A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes.

Purpose: Screening and brief intervention (SBI) is a seldom-used evidence-based practice for reducing unhealthy alcohol use among primary care patients. This project assessed the effectiveness of a regional consortium's training efforts in increasing alcohol SBI.

Method: Investigators combined alcohol SBI residency training efforts with clinic SBI implementation processes and used chart reviews to assess impact on SBI rates in four residency clinics.

Primary care residents lack comfort and experience with alcohol screening and brief intervention: a multi-site survey.

Background: Approximately one in six adults in the United States (U.S.) binge drinks.

Reinventing the reel: an innovative approach to resident skill-building in motivational interviewing for brief intervention.

To enhance the skills of primary care residents in addressing substance misuse, residency screening, brief intervention, and referral to treatment (SBIRT) programs increasingly offer motivational interviewing (MI) training, but seldom include feedback and coaching. This innovative 2-round "Virginia Reel" approach, supplementing 3 hours of basic MI instruction, was designed to teach and coach residents to use MI while providing ongoing medical care. SBIRT/MI-competent facilitators served as both trainers and actors at 8 carefully sequenced Objective Structured Clinical Examination (OSCE) stations, providing instruction, role-play practice, and feedback on 17 microskills in 2 successive clinical "visits"/rounds addressing alcohol misuse and diabetes management.

Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum.

Background: This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008), presents a model curriculum for Family Medicine residency training in substance abuse.

Methods: The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME) and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME.