Transformative Learning and Critical Consciousness: A Model for Preclerkship Medical School Substance Use Disorder...

Area of Science:

• Medical Education
• Public Health
• Social Determinants of Health

Background:

• Traditional medical education often lacks comprehensive training on substance use disorders (SUD).
• Addressing stigma, social determinants of health, and healthcare inequities is crucial for effective SUD care.
• Re-envisioning preclerkship education is necessary to prepare compassionate, person-centered providers.

Purpose of the Study:

• To develop medical students' critical consciousness regarding substance use disorders (SUD).
• To foster a holistic understanding of SUD by incorporating lived experiences and addressing systemic issues.
• To re-envision preclerkship SUD education to include discussions on stigma, social determinants of health, and healthcare inequities.

Main Methods:

• A curricular thread was designed using transformative learning theories at Duke University School of Medicine.
• Content included lectures, workshops, case studies, motivational interviewing, and an opioid overdose simulation.
• Students engaged in personal reflection through critical essays, incorporating feedback from community advocates and individuals with lived SUD experiences.

Main Results:

• Qualitative analysis of 122 student essays revealed seven major themes: race/racism, systemic barriers, bias/stigma, personal growth, language, advocacy, and poor outcomes.
• Students demonstrated the ability to connect curriculum material with prior knowledge and experiences.
• The educational intervention positively influenced students' attitudes toward advocacy and their future practice goals.

Conclusions:

• Aligning curriculum design with transformative learning principles enhanced medical students' critical consciousness toward individuals with SUD.
• The program cultivated a more holistic understanding of SUD among preclerkship medical students.
• This educational approach prepares future physicians to provide more compassionate and effective person-centered care for patients with SUD.