The Opioid Awareness and Support Team: an innovative example of medical education and community partnership.

The Opioid Awareness and Support Team (OAST) at the Memorial University Faculty of Medicine is a novel student-led initiative designed to supplement medical student learning related to opioid use disorder and the opioids crisis. OAST has focused on grounding educational initiatives related to opioid use disorder in the local community context, working with community partners, and bringing in individuals with lived experience. We present initial findings from an Opioid Education Day that suggest student-led supplemental education for medical students can improve student knowledge surrounding opioid use.

Introduction

A lack of emphasis in medical education towards opioid-related issues has been highlighted as a contributing factor to the opioids crisis.[1],[2] Due to complexities surrounding opioid use disorder (OUD), a multifaceted approach to learning may provide a deeper understanding of OUD.[3]

Background on OAST

The Opioids Awareness and Support Team (OAST) was created in 2017 by a group of medical students at Memorial University. OAST aimed to be one of the first student-led opioids education groups in Canada, collaborating with expert faculty and community groups to provide unique learning opportunities that included experiences in the community, and both receiving and providing education inside and outside the classroom. Newfoundland and Labrador has among the highest volume of prescription opioids per capita in Canada.[4] OAST initiatives have included 1) a session delivered by a harm reduction organization to students about harm reduction and naloxone administration; 2) opioid awareness workshops delivered by OAST to frontline staff at an organization for marginalized youth; and 3) a discussion of opioid-related issues between students and incarcerated individuals at a local penitentiary. All initiatives were organized independently by student volunteers and were overseen by faculty members.

OAST Opioid Education Day

OAST supplemented the formal curriculum by providing an Opioid Education Day (OED). This day-long seminar was open to any medical student, which included presentations and workshops by expert faculty and community partners. This seminar was run by student volunteers, with administrative support and space provided by the medical school.

To identify learning needs among students, OAST sent a voluntary survey to all students to ascertain what students believed would be most beneficial to their future practice. Based on the results, the OED schedule was created and expert faculty/community partners were invited to present as volunteers. Sessions included: 1) a panel on the opioids crisis in Newfoundland and Labrador; 2) a lecture on screening/diagnosis/treatment of OUD; 3) the role of equity, trauma, and a right-based perspective surrounding opioid use; 4) a discussion with a community member living with OUD; 5) motivational interviewing; and 6) emergency care and opioid overdose.

Evaluation

Following the event, participants were sent a voluntary questionnaire to evaluate whether self-identified learning needs were met and to provide feedback on the OED. The Health Research Ethics Board of the Health Research Ethics Authority determined this evaluation to be exempt from review according to the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2) 2018 definition of research.

Outcomes

Sixty first and second year medical students (out of a total 160 pre-clerkship students, ~38%) attended. Half (32/60, 53%) provided feedback (Table 1). Participants’ written comments suggested students appreciated the local relevance, focus on harm reduction and treatment in practice, value of lived experience, and value of opioid-specific education.

Table 1

Feedback from sessions during the OAST Opioid Education Day in addressing medical student learning needs.

Session Topic	Students reporting self-identified learning needs were met n/N (%)
Province-specific issues relating to OUD and the opioids crisis	30/32 (93.8%)
Screening, diagnosis and treatment of OUD	21/32 (65.6%)
Equity, trauma informed care and a rights-based perspective towards OUD	17/30 (56.6%)
Listening to an individual with lived experience speak about living with OUD	30/30 (100%)
Motivational Interviewing for OUD	7/30 (23.3%)
Emergency response to opioid overdose	22/30 (73.3%)

Reponses were provided on a 7-point Likert scale from (1 to 7) asking how much the session addressed self-identified learning needs pertaining to OUD. We defined a student self-reporting meeting a substantial learning need with a response of 6 or 7. OAST – Opioid Awareness and Support Team, OUD – Opioid Use Disorder

Next steps

OAST aims to continue to provide education on opioids to fellow students, including expansion of local initiatives and the creation of future OEDs. Other institutions should consider facilitating the creation of similar groups by partnering students with faculty and community partners to increase student knowledge surrounding opioids.