Addiction treatment goes online

In late December, faculty members from Yale School of Medicine launched a free online course about the fundamentals of managing substance use disorders. The course, called Addiction Treatment: Clinical Skills for Healthcare Providers, is a collaborative effort between multiple professional schools at Yale and the Poorvu Center for Teaching and Learning. Recorded lectures and supplemental course materials will be available to students, clinicians, and members of the public via the online platform Coursera.

Ellen Edens, MD, MPH, assistant professor of psychiatry and associate fellowship director for addiction psychiatry, was troubled by the dearth of addiction-related didactic opportunities available to students and health care professionals—especially as the opioid epidemic intensified across the United States. Hoping to fill this gap, Edens amassed a substantial collection of literature outlining the clinical skills necessary to treat patients with substance use disorder. Though she often distributed the booklet to students and colleagues from other institutions, Edens knew that a broader reach was necessary to equip the next generation of health professionals in responding to addiction.

“I’d go to conferences and it was clear that many schools just don’t incorporate addiction into their curriculum at all,” Edens says. “But there’s also an incredibly high demand for education and resources. I became interested in creating something that was widely available and accessible to people without prior expertise in substance use disorders.”

When she met Belinda Platt, a project manager for digital education initiatives at the Yale Poorvu Center for Teaching and Learning, the two saw an opportunity to collaborate. They developed a course proposal and teamed up with faculty members from several of Yale’s professional schools. “Given that a multidisciplinary approach is essential to understanding addiction in patients and populations, this course was especially well-suited to an interprofessional partnership,” Platt says.

Edens recruited colleagues from across the University, each of whom brought a unique perspective on addiction diagnosis and management. The team includes Robert Heimer, PhD, professor of epidemiology (microbial diseases) and of pharmacology at Yale School of Public Health; Shannon Drew, MD, an addiction psychiatrist; Robert Krause and Lindsay Powell, both lecturers at Yale School of Nursing; Elizabeth Roessler, MMSc, PA-C, assistant professor in the Physician Associate Program; and Jeanette Tetrault, MD, associate professor of medicine and director of the Addiction Medicine Fellowship.

Because there was no existing interdisciplinary foundational addiction course at Yale, the collaborators worked together to develop a new curriculum. They drew from relevant literature and their own experiences to identify the most basic, important, and actionable learning objectives for their audience: outlining substance use disorder screening, diagnosis, management, and identifying the barriers that limit patients’ ability to access or successfully adhere to treatment.

In September 2019, Edens received a grant from the Substance Abuse and Mental Health Services Administration, in partnership with the American Academy of Addiction Psychiatry and the American College of Academic Addiction Medicine, which funded a pilot initiative to implement the course at other institutions. So far, 37 partner institutions—composed of professional schools in medicine, nursing, social work, pharmacy, public health, and physician associate programs—have signed on to participate. In addition to the course videos and materials, they’ll have access to a discussion forum where they can connect with students at other institutions. The Yale team will rely on input from these students to measure the course’s success and make changes based on their feedback.

“In our pre- and post-course evaluations, we’re not just measuring clinical knowledge,” Platt says. “We’re also hoping to assess how confident students and clinicians feel initiating conversations about addiction with patients and connecting them with appropriate resources.”

Although the curriculum was designed for health professions students, Edens and Platt both noted that there are also salient takeaways for members of the public, especially related to stigma. “If all someone learns from the course is to use less stigmatizing language, replacing terms like ‘drug addict’ with ‘person with substance use disorder,’” Edens says, “then we see that as a success."