Purpose: To examine the immediate and delayed impact of an intensive one- or two-day interclerkship on substance abuse (SA) for third-year medical students. The program is a response to the problem of inadequacy of substance abuse education in the standard curriculum.
Method: Each year since 1997–98 all third-year students at the University of Massachusetts Medical School have participated in a one- or two-day SA interclerkship to enhance their knowledge and competence with SA assessment and brief intervention. Students' knowledge, attitudes, and confidence were assessed immediately before and after the interclerkship. In addition, during 1998–99, each student's clinical skills in SA assessment and intervention were evaluated at the completion of the student's six-week psychiatry clerkship using objective standardized clinical examinations (OSCEs) with two simulated patients, one with and one without active SA issues. Students who took the psychiatry clerkship in the first half of the year had not yet participated in the interclerkship. Students' pooled performances before and after the interclerkship were compared.
Results: Students' attitudes toward and knowledge about SA disorders and their confidence about SA assessment and intervention all showed significant positive changes immediately after the interclerkship. The OSCE performance data demonstrated a significant sustained improvement in clinical skills in SA assessment and intervention as measured up to six months following the interclerkship.
Conclusion: These data suggest that brief intensive training in SA during the clinical years of medical school can have a positive and lasting impact on students' clinical performances.
Dr. Matthews is associate professor of clinical psychiatry, associate director of psychiatric education and training, and psychiatry clerkship director; Dr. Kadish was formerly assistant professor of psychiatry; Ms. Barrett is in the division of research and evaluation; Dr. Mazor is assistant professor, Department of Medicine; Dr. Field is assistant professor of psychiatry and assistant director of the psychiatry clerkship; and Dr. Jonassen is associate professor of physiology and interclerkship director, all at University of Massachusetts Medical School, Worcester. Dr. Mazor is also senior research associate at Meyers Primary Care Institute.
Correspondence and requests for reprints should be addressed to Dr. Matthews, Office of Psychiatric Education and Training, Department of Psychiatry, UMass Medical School, 55 Lake Avenue North, Worcester, MA 01655; e-mail: 〈email@example.com〉.
The authors thank David Bellinger, PhD, MSc, and Jane Rogers, PhD, for their very helpful comments during the data analysis and preparation of the manuscript.