Undergraduate Medical Education in Substance Abuse: A Review of the Quality of the Literature

Abstract

Purpose To prepare to develop a medical school curriculum on substance abuse disorders (SAD), the authors conducted a review of the quality of the sparse published literature. Method The authors searched MEDLINE (1950–December 2008), Web of Science, PsycINFO, and PubMed to identify all studies of SAD interventions targeted toward undergraduate medical students. Of the 1,084 studies identified initially, 31 reported sufficient data to allow the authors to evaluate quality using Medical Education Research Study Quality Instrument (MERSQI) scores. The authors also determined the impact of the studies by considering three-year citation rate and journal impact factor. A detailed review of the literature provided data on contact hours and intervention content. Results The three-rater intra-class correlation coefficient (ICC) for total MERSQI score was 0.82 (95% confidence interval: 0.70–0.90). The mean MERSQI score was 10.42 of a possible 18 (SD 2.59; range: 6.33–14.83). MERSQI scores were higher for more recently published studies and correlated with three-year citation rate but not impact factor. The mean contact time for 26 studies was 29.25 hours (range: 0.83–200 hours). Conclusions The literature provides a variety of educational methods to train medical students in SAD detection and intervention skills. This literature is of variable quality and provides limited guidance for development of curricula and medical education policy. Better methods of curriculum evaluation and publication guidelines would help ensure this literature has a positive impact on educational practice and public health.

Appraising the Quality of Medical Education Research Methods

“…For the few instances of low interrater reliability, raw agreement was usually good; we return to this point in the Discussion. Four other studies [24][25][26][27] reported interrater reliabilities for overall MERSQI scores ranging from 0.68 to 0.89.…”

Curricular Innovations for Medical Students in Palliative and End-of-Life Care: A Systematic Review and Assessment of Study Quality

“…9 More recently, systematic reviews of medical education in topic areas unrelated to palliative care that utilized MERSQI have reported mean scores ranging from 9.0 to 11.4. [59][60][61][62][63][64][65][66] Overall, this suggests that palliative care education studies are of similar methodological quality to other medical education studies.…”

A Collaborative Approach to Teaching Medical Students how to Screen, Intervene, and Treat Substance Use Disorders

“…Approaches used to teach about SUDs during the undergraduate years are varied but literature suggests that active and experiential modalities are more effective for changing knowledge and attitudes (15). This is consistent with the heavy emphasis on patient interaction and skills development in this course.…”