Enhancing the Management of Opioid Use Disorder in the Emergency Department: A Holistic Curricular Intervention

Introduction Amid the opioid crisis, emergency medicine (EM) physicians increasingly tackle opioid use disorder (OUD) in the emergency department. Although the "X waiver" is no more, OUD-specific education requirements persist for EM clinicians and trainees. Traditional EM education emphasizes pathophysiology but overlooks the role of stigma in OUD as well as the importance of a peer recovery support specialist (peer) and community referral partners. We aimed to create and deliver a holistic EM OUD curriculum to boost practical OUD-specific knowledge and address OUD perceptions. Methods A task force of EM clinician-educators with expertise in OUD developed a four-hour educational curriculum to implement during a single EM residency didactic day. The curriculum highlighted a panel of peers, a series of lectures detailing specific aspects of OUD management, and an OUD tabletop simulation that focused on stigma. Pre- and post-participant surveys were obtained. Surveys assessed participant content knowledge via self-assessment as well as attitudes regarding persons with OUD via the Medical Condition Regard Scale (MCRS). A descriptive analysis was performed. Results Participants included 21 EM residents at various levels of training and faculty members, with 23 participants completing the pre-survey and 21 completing the post-survey. Post-curriculum delivery, all self-assessed knowledge categories demonstrated improvement; as examples, post-intervention, 100% of respondents reported understanding of medications for OUD (buprenorphine) indications and comfort with prescribing, compared to 52.7% and 56.5% prior to the intervention, respectively. Pre-survey MCRS assessments were largely positive; however, post-curriculum MCRS responses trended toward additional improvements in reported participant attitudes toward persons with OUD. A majority (95.2%) of respondents felt the curriculum improved topic understanding, and 90.5% reported improved confidence in treating patients with OUD. The peer panel and lectures were rated the most meaningful, followed by the simulation.  Conclusion This OUD curricular intervention demonstrates the feasibility and perceived participant value of a holistic OUD curriculum. This curriculum improved participant OUD-specific knowledge and attitudes toward persons with OUD.