Medical education about alcohol: review of its role and effectiveness

Many reports have described inadequate responses by doctors to problems associated with alcohol misuse. Low levels of medical knowledge and inappropriate attitudes continue to be documented in the alcohol area. However, in recent years, greater emphasis has been placed on the need to improve doctors' skills in relation to alcohol problem detection and intervention. Experiential teaching approaches have been recommended and strategies which incorporate feedback methods offer considerable promise. In the United Kingdom and Canada, there has been no centrally funded approach to improve alcohol medical education. In contrast, federally funded initiatives in the United States of America and Australia have been associated with impressive increases in alcohol-related teaching hours and elective opportunities. Despite the substantial effort invested in achieving these curriculum gains, there is a dearth of research demonstrating impacts on medical behaviours or evaluating the cost-effectiveness of different educational strategies. Evidence from trials in smoking cessation training indicate that well-designed programmes can alter doctor behaviours in relation to substance abuse. If the alcohol medical education field is to progress, there is an urgent need for the development and evaluation of programmes which are better designed and are more informed by theory.