Abstract
OBJECTIVE: To investigate a brief teaching intervention using standardized patients (SPs) trained to improve residents’ detection and advising of problem drinkers.
DESIGN: Pretest-posttest design assessing resident behavior and skills.
SUBJECTS: Nineteen internal medicine residents in a University Hospital General Internal Medicine Clinic.
INTERVENTION: Announced SPs were interviewed by residents and presented to faculty who provided brief instruction on the National Institute on Alcohol Abuse and Alcoholism guidelines for screening and brief counseling of problem drinkers.
MEASURE: Unannounced SPs assessed resident behavior and skills.
RESULTS: Following the teaching intervention, 2 times more residents screened for alcohol use and nearly 3 times more residents did brief counseling. Residents reported that the intervention was informative and valuable.
CONCLUSION: A single, 1-hour teaching intervention lead to a 2- to 3-fold increase in resident detection and advising of problem drinkers. SPs provide effective teaching encounters and a useful measure of resident behavior.
Similar content being viewed by others
References
Sobell MB, Sobell LC. Problem Drinkers: Guided Self-Change Treatment. New York: The Guildford Press; 1993.
Sanchez-Craig M, Lei H. Disadvantages to imposing the goal of abstinence on problem drinkers: an empirical study. Br J Addict. 1986;81:505–12.
Fiore MC, Fleming MF, Burns ME. Tobacco and alcohol abuse: clinical opportunities for effective intervention. Proc Assoc Am Physicians. 1999;111:131–40.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Cleary PD, Miller M, Bush BT, Warburg MM, Delbanco TL, Aronson MD. Prevalence and recognition of alcohol abuse in a primary care population. Am J Med. 1988;85:466–71.
Coulehan JL, Zeffler-Segal M, Block M, McClelland M, Schulberg HC. Recognition of alcoholism and substance abuse in primary care patients. Arch Intern Med. 1987;147:349–52.
Buchsbaum DG, Buchanan RG, Lawton MJ, Schnoll SH. Alcohol consumption patterns in a primary care population. Alcohol Alcohol. 1991;26:215–20.
Buchsbaum DG, Buchanan RG, Poses RM, Schnoll SH, Lawton MJ. Physician detection of drinking problems in patients attending a general medicine practice. J Gen Intern Med. 1992;7:517–21.
Schmidt A, Barry KL, Fleming MF. A new screening test for the detection of problem drinkers: the Alcohol Use Disorders Identification Test (AUDIT). South Med J. 1995;88:52–9.
Moore RD, Bone LR, Geller G, Mamon JA, Stokes EJ, Levine DM. Prevalence, detection, and treatment of alcoholism in hospitalized patients. JAMA. 1989;261:403–7.
Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: a review. Addiction. 1993;88:315–36.
Fleming MF, Manwell LB, Barry KL, Adams W, Stauffacher EA. Brief physician advice for alcohol problems in older adults: a randomized community-based trial. J Fam Pract. 1999;48:378–84.
Wilk AI, Jensen NM, Havighurst TC. Meta-analysis of randomized control trials addressing brief alcohol intervention in heavy alcohol drinkers. J Gen Intern Med. 1997;5:274–83.
Alcohol and Health. Eighth Special Report to the U.S. Congress. Screening and Brief Intervention. U.S. Department of Health and Human Services. Washington, DC: National Institute on Alcohol. Abuse and Alcoholism; 1993.
National Institute of Alcohol Abuse and Alcoholism. The Physicians’ Guide to Helping Patients with Alcohol Problems. Washington, DC: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism; 1995. NIH Publication 95-3769.
Stillman PL, Swanson DB, Smee S, et al. Assessing clinical skills of residents with standardized patients. Ann Intern Med. 1986;105:762–71.
Day RP, Hewson MG, Kindy P Jr, Van Kirk J. Evaluation of resident performance in an outpatient internal medicine clinic using standardized patients. J Gen Intern Med. 1993;8:193–8.
Stillman PL, Burpeau-Di MY, Nicholson GI, Sabers DL, Stillman AE. Six years of experience using patient instructors to teach interviewing skills. J Med Educ. 1983;58:941–6.
Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA. 1995;274:700–5.
Soumerai SB, Avorn J. Principles of educational outreach (academic detailing) to improve clinical decision making. JAMA. 1990;263:549–56.
Author information
Authors and Affiliations
Corresponding author
Additional information
This research was supported in part by a faculty development grant, D28PE55024, from the U.S. Public Health Service and the Health Resources and Services Administration.
Rights and permissions
About this article
Cite this article
Wilk, A.I., Jensen, N.M. Investigation of a brief teaching encounter using standardized patients. J GEN INTERN MED 17, 356–360 (2002). https://doi.org/10.1007/s11606-002-0039-0
Issue Date:
DOI: https://doi.org/10.1007/s11606-002-0039-0