Background: Educating physicians and other health care professionals about the identification and treatment of patients who drink more than recommended limits is an ongoing challenge.Methods: An educational randomized controlled trial was conducted to test the ability of a standalone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The "virtual reality simulation" combined video, voice recognition, and nonbranching logic to create an interactive environment that allowed trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation included 707 questions and statements and 1207 simulated patient responses.Results: A sample of 102 health care professionals (10 physicians; 30 physician assistants or nurse practitioners; 36 medical students; 26 pharmacy, physican assistant, or nurse practitioner students) were randomly assigned to a no training group (n ‫؍‬ 51) or a computer-based virtual reality intervention (n ‫؍‬ 51). Professionals in both groups had similar pretest standardized patient alcohol screening skill scores: 53.2 (experimental) vs 54.4 (controls), 52.2 vs 53.7 alcohol brief intervention skills, and 42.9 vs 43.5 alcohol referral skills. After repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months after randomization compared with the control group for the screening (67.7 vs 58.1; P < .001) and brief intervention (58.3 vs 51.6; P < .04) scenarios.Conclusions: The technology tested in this trial is the first virtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals.

Skills curriculum (TIBS) was inaugurated to begin training 147 firstyear medical students in skills for promoting health behavior change. Learning activities included lecture, demonstration, reading, quiz, role-play exercises, and standardized patient interviews. After TIBS, the 69 students who provided pre-and postintervention data exhibited more therapeutic attitudes and increased knowledge and self-confidence in applying TIBS skills. Two months later, 52% of the 109 posttest respondents had applied TIBS in clinical settings, often for behaviors other than tobacco use. We conclude that medical students can gain from early training on promoting behavior change. Previous studies have shown that resident physicians 7-11 and advanced medical students 12-14 can learn smoking cessation counseling techniques and improve patients' smoking outcomes. 15 Teaching on therapeutics has typically been reserved until the third year of the medical school curriculum. Earlier training on promoting behavior change might be advantageous. Earlier acquisition and application of skills in promoting behavior change might enhance firstand second-year medical students' sense of belonging and usefulness in clinical environments. Training on such skills might reinforce the importance of fundamental communication skills, such as building rapport, attending to affective issues, and cross-cultural communication. It also might help instill in trainees whose professional identities are still emerging the ethic that promoting behavior change is central to medical practice.These advantages could only be realized if teaching these skills earlier were feasible and acceptable to medical students. This study aimed to determine whether a curriculum on tobacco intervention could garner student acceptance; improve relevant knowledge, attitudes, and self-confidence; and be applied in students' early clinical experience. This paper describes the design and evaluation of the Wisconsin Tobacco Intervention Basic Skills curriculum (TIBS), the first experience in a new longitudinal curriculum on promoting behavior change. PROGRAM DESCRIPTION Target AudienceThe targeted learners were the 147 first-year medical students in the class of 2005 at the University of WisconsinMadison. Eighty-three (56.5%) of the students were female; 64 (43.5%) were male. Mean age and standard deviation were 22.6 ± 3.1 years; 7 (5%) of the students were age 30 or above. Behavior Change ModelWe selected motivational interviewing 16 Curriculum DevelopmentSeveral principles guided curriculum development. The greatest instructional emphasis should be skills development. The intervention model should be structured yet flexible to respond to patients' needs and clinicians' time constraints. Practicing physicians should provide role modeling on the importance of these skills in clinical practice. Sequential learning steps should include knowledge acquisition, skills demonstration, skills practice and feedback, and reinforcement by application in clinical settings. Scarce instructional tim...

This cost-effective faculty development program can serve as a model to increase educational programs on substance abuse at public universities, increase faculty research activities in the alcohol area, and increase clinical programs in university hospitals.

The American Association of Colleges of Pharmacy advocates that pharmacists can have a significant impact on substance abuse prevention provided they receive adequate training. Continuing education programs are needed to enable practicing pharmacists to augment their limited education. This paper examines the process the Society of Teachers of Family Medicine (STFM) used to develop a pilot continuing education program for pharmacists. With limited literature and a small number of pharmacy teaching about substance abuse, input on topics and training methods was obtained from a convenience sample of practicing pharmacists to enhance the information from the pharmacist faculty regarded as content experts. Results of this pilot study revealed lack of agreement between faculty and practicing pharmacists regarding the prioritizing of content and educational methods. Consequently, input must be obtained from targeted audiences instead of relying solely on the advice of identified academic content experts when designing continuing educational programs. Other professions should consider this process when designing continuing education programs. Pharmacists are poised to play an important role in the prevention of substance abuse problems, but they need continuing education about substance abuse.

This retrospective-anecdotal study was conducted to determine if involvement in a learner-centered continuing education program in substance abuse prevention would influence the careers and work-related activities of thefacilitators. A questionnaire was sent to 33 individuals who served as facilitators of a large substance abuse prevention education project. Of the 31 who responded, 21 (67.7%) indicated that serving as a facilitator resulted in either "major changes" or "some changes" to their careers, and 25 (80.6%) felt that they were "much more likely" or "more likely" to incorporate substance abuse prevention activities into their work. Teaching in substance abuse education programs may cause changes in the career paths and work-related activities of the facilitators. Investigators may need to incorporate evaluations of the effects of a particular program on the intended learners as well as the facilitators.