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Shared Medical Appointment: A Novel Model for Incorporating Group Visits Into Residency Training for Substance Use

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  • 1Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.

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Summary

Shared medical appointments (SMAs) are a feasible training tool for residents treating substance use disorder (SUD). Four weeks of co-facilitating SMAs significantly increased resident confidence in SUD care and facilitation skills.

Keywords:
addictionmedical residency educationsubstance use

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Area of Science:

  • Medical Education
  • Addiction Medicine
  • Patient Care Models

Background:

  • Shared medical appointments (SMAs) offer a novel approach to treating patients with similar conditions concurrently.
  • While beneficial for substance use disorder (SUD) patients, the feasibility of implementing SMAs in teaching clinics remains under-researched.

Purpose of the Study:

  • To assess the feasibility and impact of implementing Shared Medical Appointments (SMAs) in a primary care residency program focused on addiction medicine.
  • To evaluate changes in resident confidence, knowledge, and attitudes regarding substance use disorder (SUD) care after participating in SMAs.

Main Methods:

  • Primary care residents completed a 4-week rotation in an ambulatory addiction clinic.
  • Residents co-facilitated four SMAs, with confidence, knowledge, and attitudes assessed via web-based surveys at baseline, week 4, and week 8.
  • Pre- and post-intervention survey scores were compared using paired t-tests.

Main Results:

  • Ten residents participated. Confidence in SUD knowledge (7.0-8.3, P=.003) and counseling (7.1-8.2, P=.023) significantly increased.
  • Confidence in facilitating an SMA also significantly rose (5.7-8.3, P=.007).
  • Understanding of behavioral therapies and attitudes toward SUD patients did not show statistically significant changes.

Conclusions:

  • Shared Medical Appointments (SMAs) are a feasible and effective training modality for primary care residents on addiction medicine rotations.
  • Co-facilitating SMAs over four weeks enhances resident confidence in managing patients with substance use disorder (SUD).
  • SMAs offer a valuable training opportunity to improve SUD care delivery and potentially alter resident-physician interactions with SUD patients.