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"He Bore it Like a Scarlet Letter": Medical Student Reflections on Substance Use Disorders.
Tara Clark1, Mary E Camp2, John Z Sadler1
1University of Texas Southwestern Medical Center, Dallas, TX, USA.
Summary
Medical students
Area of Science:
- Medical Education
- Public Health
- Addiction Medicine
Background:
- Substance abuse, particularly the opioid crisis, is a significant public health issue.
- Medical students' attitudes toward substance use disorders may decline during training.
- Limited research exists on how early clinical experiences influence these attitudes.
Purpose of the Study:
- To explore how medical students' early clinical experiences with substance use disorders shape their views.
- To analyze themes in student reflective essays concerning patients with substance use disorders.
Main Methods:
- Content analysis of 802 medical student reflective essays from core clerkships (excluding Psychiatry).
- Coding for ethical and professional themes, and descriptions of substance use disorders.
- Chi-square analysis to identify statistically significant associations between themes and substance use disorders.
Main Results:
- Fifty-three essays discussed patients with substance use disorders (opioids, alcohol, cocaine).
- Five themes were significantly associated with substance use disorders (p < 0.05): adequate treatment, pain, difficult patient, jumping to conclusions, and malingering.
- Students identified the treatment of pain as a key ethical challenge.
Conclusions:
- Early clinical experiences present ethical challenges for medical students regarding substance use disorders, especially pain management.
- Medical education should incorporate experiences beyond Psychiatry clerkships to address substance use disorders comprehensively.
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