'Asking' but Not 'Screening': Assessing Physicians' and Nurses' Substance-Related Clinical Behaviors

Area of Science:

• Public Health
• Medical Education
• Substance Use Disorders

Background:

• Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a key public health strategy for addressing problematic substance use.
• Formal screening tools are central to SBIRT for risk assessment and service matching.
• Emphasis on formal screening training within SBIRT programs is often limited.

Purpose of the Study:

• To evaluate pre-training levels of SBIRT-related clinical behaviors, specifically screening practices.
• To assess the self-reported frequency of behaviors like asking about substance use, screening, and intervening among healthcare learners.

Main Methods:

• Secondary data analysis from 117 internal medicine residents and nurse practitioner students.
• Exploratory factor analysis to identify underlying constructs of SBIRT behaviors.
• Mixed ANOVA to compare utilization frequencies of asking, screening, and intervening across academic programs.

Main Results:

• Learners frequently reported asking about substance use.
• Intervention occurred some of the time, while formal screening tool use was infrequent.
• Significant but small interaction and between-program effects were observed.

Conclusions:

• Pre-training assessment reveals a gap between asking about substance use and utilizing formal screening tools among clinicians.
• Findings suggest a need to enhance the importance and content focus of SBIRT training in medical and nursing education.
• Curricular integration of comprehensive SBIRT, particularly formal screening, is crucial for effective public health practice.