Table 2 Content, format, and evaluation characteristics of 19 distinct harm reduction curricula
From: Harm reduction in undergraduate and graduate medical education: a systematic scoping review
Study | Institution | Trainees | Format | Curricular Components | HR Principles a | Content | Outcomes | Curriculum Availability |
|---|---|---|---|---|---|---|---|---|
New York University Grossman School of Medicine | MS1 | -Mandatory -30 min. -In-person synchronous & online asynchronous | Didactics, small group discussion, teach-back, naloxone demonstration, self-evaluation | No | Naloxone, Good Samaritan laws, overdose etiology/physiology, overdose risk, overdose identification, identification of at-risk patients | 1) Modified OOKS (pre/post)* 2) Modified OOAS (pre/post)* 3) Modified MCRS (pre/post) 4) Training feedback | Partially Available in article | |
Donohue 2021 [48] | University of Maryland Medical Center | FM and pediatrics PGY1 | -Mandatory -Time NR -In-person synchronous | Didactics, small group discussion, SPs, simulated scenarios, case studies, naloxone demonstration | No | Naloxone, nonjudgmental language and stigma, overdose identification, patient screening, person-centered goals and MI, MOUD, withdrawal identification and treatment, infectious complications | 1) Program-created scales on comfort treating patients with OUD (pre/post)* | Not Available |
Funke 2021 [49] | Duke University Hospital Emergency Department | EM PGY1-PGY3, PAs, nurses, attending physicians | -Requirement NR -4h hr. -In-person synchronous & online asynchronous | Didactics, small group discussion, patient panel, local organizations, EHR training, self-evaluation | No | Naloxone, related laws, overdose etiology/physiology, overdose identification, SBIRT and identification of at-risk patients, MOUD, withdrawal identification and treatment, myth-busting | 1) Program-created survey on attitudes towards patients with OUD (pre/post-3 months)* 2) Reasons given to not prescribe naloxone (post-2 months) 3) Percent of at-risk patients prescribed naloxone (pre/post.post-1 year)* | Partially Available in article supplementary materials |
Goss 2021 [50] | Drexel University College of Medicine | MS1 | -Voluntary -2 hr. -In-person synchronous & online asynchronous | Didactics, small group discussion, videos, naloxone demonstration, patient panel | Yes | Overdose prevention, naloxone, safer injection, SSPs, fentanyl test strips, nonjudgmental language and stigma, Good Samaritan laws, overdose etiology/physiology, overdose risk, overdose identification, MOUD | 1) Modified OOAS (pre/post)* 2) Modified OOKS (pre/post)* | Not Available |
Han 2017 [51] | University of Pittsburgh Medical Center: St Margaret Family Medicine Residency | FM PGY1-PGY3, fellows, pharmacy residents, social workers, faculty | -Mandatory -Time NR -In-person synchronous | Didactics, naloxone demonstration, EHR training | No | Naloxone, overdose risk, overdose identification, opioid prescription guidelines, MI | 1) Program-created scales on learner attitudes and comfort (pre/post-6 months)* 2) Number of naloxone kits prescribed 3) Number of opioid overdoses reversed 4) Patient willingness to obtain and use naloxone from providers (post-2 months) | Not Available |
Hargraves 2019 [52] | University of Cincinnati: Family and Community Medicine Residency | FM PGY1 and PA students | -Mandatory -2 hr. -In-person synchronous | Didactics, videos, naloxone demonstration | No | Naloxone, Good Samaritan laws, overdose etiology/physiology, overdose identification, identification of at-risk patients | 1) Program created scales on learner knowledge, attitudes, and self-efficacy (pre/post)* 2) Learner satisfaction with various curricular components (post) | Fully Available in article |
Jack 2018 [53] | Harvard Medical School | MS3 (pilot) MS1 (long-term program) | -Mandatory (long-term program) -5 min. -In-person synchronous | Naloxone demonstration | No | Naloxone, overdose etiology/physiology, overdose risk, overdose identification | No evaluation of student learning was reported | Not Available, but based on AHA Opioid Associated Life-Threatening Emergency Algorithm |
Jawa 2020 [54] | Boston Medical Center at Boston University School of Medicine | IM PGY1 (pilot) Medical and surgical PGY and fellows (expanded program) | -Voluntary (expanded program) -15 min. -In-person synchronous | Didactics, small group discussion, naloxone demonstration | No | Naloxone, Good Samaritan laws, overdose etiology/physiology, overdose identification | 1) Comfort administering naloxone (pre/post – 1 month)* 2) Comfort counseling patients on naloxone use (pre/post – 1 month)* 3) Naloxone prescribing behavior (pre/post – 1 month) | Fully Available in MedEd Portal |
Jawa 2021 [55] | Boston University School of Medicine | MS1, MS2, medical masters students, PA students, dental students | -Voluntary -2 hr. -In-person synchronous | Didactics, naloxone demonstration, local organizations | Yes | Overdose prevention, naloxone, safer injection, SSPs, overdose etiology/physiology, overdose risk, overdose identification, MOUD, infectious complications | 1) Comfort with harm reduction ideology (pre/post)* 2) Knowledge on safe injection technique (pre/post)* 3) Comfort and knowledge on administering naloxone (pre/post)* | Not Available |
Klapheke 2017 [56] | University of Central Florida College of Medicine | MS3 psychiatry clerkship | -Mandatory -30-50 min. -In-person synchronous or online asynchronous | Didactics, small group discussion, videos, case studies, naloxone demonstration, self-evaluation | No | Overdose prevention, naloxone, overdose etiology/physiology, overdose risk, overdose identification, opioid prescription guidelines, patient screening, person-centered goals, MOUD, withdrawal identification and treatment | 1) Program-created survey on confidence in knowledge of risk reduction, patient education (post) 2) Evaluation of module as educational tool (post) | Fully Available in MedEd Portal |
Warren Alpert Medical School at Brown University | MS2, nursing students, physical therapy students, social work students, pharmacy students | -Requirement NR -4 hr. -In-person synchronous | Small group discussion, SPs, videos, case study, naloxone demonstration, patient panel | No | Naloxone, non-judgemental language, overdose risk, overdose identification, SBIRT, MOUD | 1) Learner self-reflection (post) 2) OOKS (pre/post-12 weeks)* 3) Satisfaction survey (post) 4) Curricular component Likert scale evaluations (post) | Fully Available in MedEd Portal | |
Wayne State University School of Medicine | MS1, MS3 | -Mandatory -1 hr. -In-person synchronous | Didactics, naloxone demonstration | Yes | Overdose prevention, naloxone, Good Samaritan laws, overdose etiology/physiology, overdose risk, overdose identification, myth busting | 1) OOKS (pre/post)* 2) OOAS (pre/post)* 3) MCRS for SUDs (pre/post) 4) NaRRC-B (pre/post)* 5) Learner satisfaction and experience (post) | Not Available | |
Oldfield 2020 [62] | Yale School of Medicine | MS3 primary care and psychiatry clerkship | -Mandatory -75 min. -In-person synchronous & online synchronous | Didactics, train-the-trainer, videos, naloxone demonstration | Yes | Overdose prevention, naloxone, safer injection, SSPs, non-judgmental language, overdose etiology/physiology, overdose risk, overdose identification, identification of at-risk patients | 1) OOKS (pre/post-6 wks)* 2) OOAS (pre/post-6 wks)* 3) MCRS (pre/post-6 wks)* 4) Self-reported clinical behavior (pre/post-6 wks) 5) Anonymous satisfaction survey (post) | Fully Available in article appendix |
Parish 2013 [63] | Albert Einstein College of Medicine & Montefiore Medical Center | IM and FM PGY3 | -Mandatory -2.5 hr. -In-person synchronous | OSCEs, SPs, small group discussion, self-evaluation | Yes | Overdose prevention, safer infection, SSPs, non-judgemental language and stigma, overdose risk, SBIRT and identification of at-risk patients, person-centered goals, MI, MOUD, withdrawal identification and treatment | 1) Faculty and SP evaluation of resident communication, SUD assessment and management 2) Evaluation of OSCE as educational tool | Fully Available in article |
Riazi 2021 [64] | REACH Program at Mt Sinai Hospital & Icahn School of Medicine at Mt Sinai | MS1, IM PGY, nursing, health staff | -Mandatory -30-60 min. -In-person synchronous | Didactics, train-the-trainer, naloxone demonstration, local organizations | No | Overdose prevention, naloxone, SSPs, person-centered language, Good Samaritan laws, overdose etiology/physiology,overdose risk, overdose identification | No evaluation of student learning was reported | Fully Available in article supplemental materials |
Taylor 2018 [65] | Beth Israel Deaconess Medical Center at Harvard Medical School | IM PGY | -Mandatory -2 hr. -In-person synchronous | Didactics, small group discussion, videos, naloxone demonstration, EHR training | No | Naloxone, safer injection, identification of at-risk patients | 1) Inpatient & outpatient naloxone prescriptions (pre/post-3 months)* 2) Program-created survey on learner knowledge (pre/post) 3) Program-created survey on learner attitudes (pre/post)* | Partially Available in article |
Tringale 2017 [66] | Keck School of Medicine of USC & Homeless Healthcare Los Angeles | MS1 | -Voluntary -4 hr. -In-person synchronous | Didactics, small group discussion, shadowing, patient interaction, local organizations, self-reflection | Yes | Safer injection, SSPs, nonjudgmental language and stigma, person-centered goals, MOUD | 1) Learner evaluation of experience and learning objectives (post) 2) Open-ended reflection (post) | Not Available |
Winograd 2017 [67] | Veterans Affairs St. Louis Healthcare System | MS4 IM rotation, PGY (mostly primary care), attending psychiatrists, NPs, PAs, clinical pharmacists | -Voluntary -25-40 min. -In-person synchronous | Didactics, naloxone demonstration | No | Overdose prevention, naloxone, SSPs, overdose etiology/physiology, overdose risk, overdose identification, identification of at-risk patients, MI | 1) Modified OOKS (pre) 2) Modified OOAS (pre) 3) Monthly naloxone prescriptions (pre/post – 10 months) 4) # naloxone prescribers (pre/post – 10 months) | Fully Available through corresponding author |
Zanjani 2020 [68] | Virginia Commonwealth University & Richmond Health and Wellness Program | MS, nursing, pharmacists, psychologists, social workers, allied health professionals, faculty | -Mandatory -1 hr. -In-person synchronous & online asynchronous | Didactics, small group discussion, SPs, case studies, | No | Overdose prevention, overdose risk, opioid prescription guidelines, SBIRT, MI | Program-created scales on (pre/post): 1) Learner knowledge* 2) Learner perceived skills* 3) Learner motivations | Not Available |