Early diagnosis of substance abuse: evaluation of a course of computer-assisted instruction

A computer-assisted, experiential course of instruction on early diagnosis of substance abuse was developed and compared to three existing substance abuse curricula for third-year medical students on family medicine clerkships. The experimental course, requiring 2 hours of teacher contact, consisted of three computer-assisted instruction modules, active discussion, role play, opportunities for applying new knowledge and clinical skills, and modelling of clinical interest by a family doctor. The three comparison educational programmes were a one-week immersion experience on a substance abuse in-patient unit, 1-4 hours of lecture, and no formal teaching. For 6 months, all third-year medical students at Jefferson Medical College were exposed to one of these courses, and to the same required readings on substance abuse, on their required family medicine rotations at different clerkship sites. They completed end-of-rotation questionnaires assessing their knowledge, satisfaction with substance abuse teaching, and motivation for continued learning. Groups were similar with regard to demographic variables, academic performance, and previous curricular and extra-curricular exposure to substance abuse. Despite a possible selection bias favouring the immersion experience, the computer-assisted course resulted in higher levels of knowledge on early diagnosis, but similar attitudes and satisfaction. The computer-assisted and immersion courses produced more favourable outcomes than lecture-based teaching and no formal teaching. Compared to no formal teaching, lecture did not produce measurable effect. The results suggest that a computer-assisted, experiential substance abuse course, based on relevant and practical goals, can efficiently augment knowledge and motivation for further learning of third-year medical students.