Management of Adolescents With OUD: A Simulation Case for Subspecialty Trainees in Addiction Medicine and Addiction Psychiatry

MedEdPORTAL. 2021 Apr 20;17:11147. doi: 10.15766/mep_2374-8265.11147.

Abstract

Introduction: The opioid epidemic impacts all ages, yet few published medical education curricula exist to train physicians on how to care for opioid use disorder (OUD) in adolescents, a developmental stage where confidentiality protection is appropriate and contributes to quality health care. We developed a simulation-based educational intervention to increase addiction medicine and addiction psychiatry trainees' confidence in managing adolescents with OUD.

Methods: Trainees completed a confidence survey and viewed an educational video covering state-specific confidentiality laws pertinent to treating adolescents with OUD. One week later, trainees participated in a simulated encounter where they described the scope of confidentiality to a trained actor, used the Clinical Opiate Withdrawal Scale to assess symptoms of opioid withdrawal, and explained adolescent-specific OUD medication treatment options. Immediately afterward, trainees completed a self-reflection and satisfaction survey and participated in a debriefing session with a faculty member where they identified learning goals. One month later, they completed the confidence survey to quantify changes in confidence.

Results: Thirty-five fellows (21 male, 14 female) completed the simulation-based educational intervention between 2016 and 2019. When asked to answer yes or no, 96% of participants described the exercise as effective and 100% (n = 26) would recommend it to peers. In addition, learners identified future learning goals, including researching specific topics and seeking out additional opportunities to evaluate adolescents with OUD.

Discussion: Based on our participants' report, this simulation-based educational intervention is an effective teaching method for increasing trainee confidence in managing adolescents with OUD.

Keywords: Addiction; Adolescent Medicine; Confidentiality; Ethics/Bioethics; Opioid Use Disorder; Opioids; Simulation; Standardized Patient; Substance Abuse/Addiction.