# Implementing a Screening, Brief Intervention, and Referral to Treatment Curriculum for Medical Students on their Emergency Department Rotation

## TL;DR

This study developed and tested a curriculum to train medical students in SBIRT techniques during their emergency department rotation, showing improved attitudes and knowledge.

## Contribution

A novel SBIRT curriculum for medical students was developed and demonstrated significant improvements in attitudes and preparedness.

## Key findings

- Medical students showed significant improvements in attitudes and preparedness after the curriculum (p < .001).
- Knowledge scores improved significantly (p = .002) and OSCE performance increased over three encounters (p = .03).
- The curriculum effectively integrated SBIRT and motivational interviewing into medical education.

## Abstract

The screening, brief intervention, and referral to treatment (SBIRT) approach is an evidence-based tool that combines standardized screening for unhealthy or risky alcohol and drug use with principles of motivational interviewing to promote behavior change and connect patients with the appropriate treatment and recovery support services. There is an increased demand for health care students and providers to be trained in SBIRT. We developed a curriculum to improve medical students’ attitudes toward and proficiency in administering SBIRT.

The curriculum was deployed as part of the emergency department clerkship of an undergraduate medical education program at an urban, safety net academic medical center. The content and structure, developed with input from medicine, nursing, and social work educators, consists of a 1-hour didactic session, three rounds of formative OSCE encounters, and one SBIRT delivery in the emergency department. Students were evaluated on their attitudes, sense of preparedness, and practical understanding of SBIRT.

Fifty-six medical students participated in the curriculum. There were significant differences between students’ pre- and postcurriculum attitudes and preparedness scores (p < .001) and knowledge scores (p = .002), and in OSCE scores between the first and third standardized patient encounter (p = .03).

This curriculum significantly impacted medical students’ attitudes and knowledge regarding SBIRT and motivational interviewing techniques. Widespread implementation of similar curricula could equip future physicians with the skills to implement evidence-based substance use screening and intervention into their practice.