1. Screening, Brief Intervention and Referral to Treatment
Lessons from SBIRT
Translating Curriculum for
Screening, Brief Intervention and Referral to Treatment
into Real-time Learning

2. Your Goals for this session
Introductions
What are you currently doing in your programs to teach substance abuse issues?
What is working for you?
What are your challenges?
All - Phil

3. Our Goals & Objectives Define key elements of SBIRT
Screening, Brief Intervention, Referral to Treatment
Review progression of learning and use of innovative SBIRT didactic materials
Identify strategies for resident skills training in brief interventions
Phil

4. Screening What is SBIRT? Brief Intervention Referral to Treatment
for Alcohol and Drug Misuse
Shari

5. Causes of Preventable Death in the United States
Shari
Mokdad et al., 2004

6. SBIRT Medical Residency Training Grant
Funded by Substance Abuse and Mental Health Services Administration (SAMHSA) and Center for Substance Abuse Treatment (CSAT)
Started in 2008
5 year award
17 funded grantees in US

7. SBIRT Medical Residency Training Grantee Locations
Shari

8. SBIRT Training Grant Sites in Pennsylvania
Shari

9. SBIRT Training - PA (as of 2010)
1,256 residents trained since September 2008
675 new residents trained Oct May 2010
Grant sites trained 1,021 non-residents
(physician assistants, psychologists, social workers, other healthcare professionals)
Shari
Source: Singh, Kasten, & Hayashi. (2010). Training in SBIRT in Medical Schools in the United States: An Examination of Physician Education and Training
on Conducting Screenings, Brief Interventions, and Referrals to Treatment. Retrieved May 12, 2011, from

10. SBIRT Curriculum Vision
Create a publisher ready, turn-key SBIRT curriculum :
Evidence-based
Comprehensive yet concise
Highly modular and adaptable to a variety of training environments
Emphasis on knowledge that is clinically relevant and interesting to trainee and practicing physicians
Patty

11. SBIRT Curriculum Modules
Special Populations
Adolescents
Criminal Justice
Emergency Dept
Geriatrics
HIV+
Homeless
Injectors
In-patients
Impaired Professionals
Military & Veterans
Obstetrics
Pain in Addicted Populations
Sexual Minorities
Core Curriculum
Module 1 Intro to SBIRT & Screening
Module 2 Medical/Psych Complications
Module 3 Effective Brief Intervention
Module 4 Referral to Treatment
Module 5 Pharmacotherapy for SUD
Patty

12. SBIRT Implementation – Part 1
Curriculum Development
Level 1 - Basic SBIRT topics
Level 2 - SBIRT for Special Populations
dex.php

13. SBIRT Implementation – Part 2
Universal Screening
Paper vs. EHR
Brief Screen
Modified ASSIST
AUDIT / DAST
Patty

14. SBIRT innovative learning tools
SBIRT Jeopardy game
SBIRT Jeopardy ppt
Interactive BI internet program
Smartphone App (in development)
SBIRT_App_in_PowerPoint_2013.pptx
Patty

15. Interactive BI skills training
Didactic materials
Role plays
Simulated patient exercises
Shari

16. Barriers to Implementation
Curricular time
Competing priorities for residents
Varying levels of faculty expertise and commitment
Varying levels of interest and motivation from residents
Competing demands for faculty “champions”
Phil

17. Outcomes Resident Satisfaction Surveys Pre-training Post- training
Phil

18. Resident Satisfaction all sites, Level 1, n=232
Gender
Male
Female
110 (47%)
117 (50%)
Ethnicity
Hispanic/Latino
Not Hispanic/Latino
7 (3%)
215 (93%)
Race
White
African-American
Asian
Biracial/Multiracial
139 (60%)
12 (5%)
70 (30%)
2 (<1%)
Phil

19. Resident Satisfaction - Overall
Item n
Mean Score (SD)
Overall quality of training
230
2.46 (1.00)
Quality of instruction
2.30(.99)
Quality of training materials
2.42(1.01)
Overall training experience
229
2.42(1.07)
Phil
very satisfied not at all satisfied

20. Resident Satisfaction - Instructor
Item n
Mean Score (SD)
Knowledgeable in subject matter
230
1.78 (.80)
Well-prepared for course
1.80(.80)
Receptive to participant comments
229
1.80(.79)
Phil
very satisfied not at all satisfied

21. Resident Satisfaction - Training
Item n
Mean Score (SD)
Was well-organized
230
2.16(.85)
Enhanced skills in topic area
229
2.25(.95)
Was relevant to career
228
2.07(.98)
Relevant to substance abuse treatment
1.92(.81)
very satisfied not at all satisfied

22. Resident Satisfaction - Other
Item n
Mean Score (SD)
Material useful in dealing with substance abuse
230
2.18(1.00)
Currently effective working in topic area
229
2.44(.74)
Expect to use information from training
2.13(.97)
Expect training to benefit clients
Recommend training to colleagues
2.57(1.17)
very satisfied not at all satisfied

23. SBIRT Curriculum Sustainability
Successes of curriculum
Challenges of curriculum
Future plans
What to incorporate into overall Behavioral Health/Family Medicine curricula?
Shari & All

24. Discussion
All