TY - JOUR
T1 - “He Bore it Like a Scarlet Letter”
T2 - Medical Student Reflections on Substance Use Disorders
AU - Clark, Tara
AU - Camp, Mary E.
AU - Sadler, John Z.
N1 - Publisher Copyright:
© 2020, Academic Psychiatry.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objective: Substance abuse in the context of the opioid crisis presents a major public health concern. Despite some evidence that medical students’ attitudes towards substance use disorders worsen during medical school, very few studies have examined how students’ early clinical experiences with substance use disorders shape their views of this clinical population. This study uses student reflective essays to explore these formative educational experiences. Methods: Using content analysis, the authors analyzed a collection of 802 medical student reflective essays written during core clerkships (excluding Psychiatry), coding for ethical and professional themes as well as descriptions of substance use disorders. In addition to the qualitative identification of themes, the authors used chi-square analysis to determine which themes had statistically significant associations with substance use disorders. Results: Fifty-three essays described patients with substance use disorders. The most common substances described were opioids (n = 25), alcohol (n = 18), and cocaine (n = 11). There were five themes statistically associated with substance use disorders (p < 0.05): (1) adequate treatment, (2) pain, (3) difficult patient, (4) jumping to conclusions, and (5) malingering. Conclusions: In the sample, students found the treatment of pain to be a significant ethical challenge related to substance use disorders. In considering a comprehensive educational plan, medical educators may need to consider educational venues outside of the Psychiatry clerkship to address substance use disorders.
AB - Objective: Substance abuse in the context of the opioid crisis presents a major public health concern. Despite some evidence that medical students’ attitudes towards substance use disorders worsen during medical school, very few studies have examined how students’ early clinical experiences with substance use disorders shape their views of this clinical population. This study uses student reflective essays to explore these formative educational experiences. Methods: Using content analysis, the authors analyzed a collection of 802 medical student reflective essays written during core clerkships (excluding Psychiatry), coding for ethical and professional themes as well as descriptions of substance use disorders. In addition to the qualitative identification of themes, the authors used chi-square analysis to determine which themes had statistically significant associations with substance use disorders. Results: Fifty-three essays described patients with substance use disorders. The most common substances described were opioids (n = 25), alcohol (n = 18), and cocaine (n = 11). There were five themes statistically associated with substance use disorders (p < 0.05): (1) adequate treatment, (2) pain, (3) difficult patient, (4) jumping to conclusions, and (5) malingering. Conclusions: In the sample, students found the treatment of pain to be a significant ethical challenge related to substance use disorders. In considering a comprehensive educational plan, medical educators may need to consider educational venues outside of the Psychiatry clerkship to address substance use disorders.
KW - Medical student education
KW - Opioid epidemic
KW - Stigma
KW - Substance use disorders
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U2 - 10.1007/s40596-020-01194-0
DO - 10.1007/s40596-020-01194-0
M3 - Article
C2 - 32048175
AN - SCOPUS:85079490077
SN - 1042-9670
VL - 44
SP - 122
EP - 128
JO - Academic Psychiatry
JF - Academic Psychiatry
IS - 2
ER -