A Cross-Sectional Survey of Internal Medicine Residents’ Knowledge, Attitudes, and Current Practices Regarding Patient Transitions to Post-Acute Care

Limes, Julia; Callister, Catherine; Young, Eric W.; Burke, Robert E.; Albert, Tyler J.; Cornia, Paul B.; Sehgal, Raj; Jones, Christine

doi:10.1016/j.jamda.2021.02.011

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…The response rate was low at 48%, although this is in line with other resident survey studies. 42 Our institution is a large academic IM program, thus our findings may not be generalizable to programs in other locations, smaller community programs, or to residency programs in other specialties. The residency compensation for X-waiver training completion is likely not available in most residency programs; however, because an X-waiver is no longer required for buprenorphine prescribing, how this impacts future education and resident preparedness remains unclear.…”

Section: Discussionmentioning

confidence: 92%

The Impact of Completing X-Waiver Training and Clinical Addiction Exposure on Internal Medicine Residents Treating Patients With Opioid Use Disorder

Callister,

Porter,

Vatterott

et al. 2024

Substance Use & Addiction Journal

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Background: Treating opioid use disorder (OUD) with buprenorphine or methadone significantly reduces overdose and all-cause mortality. Prior studies demonstrate that clinicians and residents reported a lack of preparedness to diagnose or treat OUD. Little is known about how clinical exposure or buprenorphine X-waiver training impacts OUD care delivery by resident physicians. Objective: Distinguish the effects of X-waiver training and clinical exposure with OUD on resident’s knowledge, attitudes, feelings of preparedness, and practices related to OUD treatment provision. Methods: From August 2021 to April 2022, we distributed a cross-sectional survey to internal medicine residents at a large academic training program. We analyzed associations between self-reported clinical exposure and X-waiver training across 4 domains: knowledge about best practices for OUD treatment, attitudes about patients with OUD, preparedness to treat OUD, and clinical experience with OUD. Results: Of the 188 residents surveyed, 91 responded (48%). A majority of respondents had not completed X-waiver training (60%, n = 55) while many had provided clinical care to patients with OUD (65%, n = 59). Most residents had favorable attitudes about OUD treatment (97%). Both residents with clinical exposure to treating OUD and X-waiver training, and residents with clinical exposure without X-waiver training, felt more prepared to treat OUD ( P < .0008) compared to residents with neither clinical exposure or X-waiver training or only X-waiver training. Conclusions: Residents with clinical exposure to treating OUD are more prepared to treat patients with OUD than those without clinical exposure. Greater efforts to incorporate clinical exposure to the treatment of OUD and education in internal medicine residency programs is imperative to address the opioid epidemic.

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Section: Discussionmentioning

confidence: 92%

The Impact of Completing X-Waiver Training and Clinical Addiction Exposure on Internal Medicine Residents Treating Patients With Opioid Use Disorder

Callister,

Porter,

Vatterott

et al. 2024

Substance Use & Addiction Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…The complex web of payors, regulations, and paperwork related to discharge to an SNF makes it unlikely that all parties involved, including hospitalists, patients, and families, fully understand the process. In academic settings, internal medicine residents lack knowledge about the frequency of skilled therapy and report a disconnect between discharge communication and timely completion of discharge summaries unless they had a clinical rotation in an SNF 8 . In addition, the shortage of SNF beds leads to a situation where SNFs are incentivized to accept patients with fewer and less complex needs.…”

Section: Figurementioning

confidence: 99%

“…In academic settings, internal medicine residents lack knowledge about the frequency of skilled therapy and report a disconnect between discharge communication and timely completion of discharge summaries unless they had a clinical rotation in an SNF. 8 In addition, the shortage of SNF beds leads to a situation where SNFs are incentivized to accept patients with fewer and less complex needs. While this is frustrating for hospitals and hospitalists who are sending patients to SNFs, there are very understandable reasons leading to which patients are accepted by SNFs.…”

mentioning

confidence: 99%