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Prisma Health-Upstate, University of South Carolina School of Medicine Greenville (UofSCSOMG), and Clemson University School of Nursing in Greenville, SC (CUSON) will develop and implement Project TRANSFORM (Teaching Recovery-informed Addiction Care And Negating Stigma FOR Medical Professionals) to provide training for professionals in the health care team who in the course of their roles may serve individuals and families affected by SUD. The proposed module-type educational pedagogy includes review of sensitivity to the unique needs of those affected, information on various substances of use, and clinical considerations and supportive intervention strategies for health care professionals. The project will serve an estimated 5,200 students over the two year period. The Project Goal is to expand the number of practitioners to deliver high-quality, evidence-based SUD treatment. The objective is to expand the integration of substance use disorder (SUD) education into the standard curriculum of a minimum of 20 relevant healthcare and health services education programs over two years. The proposed approach for this project is to: 1. Develop an online curriculum that will cover each of the subject areas required in the FOA. The modules will be in an online platform where the instructor can either assign the curriculum to be done outside of the class or the instructor can use the curriculum as a part of their lecture. 2. Provide each module to consist of the evidence based educational piece followed by a short quiz on the topic, then a review of the quiz and topic. Following the module will be brief videos, produced by national experts in addiction medicine, education and recovery in collaboration with a professional video company, interviewing people in recovery and their experience with that particular drug and what was helpful to them in recovery. This innovative approach of integrating the medical knowledge with lived experience education provided by individuals living with addiction and in recovery will result in an educated, compassionate and involved healthcare workforce addressing SUD.

Emergency departments (ED) across the country are experiencing an alarming increase in patients seeking care for substance use disorder (SUD) including opioid use disorder. Today, the ED is considered a frontline in the treatment of these patients. To meet this demand, emergency physicians and medical toxicologists must be able to effectively care for these patients, yet education, training and competencies in this area are limited. This program, On the Frontline: Training Emergency Medicine Residents and Medical Toxicology Fellows to Effectively Screen, Assess, and Treat Patients with Substance Use Disorder, is intended to meet this need. To that end, this project will develop and test SUD curricula for emergency medicine residency and medical toxicology fellowship programs among nearly 1,000 emergency medicine residents and 90 medical toxicology fellows. The curricula will then be shared with all emergency medicine resident and medical toxicology fellowship programs across the country. The curricula will also be used to develop questions about SUD assessment, and treatment in board certification exams for both emergency medicine and medical toxicology. Lastly, medical toxicologists consult on overdose patients in the ED daily and play a critical role in providing guidance to emergency departments on SUD. Medical toxicology fellows will take this training one step further and provide in-service training to the multidisciplinary emergency department team and staff that care for patients with SUD.

The Council on Social Work Education (CSWE) is the national association representing social work education in the United States and the sole accrediting agency for social work education in the U.S. and its territories. CSWE proposes a project, Substance Use Disorders (SUD) Expansion of Practitioner Education in Social Work, to address the lack of a high-quality standardized SUD curriculum in accredited schools and programs of social work. CSWE will partner with at least 32 colleges and universities to integrate a newly designed SUD curriculum into their accredited programs of social work. This will strengthen the preparation of future social work practitioners to deliver high-quality, evidence-based SUD prevention, treatment and recovery services. The new curriculum will align with social work competencies used in CSWE’s accreditation standards and will include plug and play modules as well as a newly developed SUD social work course. An integral part of social work education is the field experience. According to CSWE’s accreditation standards, “The intent of field education is to integrate the theoretical and conceptual contribution of the classroom with the practical world of the practice setting. It is a basic precept of social work education that the two interrelated components of curriculum—classroom and field—are of equal importance within the curriculum, and each contributes to the development of the requisite competencies of professional practice.” Each field experience is supervised by an MSW practitioner. Therefore, the SUD curriculum will contain a field component where students will practice with individuals, families and groups affected by a substance use disorder. To accompany the curriculum, an assessment matrix will be developed to ensure that programs are assessing student competency in a standardized way.

The Physician Assistant Education Association (PAEA) will lead the Expansion of Practitioner Education-Physician Assistant (PRAC-ED-PA) project to (1) Increase the number of PAs delivering high-quality, evidence-based SUD treatment by 2021, (2) Expand the integration of SUD education into PA programs by 2020, and (3) Advocate to include SUD questions on PA certification exams before 2021. PAEA was founded in 1972 and represents all 242 PA education programs in the United States. We serve approximately 2,000 faculty along with approximately 26,000 applicants and more than 18,000 students split between didactic and clinical education phases in each year. The Association is responsible for leadership, program support, faculty development, advocacy, assessment, and collecting and disseminating information on PA education programs. Our programs now graduate more than 9,000 new PAs each year who practice medicine in all specialties across every state, multiple territories, and the District of Columbia. PAEA strives to ensure quality PA education through the development and distribution of education services and products geared toward meeting the emerging needs of PA programs, the PA profession, and the healthcare industry. PAEA's vision is Health for All. Its mission is leadership, innovation, and excellence in PA education. The immediate population to be served will be 900-1,000 students in 10 pilot programs whose knowledge will be enhanced through expansion of existing behavioral health and SUD curricula in 2020 and 2021. PAEA will employ a strategy requiring the 10 pilot programs to actively assist in the process of adapting existing SUD curricula into a 6-8 hour modular format that is suitable for programs to integrate as a stand-alone curriculum or to merge with other curricular components where SUD content is delivered. After piloting and modifying the curriculum, we will expand it to 10 additional programs and 400-500 more students will be impacted by 2021. Progress toward achieving the objectives will be measured and analyzed through scores on student pre- and post- assessments in addition to satisfaction scores and faculty evaluations to continuously improve the quality of the curriculum. The success of the advocacy goal will be measured through the acceptance by the National Commission on the Certification of Physician Assistants (NCCPA) of the PRAC-ED-PA SUD curriculum as one resource for test item writers and the continued inclusion of SUD questions in the Physician Assistant National Certifying Examination (PANCE). The 6-8 hour PRAC-ED-PA curriculum will be made available to all PA programs. This expanded SUD treatment knowledge will be drawn upon by PA graduates to reduce stigma associated with SUD and impact the care they will provide to millions of patients over the course of their careers. These demographically diverse patients, and their families, constitute the ultimate population to be served by new graduates in every specialty and practice setting.

Project Name: The NP Substance Use Disorder Medical Education Project (NP-SUDMedEd) Population(s) to Be Served: (demographics and clinical characteristics): Nurse Practitioner (NP) students enrolled in schools and universities with Nurse Practitioner education programs. Strategies/Interventions: The American Society of Addiction Medicine (ASAM) will work in partnership with the American Association of Colleges of Nursing to expand the integration of substance use disorder (SUD) into the standard curriculum of NP programs through development and implementation of a high-quality, evidence-based online module for NP students. In implementing its proposed curriculums, ASAM will build on its extensive experience as the single largest provider of live and online education programs on addiction medicine. The nationally recognized ASAM Fundamentals of Addiction Medicine, an innovative educational program empowering primary care and other providers to diagnose and treat patients at risk for, or with, addiction, will be adapted for ASAM’s proposed NP-SUDMedEd curriculum. The curriculum will be piloted in year with 10 universities/schools with NP education programs and after modification as needed in year 2, with 10 additional universities/schools. Project Goals and Measurable Objectives: Goal: Reduce stigma around SUD and increase SUD treatment providers through development and piloting of a curriculum designed for university NP programs on identifying and treating of SUDs Objective 1: By 11/15/2019, develop curriculum on SUD treatment that includes components on: 1) screening, brief intervention, and referral to treatment (SBIRT) strategies; 2) assessment; and 3) treatment principles and their application particularly with regard to alcohol, marijuana, stimulants, and opioids. Objective 2: By 9/14/2020, pilot and ensure use of curriculum in at least 10 schools/universities with NP education programs. By 9/14/2021September 14, 2021, implement and ensure use of modified curriculum by 10 additional schools/universities with NP education programs. Objective 3: By 9/14/2020, collect data from participating NP students and educators to evaluate pilot curriculum and develop report that outlines needed curriculum modifications for Year 2. Objective 4: By 10/15/ 2020, modify curriculum based on Year 1 pilot evaluation and identification of recommended curriculum improvements. Objective 5: By 9/14/2021, work collaboratively with the American Academy of Nurse Practitioners Certification Board (AANPCB) to integrate SUD questions into the certification process by inviting SUD content experts who meet qualification requirements to participate in AANPCB certification examination item-writing sessions. Number of People to Be Served Annually and Through Life of Project: 750 Nurse Practitioner students in year 1 and 750 in year 2 for a total of 1,500.

This program will increase the number of psychologists trained to assess and treat substance use disorder (SUD) through the development and implementation of a curriculum by the American Psychological Association (APA). Many psychology programs do not routinely include SUD training as programs do not have faculty with expertise in this area. Increasing the number of psychologists trained to assess and treat SUD will impact unmet need. Psychologists are well positioned to assess and treat SUD given the emphasis in their training on evidence-based practice and understanding patients using a biopsychosocial framework. Further, psychologists treat patients with problems that often co-occur with SUD. The curriculum will be developed in consultation with a nationally recognized psychologist with expertise in research, service delivery, and training in the area of SUD. The curriculum will be implemented by ten programs in year one and additional ten in the second year. The curriculum will include sufficient detail and resources to enable the instructor to implement as is. Organized as a series of content-related modules the curriculum will be built by first defining student learning outcomes for each module and include content to be covered, suggested learning activities including videos, and methods to assess student learning. It is expected that this program will impact 130 students and 10 faculty in each year of the project for a total of 260 students and 20 faculty. The APA is the organization that will oversee this program and has formal and long-standing connections to psychology training programs and the organization that administers the psychology licensure exam. These existing relationships will facilitate the adoption of the curriculum and meeting the goals for the program. There are three goals for this program: reduce unmet need for screening, assessment, and treatment of SUD by fostering a psychology workforce that is competent to screen, assess, and treat SUD; provide evidence-based training to psychology graduate students related to SUD; and enhance psychology graduate programs' capacity to provide education and training related to SUD. Data will be submitted by participating programs and students to assess the degree that the program meets the stated objectives. Such data includes, percent of students meeting course objectives, student rated increases in their SUD knowledge, utility of curriculum as applied to their clinical work, achieving ten participating programs in each year, and increases in instructor's self-reported competence to provide SUD training.

The goal of this project is to increase the competence and capability of emergency medicine residents/physicians to provide their patients with high-quality and evidence-based substance use disorder screening, assessment and treatment. The American College of Emergency Physicians (ACEP) will develop and disseminate SUD curriculum to our emergency medicine residencies to improve patient care. Emergency department (ED) residents are in a unique position to play an integral and pivotal role in reducing substance use disorder (SUD) overdose deaths and increasing linkage to addiction treatment. EDs serve as a key access point for the health care system and are often the first and only point of contact for patients with a SUD. EDs also serve as an optimal setting for screening and intervention for opioid use disorder and treatment due to high volumes of patients and the potential for staff to leverage patients’ motivation to change. It is critical that education on SUD be emphasized in every EM residency in the nation. Patients treated with respect and understanding and offered effective treatments are more likely to continue with that treatment and enter recovery programs. Today, only a handful of residencies have content experts that can expose residents to up-to-date information on the theory of addiction, brief intervention techniques and use of medication assisted treatment. Without a developed curriculum to guide them, residents will graduate with a knowledge gap, patients will not receive the best treatment, and referral networks will not be established. ACEP will partner with American Board of Emergency Medicine (ABEM), Council of Residency Directors in Emergency Medicine (CORD), and Emergency Medicine Residents' Association (EMRA). ACEP will convene subject matter experts (SMEs) to form a SUD Curriculum Advisory Group to assist in developing the curriculum. ACEP will pilot the curriculum in 12 emergency medicine residents. Evaluation data from these pilot sites will inform any necessary revisions to the curriculum and content. We will then implement in an additional 12 residencies. ABEM will develop exam questions based on the SUD curriculum. These will be included in the Emergency Medicine In-Training Exam and the Qualifying Exam. ABEM will provide ACEP the aggregate data collected from 2021 In-Training Exam comparing residencies utilizing the SUD curriculum with those not utilizing curriculum. In addition, we will compare the change in scores on the questions over time among all residencies.

Creating and test-piloting curriculum for undergraduate and graduate nursing students with training in Screening, Brief Intervention, Referral and Treatment (SBIRT) , Motivational Interviewing (MI), and principals and resources for treatment of substance use disorders with consideration of culturally diverse backgrounds to improve their ability to screen, identify, and support at-risk patients. Additionally, we will offer evidenced based curriculum that is easily incorporated into current nursing curriculum and provide guidance to instructors, with the aim of addressing current barriers in the educational environment to increase SUD education and ultimately better leveraging nurses to become potent agents in address the substance use disorder crisis.

Access to high-quality, foundational teaching of clinical skills is urgently needed to identify and treat substance use disorders (SUDs). "Expansion of Interprofessional Healthcare Practitioner SUD Education," intended for interprofessional healthcare learners, will use a massive open online course (MOOC) designed and taught by an interprofessional team of substance use prevention and treatment experts from Yale University. The course will increase access to and standardize education on evidence-based skills necessary to prevent and treat SUDs. The American Academy of Addiction Psychiatry (AAAP), collaborating with Yale University and the American College of Academic Addiction Medicine (ACAAM) and partnering with 34 universities and professional schools representing medicine, nursing, physician associate, social work, pharmacy and public health, will administer the curriculum and provide follow-up course evaluation. Students participating in the pilot will include all levels: undergraduate, graduate, residency and fellows. Plans to expand representation from other healthcare schools in the first 30 days of the funding include: psychology, family and marriage therapy, and other healthcare professionals. Data will be collected to determine the course usefulness in improving learner knowledge and confidence to screen, diagnose, and treat SUDs. Findings of the evaluation from students and faculty will be used to modify the curriculum in year 2. In year 2, we will increase the number of professional schools participating, increase the number of interprofessional students completing the course, and address licensure and certification of each discipline to integrate the course into training schools' curriculum nationwide. Secondary goals of the project are to: 1) implement and assess the impact of interprofessional learning and 2) to increase knowledge on structural determinants of health impacting patient access to high-quality SUD care.

Family medicine residents do not feel prepared to treat substance use disorder (SUD), and many residency programs do not have a required curriculum. “Implementing and Standardizing Substance Use Disorder Curricula in Family Medicine Residency Programs” is a partnership between the New Jersey Academy of Family Physicians (NJAFP) and the New Jersey Society of Addiction Medicine (NJSAM) to develop a comprehensive SUD curriculum for family medicine residency programs in New Jersey, Delaware and Pennsylvania. It features turn-key programming plus slide decks and tools to accelerate and ease implementation.