Can a Brief Clinical Practicum Influence Physicians' Communications With Patients About Alcohol and Drug Problems? Results of a Long-Term Follow-Up

Abstract

Background: A survey was conducted in 1996 to assess the perceptions of medical school graduates concerning alcohol and drug problems among their patients, and their attitudes and comfort toward addressing these issues. Survey questionnaires were sent to all individuals who graduated from Wright State University School of Medicine, Dayton, Ohio, between 1982 and 1990. Purpose: The study aimed to assess the long-term impact that participation in a brief clinical experience in tandem with a standard didactic substance abuse curriculum material had on former medical students now in practice. The study examined how these physicians perceived their skills in communicating with their patients about alcohol and drug use, and attendant problems. Methods: An Alcohol and Drug Use Communication (ADUC) scale was developed by combining several survey items. Data analyses included correlation assessments of the ADUC scale and other variables, and multiple-regression analyses for identifying factors independently associated with the ADUC scale although other factors were controlled. Results: Former students who participated in the brief clinical program, known as the Weekend Intervention Program, as part of their medical school curriculum were more likely to report having better communication concerning alcohol and drug use with their patients than students who only had didactic education. Also, additional training in addictions after graduation was significantly associated with better alcohol and drug use communication between physician and patient. Former students who participated in the Weekend Intervention Program were more than twice as likely as those without the experience to report confronting at least 10% of their patients about their concerns about the patients' alcohol or drug use. Conclusions: The results of this study suggest that undergraduate medical students' participation in a modest clinical program can enhance substance abuse education. Through increased training in substance abuse, physicians reported greater confidence in their ability to relate to patients with substance abuse problems.