the project included reachingconsensus on terminal behavioral objectives related toalcohol and other drug abuse content and a review ofstanding courses for necessary modifications and en-richment.

Important resources for review in the developmentof consensus were two documents recently published bythe American Nurses' Association in collaboration withthe National Nurses' Society on Addictions and theDrug and Alcohol Nurses' Association. The first, en-titled Dimensions of Nursing Practice: Cam of the Clientwith Addictions, describes the scope and nature of nurs-ing practice as well as the components of cart central tothe prevention, intervention, and long-term rehalatta-don of clients with addictive phenomena. Nursing rolesand activities appropriate to generalist and prhnary carepractitioners of nursing are described in thismonograph.

Of additional assistance was the publication Stand-ards of Addictions Nursing Practice with Selected Diaknoses and Criteria. This document describes morespecifically the application of the nursing process toaddictive phenomena, its use with populations at risk,and roles for the nurse in long-term care. The workingcommittee also referred to the 1985 AMERSA (As-sociation for Medical Education and Research in Sub-stance Abuse) generic competencies for medicalstudents,

Dialog within the working committee proved essen-tial to decisions regarding the interface of alcohol andother drug content and the theory and practice of nurs-ing at baccalaureate and masters' degree levels, TheDivision of Nursing, like most other nursing depart-ments, uses nursing theory in the theoretic4 andphilosophical framework of the curriculum. The designof curricular units must consider that content and learn-ing experiences will be modified in other settings as afunction of other schools' frameworks ard the level atwhich courses arc offered. The working committeedecided that curricular modules at levek appropriate tobaccalaureate and masters' degree levels of study willallow for the greatest replicability and inclusion of amaximum amount of relevant content.

Freestanding modules organize content in such a wayas to facilitate its incorporation into existing courses. Atthe same time, modules are sufficiently complete to beoffered as elective courses or in continuing educationprograms. They provide other nursing programs withoptions regarding the modifications necessary to meetterminal objectives, as well as access to resourcematerials sufficient to expand alcohol and other drugcontent to meet requirements for specialization at themasters' degree level.

Modules will be designed to correspond to levels ofexpected learner outcomes. The following modules havebeen developed:

Level 1:

Attkudes and Values About Alcohol andOther Drug Use

Health Implications of Drug UseAssessment of the Adult Client for Alcohol

and Other Drug UseFetal Effects of Maternal Drug UseThe Pharmacology of Common Drugs of

AbuseDysfunctional Processes in Families With

Alcohol and Other Drug ProblemsLevel II:

Preventive Health Teaching and Drug Use ivChildhood

The Adolescent Who Uses Alcohol and OtherDrugs

Drug Misuse and Dependencies in the Elderly

New York Uninetsfty Dndsion of Nursing, Shimkin Hau. Room 429, SO West Fourth Street, New York, NY 10003; (212) 996-5300.

414 0

New York UnMersity Dion of Minim

Nursing Care in Acute IntoxicationNursing Care in Stages-of Drug/Alcohol

Withdrawal- --Addictions: Nursing diagnoses and TreatmentImpairment Among Ma Ith Professionals: Health

and Professional ImplicationsAlcohol- and Other Drug-Related Health Risks

in Special PopulationsAlcohol- and Other. Drug-Related Nursing Needs

of Special PopulationsThe module entitled -The Pharmacolog of Com-

mon Drugs of Abuse" was evaluated by content expertsand piloted in spring 1989. In addition, faculty andworking committee members, with content Mats, willreview the modules for (1) relevance of content to al-cohol anJ other drug education, and (2) appropriateplacement within the nursing curricula. The modules

were implemented beginning in September 1989, atwhich time curricular modules were distauted to twoother nursing programs for their evaluation.

42

Materials

Instructor's Guides, Guidelines for Clinical Expe-riences, and Recommendations for Integraion into ex-isting curricula will be developed starting in the fall of1989. On completion, the curricular modules, outcomes,and learning experiences of the project and recommen-dations for proceeding with curricular changes in othersettings, as well as the above materials, will be preparedfor use by NIAAA-NIDA in accord with the provisionof the contract proposal.

4

The Ohio State UniversityCollege of Nursing

ADM-281-88-0005, 1988-90

The Ohio State University College of Nursing

Project Staff

Director

Elizabeth M. Burns, R.S.W., R.N., Ph.D., F.A.A.N.ProfessorDepartment of Lifespan ProcessCollege of Nursing with joint appointment as aProfessor of Psychiatry and NeuroscienceCollege of Medicine

Codirector

Arlene Thompson, R.N., Ph.D.lenured full-time faculty member in the Departmentof Lifespan ProcessCollege of Nursing

Coordinator

Juliet V. Miller, Ph.D. in EducationWith extensive experience in counseling andcurriculum development

Undergraduate Subcommittee Coordinator

Carol Bininger, R.N., Ph.D.Thnured, full-time faculty member in the Departmentof Lifespan Process, College of Nursing

Graduate Subcommittee Coordinator

Joanne S. Stevenson, R.N., Ph.D., F.A.A.N.Rill-time tenured Professor in Department ofLifespan Process, College of Nursing

Faculty Development Subcommittee Coordinator

Arlene Thompson (see Codirector)

Working Committee

Nursing Faculty

Dr. Carol BakerDr. Carol BiningerDr. Elizabeth Burns

Key Spedalty

Adult Health/IllnessPsych/Mental HealthSubstance Abuse

Dr. Jeanne ClementLouise Curtis, MS.Dr. Edna MenkeDr. Juliet MillerDr. Joanne StevensonDr. Arlene ThompsonDr. Mary Ellen Wewers

Consultants

Psych/Mental HealthAdult Health:IllnessParent-Child Health/IllnessSubstance Abuse, CounselingOlder Adult Health/IllnessSubstance AbuseAdult Health/Illness

Key Specialty

Dr. Michael Klein Curriculum and EvaluationDr. Betty Melragon Curriculum and EvaluationDr. Joseph Cluarants, Jr. Curriculum and Evaluation

Project Consultants:

Carole, A. Anderson, R.N., Ph.D., F.A.A.N.Dean, College of Nursing

Jack ButlerMaryhaven, Inc.

John Chappel, M.D.University of Nevada College of Nursing

Jeffrey A. Coffman, M.D.Ohio State University, College of Medicine

Michael McNeer, M.D.Harding Hospital

Henry Nasrallah, MD.Ohio State University, College of Medicine

Richard Riley and Craig Pratt, M.D.Shepherd Hills Hospital

Linda Skaggs Ph.D.Ohio State UniversityFaculty and Staff Assistance Program

Carolyn Waltz, R.N., Ph.D., F.A.A.N.University of Maryland, College of Nursing

The Ohio State Univessity Oiler of Noting

Project CANDID Curriculum for Addictions Nursing: Directions forintegrated Design (Tentative)*

Purpose

The primary purpose of the project is to design, pilot,implement, evaluate, and disseminate a model in-tegrated curriculum for both undergraduate andgraduate (masters and doctoral level) nursing educa-tion. The undergraduate curriculum will focus ongeneric bowledge, skills, and attitudes needed for nur-ses who will week in a variety of health care settings tobe effective in the diaposis and treatment of humanresponse to patterns of addiction, i.e., to actual or poten-tial problems, concurrent with and consequent to adclic-tion. The graduate curriculum will focus on developingan addictions nursing subspecialty within such specialtyareas as adult health/anew parent-child healthalness,and oldes adult health/illness. A faculty developmentmodel to support the delivery of the undergraduate andgraduate curriculum will be a major emphasis of theProject

The project will focus on developing three levels offaculty expertise: general awareness level, special skillslevel, and advanced educator level.

'Approach

A Working Committee has been formed and or-ganized into three subcommittees: the Graduate Sub-committee, the Undergraduate Subcommittee, and theFaculty Development Subcommittee. These subcosn-minas will first develop a conceptual model, com-petencies, and overall curriculum format for theirrespective levels. Once the broad curriculum frameworkhas been developed, special curriculum modules includ-ing curriculum objectives, instructional activities andresources, and evaluation procedures will be developed.

The American Nurses' Associaticm's Standards ofAddictions Nwsing Praalce Nth Selected DivnosisCritoia (1988) will provide an initial basis for the devel-opment of student competencies to guide curriculumdevelopment. These standards include;

TheoryData CollectionDiagnosis'PlanningInterventionEvaluationEthical CareQuality AssuranceContinuing EducationInterdisciplinary Collaboration

Throughout the curriculum development process,representative modules will be piloted on a small scale.When the model CUITiclahla has been developed, asurvey will be conducted to determine the most effectiveway to conduct implementation within the Ohio StateUniversity College of Nursing. Based on the survey, animplementation and evaluation process wal be designedand completed. Evaluation data will be used to revisethe curriculum and to recommend implementation pro-cedures that can assist other nursing education institu-lions effectively implement the curriculum.

Materials

Products will include the curriculum modules and aninstructor's guide that includes guidelines for programimplementation. These materials will support the adop-tion of the curriculum by other nursing education insti-tutions. Journal articles and convention presentationswill be developed to support dissemination of thecurriculum.

The Ohio State Uahontity Coikge ot Mash% 150 Neil Manna Columbus, Ohio 43210; (614)192-4746, and 292455.

45 4 4

University of ConnecticutSchool of Nursing

ADM-281-88-0007, 1988-90

UnivetWy of Connecticut Scbool of Nursing

Project Staff

Director

Olga Maranjian Church, KID., FAA.N.Professor and ChairGraduate ProgamUniversity of Connecticut School of Nursing

Program Assistant

Ann Merritt, BA.Educational Assistant/Research Assistant'

Program Evaluator

Thomas Babor, Ph.D., M.P.H.Professor, Department of PsychiatryUniversity of ConnecticutAssociate Scientific Director of the University of

Connecticut Alcohol Research Center

Working Committee

Doris Annstong, R.N., KED., FAA.N.Associate Clinical ProfessorUniversity of ConnecticutVice President for NursingHartford Hospital

Robert Atherley, Ph.D.DirectorCounseling ServicesUniversity of Connecticut

Beatrice Burns, R.N., MS.Clinical SpecialistSubstance Abuse NursingVA Hospital, West Haven, Connecticut

Marga Co ler, Ed.D.,Associate ProfessorUniversity of Connecticut School of Nursing

Dorothy Fishman, Ed.D., R.N.Associate Dean, Undergraduate AffairsAssociate ProfessorUniversity of Connecticut School of Nursing

Barbara Goldrick, Ph.D., R.N.Assistant ProfessorUniversity of Connecticut School of Nursing

Eva Gorbants, MA., BS.Director, Academic Advisory CenterUniversity of Connecticut, School of Nursing

Pending appointment.

48

Patricia Korner, R.N.Nurse ClinicianClinical Research and Evaluation UnitUniversity of Connecticut Health CenterDepartment of Psychiatry, Alcohol Research Center

Iris Mauriello, R.N., AD.Certified Psychiatric and Mental Health NurseClinical InstructorUniversity of Connecticut School of Nursing

Bonnie McRee, MS.Research AssistantClinical Research and Evaluation UnitUniversity of Connecticut Health CenterDepartment of Psychiatry, Alcohol Research Center

Jane E. Murdock, Ed.D., R.N.Associate ProfessorUniversity of Connecticut School of Nursing

Eileen Murphy, D.NSc., R.N.Assistant ProfessorUniversity of Connecticut School of Nursing

Jean Steel, D.NSc., R.N.Visiting Associate ProfessorUniversity of Connecticut School of Nursing

Donald St. Onge, MS., R.N.LecturerUniversity of Connecticut School of Nursing

Dori Thylor, MS., R.N.Attiticront Clinicid ProfessorUniversity of Connecticut School of NursingDirector Nursing Education and ResearchUniversity of Connecticut Health Center

A.W. Bill TingeyDirector, iblecommunicationsUniversity of Connecticut

Constance S. Weiskopf, MS., R.N.Assistant Clinical ProfessorUniversity of Connecticut School of NursingDirector, Psychiatric NursingUniversity of Connecticut Health Center

Patrick J. Wilkinson, B.S., R.N.Nurse Therapist, Institute of LivingChemical Dependency ProgramHartford, ConnecticutNurse SpecialistMt. Sinai Hospital, Hartford, Connecticut

4 6

University of Connecticut School of Nursing

Clara Williams, MA., R.N.Assistant ProfessorUniversity of Connecticut,Achool of Nursing

Program Consultants

Ann SolarilWade 11, R.N., B.S.N., M.P.A.Immediate Past PresidentNational Nurses' Society on AddictionsDirectorCongregational Health PartnershipLutheran General Health Care SystemIllinois

Henry Kranzler, M.D.Assistant Director Postdoctoral Program in

Alcohol StudiesAlcohol Research CenterUniversity of Connecticut

Virginia DeForge, D.N.Sc., R.N.Certified specialist in Substance Abuse Nursing and

Nursing EducationAssociate Professor in NursingGraduate Program Research CoordinatorMassachusetts College of Pharmacy and Allied

Health Sciences, Boston, MA

Project NEADA - Nursing Education in Alcohol and Drug Abuse*

Purpose

The overall purpose of the project is to design,develop, implement, and evaluate a model program thatcan be integrated into already existing nursing educa-tion curricula at the undergraduate, graduate, and con-tinning education levels. The model program willincorporate learning modules that deal with prevention,acute care, and postcrisis care and interventions forclients with alcohol and other drug abuse problems.

Approach

An 18-member Working Committee comprising aca-demic faculty and their clinical counterparts along withnursing and nonnursing professionals who represent theuniversity and the larger community has been estab-lished. Working with the project director and the projectconsultants, and guided by the American Nurses' As-sociation recently published Standards of AddictionsNursing Praaice and The Care of Clients with Addictions(1988), the committee has assumed the responsibility fordetermining the generic competencies for knowledgeand skills for nursing education It the undergraduate,graduate, and faculty levels.

To facilitate goal accomplishment, the WorkingCommittee has been subdivided into six smaller com-mittees:

Faculty Development/EvaluationUndergraduate CurriculumComputer Assisted InstructionGraduate Curriculum Critical CareGraduate Curriculum Primary Community CareGraduate Curriculum Administration

These task forces will prioritize and recommend tothe committee as a whole their expectations for learningat all three levels and will then develop the learningmodules specific to their area.

Evaluation procedures have been established fromthe very beginning for example, a survey of the WorkingCommittee will provide input for the Evaluation Teamas they develop instruments for assessment to determineattitudes, knowledge, and skill levels of project par-ticipants.

Materials

The materials developed from the project will bedisseminated through workshops, seminars, and publi-cations and will be available through the National Clear-inghouse for Alcohol and Drug Information.

University of Connecticut School of Nursing. 175 Auditorium Road, U-59, Stons, Cr 06268, (203) 486-3713.

49

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