Rewriting the Hidden Curriculum via Addiction Consult Services: Meeting Patients Where They Are At

Balasanova, Alëna A.; Eagen, Kellene; Marcovitz, David

doi:10.1007/s11606-023-08194-4

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…The literature describes addiction consult services as having the potential to rewrite the “hidden curriculum” around SUD in the hospital setting and to reduce stigma among trainees. 14 Our findings provide important groundwork for inclusion of medical students on addiction consult services and affirm the notion that such services may play an important role in combating healthcare stigma against patients with SUD. Future studies should compare changes in attitudes after rotating on an addiction consult service to other rotations and examine which aspects of clinical experiences and anti-stigma training most contribute to attitude improvement.…”

Section: Discussionsupporting

confidence: 72%

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Medical Student Attitudes Toward Patients With Substance Use Disorder After Experiential Learning on an Addiction Psychiatry Consultation-Liaison Service: A Pilot Study

Lew,

Balasanova

2024

Substance Use & Addiction Journal

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Background: Stigma surrounding substance use disorder (SUD) is highly prevalent in health care. Negative attitudes toward patients with SUD have been shown to negatively impact patient care. Addressing SUD stigma in medical students is a promising approach, however, few curricula include experiential learning on addiction psychiatry clinical services. We describe a medical student rotation on an addiction psychiatry clinical service and examine its effect on attitudes toward patients with SUD. Methods: Medical students were integrated onto an addiction psychiatry consultation-liaison service serving medically/surgically hospitalized patients with co-occurring SUD and other psychiatric disorders. Students learned and practiced in-person assessment of patients and received instruction on basic principles of psychiatry and evaluation and management of SUD. A targeted anti-stigma curriculum was included. Attitudes toward patients with SUD were measured with the Medical Condition Regard Scale (MCRS) before and after the experience. Each item of the MCRS and an overall composite attitude score were analyzed. Results: Of the 36 students on the clinical rotation, 33 completed the survey. Attitudes showed widespread improvement toward patients with SUD. Mann–Whitney U tests showed significant improvement in most items of the MCRS. Further analysis of composite scores showed an improvement in overall attitudes toward patients with SUD. Conclusions: Inclusion of medical students on an addiction psychiatry consult service as part of the core psychiatry clerkship may hold promise for helping improve student attitudes and decrease stigma toward patients with SUD. Controlled study is needed to compare other clinical experiences and determine specific causative effects.

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Section: Discussionsupporting

confidence: 72%

“…Prior work suggests that increased face-to-face contact with individuals with lived experience has the largest effect in reducing stigma, 21 however, targeted anti-stigma instruction and observation of faculty may be helpful contributors, particularly when part of an addiction consult experience. 14…”

Section: Discussionmentioning

confidence: 99%