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SBIRT at UNE Peer-to-Peer Presentation
The document outlines the collaborative interprofessional education (IPE) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiatives at the University of New England (UNE), aimed at enhancing training for health profession students. It details the integration of various health disciplines, educational programs, and community health efforts designed to address substance use disorders and improve patient care. The report also includes information about funding, faculty involvement, and objectives of ongoing training initiatives to prepare future healthcare professionals for collaborative practice in a complex healthcare environment.
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SBIRT at UNE Peer-to-Peer Presentation
- 1. Kris Hall MFA,IPEC/SBIRT Program Manager Brianna Nalley MPH, SBIRT Program Coordinator Collaborative SBIRT Training for Maine’s Future Health Profession Leaders
- 2. Today’s Agenda 1. IPEat UNE 2. SBIRT and the College of Osteopathic Medicine 3. SBIRT Student Leader Program 4. Questions/Comments
- 3. University of NewEngland Urban and Oceanside Campuses 13 Health Professions Majority of Maine’s Health Professionals 8000 students total, 4000 in health professions
- 4. Health Professions atUNE • Applied Exercise Science • Athletic Training • Dental Hygiene • Nursing • Nurse Anesthesia • Occupational Therapy • Physical Therapy • Physician Assistant • Social Work • Public Health • College of Dental Medicine • College of Osteopathic Medicine • College of Pharmacy Collaborative Health Team Patient FAMILY NATURAL SUPPORTS COMMUNITY
- 5. Interprofessional Education occurswhen two or more professions learn about, from & with each other to improve collaboration and the quality of care. IPE at UNE https://youtu.be/ZRdgoTSum7g
- 6. Interprofessional Competencies atUNE COMPtime: https://www.une.edu/wchp/ipec-2
- 7. IPEC Grants • Bingham- COMPtime • Arthur Vining Davis - COMPtime • Macy – Statewide Summit, Inaugural Showcase • Dallaire – Mini-grants • AHEC – Mini-grants • SBIRT – IP Activities • Institutional Support – Events, Staff
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- 10. IP STUDENT-LED MINI-GRANTS GOAL • Collaboration-readyhealth professionals METHODS • Modest funding through a comprehensive grantmaking process • Deliberately crafted Interprofessional Teams • Service learning, cultural curiosity and humility, and the use of arts encouraged • Student and faculty accountability • Requirement to present finished work
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- 12. IP Honors Distinction Purpose:To provide opportunities for students to receive academic recognition for participating in and demonstrating interprofessional knowledge and skills for practice. EMPLOYERS ARE LOOKING FOR THESE SKILLS! • IPE Student-led Mini-Grant • Interprofessional Team Immersion • Chronic Pain Support Group • IPE poster submission for research • and scholarship day or professional conference • IP Service Learning (Milestone) • Multicultural Diversity Leadership • Trans-disciplinary Playgroup • Interdisciplinary Geriatric Education Program (I-GEP) • Cumberland County Jail Project • Interprofessional Clinical Rotation or extended course experience • Engagement in IP Team Project (Pain Clinic) • International (Ghana) • SBIRT
- 13. Collaborative SBIRT Trainingfor Maine’s Future Health Profession Leaders 2016-2019
- 14. SBIRT GRANT ACTIVITIES •Curricular integration across 8 health professions (300-500 students per year) • Additional Training for Student Leaders (~63 per year) • Training for Faculty • Training for Clinical Faculty and Field Instructors/Preceptors • Clinical integration during rotations • Web-based resources (www.une.edu/SBIRT) • Sustainability
- 15. Faculty Champions from8 Programs (We’ve gained a program since the grant started) Champions advise the grant management team, integrate SBIRT into their curriculum, and recruit SBIRT Student Leaders. Program Faculty Champion Program Faculty Champion College of Dental Medicine Eileen Dunfey, RDH, MS. Elizabeth Franco, D.M.D. Dental Hygiene Beverley Litchfield RDH, DHSc College of Osteopathic Medicine Selma Holden, M.D., M.P.H, M.S. (IP Coordinator Jen Van Deusen, College of Pharmacy Devon Anne Sherwood, BSPharm, PharmD, BCPP Nursing Debra Kramlich, MSN, RN, CCRN, CNE Occupational Therapy Jan Froehlich, M.S., OTR/L Regi H. Robnett, Ph.D., OTR/L Physician Assistant Amy Patrick, P.A.-C. Social Work Craig Owens, MSW, LCSW Health, Wellness and Occupational Studies Bethany Fortier, M.P.H. STATEMENT OF INTENT: Substance use issues play a key role in the health of individuals and communities, and we believe that intervention can occur in even the briefest encounter with a sensitive, caring, and professional health care provider.
- 19. Josiah Macy Jr.Foundation Grant The University of New England received a four-year Josiah Macy Jr. Foundation grant in 2015. The objectives of the grant are to: 1. Integrate osteopathic medical students located on the UNE Biddeford campus into UNE's existing robust IPE programming 2. Develop and implement clinical IPE curricula in outpatient rural community health centers that care for the underserved 3. Integrate public health competencies into UNE's IPE curriculum 4. Evaluate and disseminate findings on UNE's statewide IPE model IPE and Osteopathic Medicine Class size: 175
- 20. Curriculum Related toPain, Substance Use Disorder, Opioid Management University of New England College of Osteopathic Medicine Osteopathic Medicine, Opioids and Chronic Pain In the early 1900s, the founder of osteopathic medicine, Andrew Taylor Still, MD, DO, found himself practicing in an opioid epidemic similar to the epidemic taking place today. After he returned from the Civil War, he discovered that many people had developed terrible habits through medications and drug use. More than a century later, the United States is in the midst of an opioid epidemic of plague-like proportions. From 1999 to 2010, opioid analgesic sales quadrupled.2 Correspondingly, from 1999 to 2012, opioid-related deaths more than tripled.2 In 2014 alone, nearly 29,000 people in the United States died of an opioid overdose (including heroin).3 According to a 2015 report,4 an estimated 33 million people use opioids worldwide. Fishbain et al5 estimated that abuse develops in nearly 5% of patients with chronic pain who are treated with prescription opioids, though this rate varies across studies. (Blumer, 2018) 1 “Chronic pain reduces quality of life and productivity, costing billions in health care dollars and lost revenue. Physicians routinely prescribe opioids, which has led to opioid addiction and overdose. The US surgeon general recommends non-pharmacologic treatment for patients with chronic pain. A paradigm shift is necessary for patients to partner with physicians to take control of their own health…Non opioid therapies are preferred for the management of chronic pain outside of active cancer, palliative, and end-of-life care. Cognitive behavioral therapy and physical strategies such as exercise and Osteopathic Manipulative Medicine (OMM) can be frontline strategies. The paradigm shift to a pain self-management model begins with listening to patients’ responses to inquiries about the effects pain has on mood function and quality of life. Physical examination is focused on somatic dysfunction, the biological pain generator and what, if necessary, can be done to help the patient with pain-related stress, anxiety, depression, fatigue, insomnia, and substance use. Pain self-management uniquely addresses the dynamic interaction of biopsychosocial elements within a trusted patient- physician relationship to promote health, clearly reflecting the true art and science of medicine. ” (Jerome, 2017) 2 1 Janice Blumer, DO. Addressing the Opioid Crisis Through the Teachings of A.T. Still The Journal of the AmericanOsteopathic Association, March 2018, Vol. 118- 139140.doi:10.7556/jaoa.2018.032 2 John A. Jerome, PhD. An Osteopathic Approach to Chronic Pain Management The Journal of the AmericanOsteopathic Association, May 2017, Vol. 117, 306 314. doi:10.7556/jaoa.2017.056 For More Information: Jane Carreiro, DO Vice President of Health Affairs and Dean jcarreiro@une.edu Cheryl Doane, MSEd, DO cdoane@une.edu Ryan Smith, DO rsmith8@une.edu Ling Cao, PhD lcao@une.edu Topics Prevention SUDs /OUD* Pain Treatment/ Recovery Osteopathic Medical Knowledge 1 Chronic Pain in Real Life X X WellCOM at UNE COM X Interprofessional Clinical Practice Conference with Physician Assistant and Osteopathic Medical Students X X X SBIRT 101 and Interprofessional Application X X X Health Professionals in Recovery X X Osteopathic Clinical Skills 1 Osteopathic Manipulative Medicine: Intro to Soft Tissues Approach Intro to Strain and Counterstrain Approach Introduction to Muscle Energy Approach Osteopathic Evaluation and Treatment of the Lower and Upper Extremities Intro to HVLA and Articulatory Approaches Osteopathic Evaluation & Treatment of the Head, Neck and Back X Osteopathic Medical Knowledge 2 Neuroscience: Complex Regional Pain Syndrome; Trigeminal Neuralgia; Acute Pain; Chronic Pain; Traumatic Peripheral Neuropathy; Acute and Chronic Pain / Headache: Approach to the Patient; Migrane Headache; Tension-Type Headache; Cluster Headaches X Introduction to Substance Use Disorders and Addicition X X* X X* Behavioral Approaches to Psychiatric and Other Disorders X X* X* Psychopharmacology Somatic Treatment X X Medical Marijuana Panel X X Impact of Adverse Childhood Experiences X SBIRT 202 and Interprofessional Application X X Medication-Assisted Treatment X* X* X* Interprofessional Clinical Practice Conference with Advanced Basic Science Nursing Students and Osteopathic Medical Students X X X Osteopathic Clinical Skills 2 Osteopathic Manipulative Medicine X X Older Adult Patient Visits / The 4 D's: Delirium, Depression, Dementia & Drugs X X Osteopathic Approach to Headache X Counseling (alcohol/ smoking) and education X X X Substance Use Disorders including intoxication and withdrawal presentations X X* X* Psychosocial Interventions X* X* Treatment Complications X* Disorders of Childhood and Adolesence X X X Principles of Pain Management X X The Identification of Suicidality and Homicidality X X PTSD and Trauma-Related Disorders X X Mercy InterProfessional Pain Clinic X X Addiction Medicine Club X* X* X* X* SBIRT Student Leaders X* X* X X* Milestone Recovery Preceptorship and Volunteer Opportunities X X X UNE COM Prevention, Substance Use Disorder, Pain and Treatment/ Recovery Learning Experiences Required Core Clerkship Curriculum Optional Learning Opportunities (Examples) Required Pre-Clinical Curriculum Jenifer Van Deusen, MEd jvandeusen2@une.edu Kathryn Brandt, DO, MMEL kbrandt@une.edu Toho Soma, MPH tsoma@une.edu https://www.une.edu/people/jenifer-van-deusen http://www.coperems.org/about-page/
- 21. Osteopathic Curricular Integration TopicsPrevention SUDs /OUD* Pain Treatment/ Recovery Osteopathic Medical Knowledge 1 Chronic Pain in Real Life X X WellCOM at UNE COM X Interprofessional Clinical Practice Conference with Physician Assistant and Osteopathic Medical Students X X X SBIRT 101 and Interprofessional Application X X X Health Professionals in Recovery X X Osteopathic Clinical Skills 1 Osteopathic Manipulative Medicine: Intro to Soft Tissues Approach Intro to Strain and Counterstrain Approach Introduction to Muscle Energy Approach Osteopathic Evaluation and Treatment of the Lower and Upper Extremities Intro to HVLA and Articulatory Approaches Osteopathic Evaluation & Treatment of the Head, Neck and Back X Osteopathic Medical Knowledge 2 Neuroscience: Complex Regional Pain Syndrome; Trigeminal Neuralgia; Acute Pain; UNE COM Prevention, Substance Use Disorder, Pain and Treatment/ Recovery Learning Experiences Required Pre-Clinical Curriculum Prevention SUDs/OUD Pain Treatment/Recovery
- 22. Health Professionals inRecovery X X Osteopathic Clinical Skills 1 Osteopathic Manipulative Medicine: Intro to Soft Tissues Approach Intro to Strain and Counterstrain Approach Introduction to Muscle Energy Approach Osteopathic Evaluation and Treatment of the Lower and Upper Extremities Intro to HVLA and Articulatory Approaches Osteopathic Evaluation & Treatment of the Head, Neck and Back X Osteopathic Medical Knowledge 2 Neuroscience: Complex Regional Pain Syndrome; Trigeminal Neuralgia; Acute Pain; Chronic Pain; Traumatic Peripheral Neuropathy; Acute and Chronic Pain / Headache: Approach to the Patient; Migrane Headache; Tension-Type Headache; Cluster Headaches X Introduction to Substance Use Disorders and Addicition X X* X X* Behavioral Approaches to Psychiatric and Other Disorders X X* X* Psychopharmacology Somatic Treatment X X Medical Marijuana Panel X X Impact of Adverse Childhood Experiences X SBIRT 202 and Interprofessional Application X X Medication-Assisted Treatment X* X* X* Interprofessional Clinical Practice Conference with Advanced Basic Science Nursing Students and Osteopathic Medical Students X X X Osteopathic Clinical Skills 2 Prevention SUDs/OUD Pain Tx/Recovery
- 23. SBIRT 202 andInterprofessional Application X X Medication-Assisted Treatment X* X* X* Interprofessional Clinical Practice Conference with Advanced Basic Science Nursing Students and Osteopathic Medical Students X X X Osteopathic Clinical Skills 2 Osteopathic Manipulative Medicine X X Older Adult Patient Visits / The 4 D's: Delirium, Depression, Dementia & Drugs X X Osteopathic Approach to Headache X Counseling (alcohol/ smoking) and education X X X Substance Use Disorders including intoxication and withdrawal presentations X X* X* Psychosocial Interventions X* X* Treatment Complications X* Disorders of Childhood and Adolesence X X X Principles of Pain Management X X The Identification of Suicidality and Homicidality X X PTSD and Trauma-Related Disorders X X Mercy InterProfessional Pain Clinic X X Addiction Medicine Club X* X* X* X* SBIRT Student Leaders X* X* X X* Milestone Recovery Preceptorship and Volunteer Opportunities X X X Required Core Clerkship Curriculum Optional Learning Opportunities (Examples) Prevention SUDs/OUD Pain Tx/Recovery
- 24. Faculty Trainers from4 Programs Trainers are responsible for the SBIRT Student Leader Program which includes: • Additional SBIRT material • Motivational Interviewing • Leadership Program Faculty Trainer College of Pharmacy Devon Anne Sherwood, BSPharm, PharmD, BCPP Occupational Therapy Regi H. Robnett, Ph.D., OTR/L Social Work ClayGraybeal,Ph.D.,M.S.W. (SBIRTGrantPI) Health, Wellness and Occupational Studies (Undergraduate) Bethany Fortier, M.P.H.
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- 28. University of NewEngland 716 Stevens Avenue 326/7 Hersey Hall, Portland Campus 207/221-4491 sbirt@une.edu Twitter: @UNESBIRT ipec@une.edu Keep in Touch! @UNEIPE or @IPE4all Interprofessional Education Collaborative
Editor's Notes
- #2 Thanks to JBS for asking us, who we are, year three, staff of two, plus graduate assistants
- #3 Brian’s suggested topic areas
- #4 Shelley Cohen Konrad, Ph.D., and Associate Professor in the School of Social Work has worked for 10 years at UNE to affect culture change among the health professions at UNE, paving the way for a wide variety of interprofessional innovation and impact. Kris Hall is the Program Manager for the University of New England Center of Excellence in Interprofessional Education. She oversees the weekly IPE event series on campus, and the Student-Led Mini-Grant program. Kris is an MFA graduate of Maine College of Art and the Skowhegan School of Painting and Sculpture. She brings over 20 years of intensive teamwork in higher education and professional theatre to her work at the Collaborative. University of New England is a private institution that was founded in 1831. It has a total enrollment of 8000 students, half of which are studying for a health professions career of some kind. University of New England's ranking in the 2018 edition of Best Colleges is Regional Universities North, 78. Its tuition and fees are $36,530 (2017-18).
- #5 Health Professions trained at UNE
- #6 IP Is
- #7 Competencies and culture
- #8 Brian’s suggested topic areas
- #9 IPE opportunities on campus
- #10 IPE opportunities on campus
- #11 KH Our students are beset on all sides with expectations for their future practice. Accreditation Standards. New ACA payment policies. As many as 210,000 people per year dying from medical error in the United States. Our challenge as interprofessional educators at UNE (where there are 13 health professions programs) is not to add to their burden, but rather inspire confidence in student’s ability to rely on each other to achieve excellent patient care, thereby making some of the other expectations easier to achieve. There are various ways to “do” interprofessional - and it is important to do it in a supervised setting before attempting it in the ”real” world, since our students are by and large much more IPE ready than their preceptors or rotation environments may be. In the educational setting, we can conduct case-based learning, simulated clinical environments, and interactive role playing. Some institutions have student led clinics, where IP is part of the infrastructure. Most formal clinical rotation requirements are not purposely interprofessional, and unless the experience is deliberately crafted to be so… With this program we seek to provide a bridge from the classroom to the clinic and create collaboration ready health professionals who have grant seeking experience, have crafted their own teams toward their own objectives, have incorporated service learning, cultural humility and the arts in their scope of practice, have been accountable to themselves, their patients/clients and us, and have presented their finished work at a conference, or conference-like forum. Relationship between gathering evidence and clinical practice – not just one or the other, but a continuum. Student-Led Mini-Grant program provides modest funding for IP research and scholarship. Our goal is to develop collaboration-ready health professionals who have practiced successful teamwork, leadership and hands-on problem solving as part of their education. These grants fund interprofessional scholarship and research conceived and carried out by students with faculty mentorship. Methods: The presenters will provide the application and marketing materials to enable other institutions to develop their own Student-Led Mini-Grant program. Successful grants are widely varied in their approach and outcomes, presenters will discuss the challenges and opportunities that a small investment in IPE interest generated. Grant recipients share their perspectives on IPE as a result of developing and leading their own research and scholarship efforts. Results: Knowledge gained from the projects completed so far has led students and faculty to consider varied approaches to IP education and practice. Whether interviewing pain patients with an eye toward utilizing the power of their stories to help others, or providing physical therapy intervention at a Medically Oriented Gym for diabetes patients, students, faculty and clients are actively learning about, from, and with each other. Implications: Small-scale, hands-on experiences such as these help to create an IP leadership ethic among students that they will carry with them in addition to expertise in their field, making them dynamic members of their future teams. The discipline and organization necessary to apply for and execute a grant, the reassurance of faculty mentorship while providing a valuable community service are a powerful educational combination.
- #12 Journal of Interprofessional Education & Practice Volume 6, March 2017, Pages 49-54 The interprofessional team immersion (IPTI) is a developmental, longitudinal, and sustainable curricular resource that was designed in response to student requests for small, interactive, cross-professional learning experiences. Learning objectives are aligned with behaviors as identified in the Core Competencies for Interprofessional Practice and aim to increase students' understanding of each other's roles and responsibilities, to apply teamwork principles, to refine communication skills for contextualized person-centered practice, and to utilize knowledge in the presentation of a collective project. Instructional formats include a team-building exercise, case-based learning, and simulation. Pre- and post-session evaluation measured students' attitudinal and behavioral changes. Rapid cycle program evaluation used student feedback to continuously improve the quality of the learning experience. Overall students found IPTI to increase their knowledge of other professions, build confidence in their team skills, and provide a basis for working collaboratively in their future workplace settings. Program evaluation feedback reinforced the efficacy of small group, interactive learning and full faculty engagement in IPE learning activities. Both a successful and sustainable shared learning activity, IPTI offers generalizable content, instructional approaches, and assessment strategies for other institutions seeking transformative team-based learning experiences.
- #13 Various activities and Honors Distinction – all of these are available to SBIRT Student Leaders
- #14 SBIRT Training Grant
- #15 Key Grant Activities, some not completed during the year with 34% budget cut, sustainability reinforced by curricular integration.
- #16 Cover the programs included, subsequently added, and statement of intent, as informed by IPE Culture
- #17 Dental Hygiene Clinic!
- #20 Macy Grant – Logistical Difficulties
- #21 Jenifer Van Deusen, Med, COPE http://www.coperems.org/about-page/ COPE educates healthcare providers on how to safely treat and manage the care of people with chronic pain in order to improve patients’ lives and end the prescription opioid epidemic.
- #22 Overview of integration of Prevention, SUD, Pain/Treatment, Recovery – Jen Van Deusen (Early Champion) a member of COPE, combining Pain and SUD, and using the harm reduction language of recovery, rather than Addiction/Treatment. Our approach – insert SBIRT in bite sized pieces – everyone does some kind of screening, Intervention, Referral – add it as you would for any chronic disease.
- #26 Students are accustomed to and looking for extracurricular because of IPEC, we know the best times to schedule, and the kind of programming that appeals to them. We always find a way to provide food.
- #29 IPEC and SBIRT contact info.