Promoting addiction medicine teaching through functional mentoring by co-training generalist chief residents with faculty mentors

ABSTRACT

Background: Generalist physicians should play a vital role in identifying and managing individuals with substance use but are inadequately trained to do so. Methods: This 5-year (2008–2012) controlled educational study assessed whether internal medicine and family medicine chief residents' (CRs) addiction medicine teaching increased by co-training with faculty mentors at a Chief Resident Immersion Training (CRIT) program in addiction medicine. All CRIT CR attendees identified a residency program faculty mentor to support addiction medicine teaching after CRIT through functional mentoring with a focus on developing and implementing an Addiction Medicine Teaching Project (“Teaching Project”). Approximately half of the CRs attended CRIT with their mentor (co-trained) and half without their mentor (solo-trained). Addiction medicine teaching outcomes were compared between groups using 6- and 11-month questionnaires and 4 bimonthly teaching logs. Of co-trained CRs, mentor characteristics that positively influenced addiction medicine teaching outcomes were identified. Results: One hundred CRs from 74 residency programs attended CRIT from 2008 to 2012; 47 co-trained with their mentors and 53 solo-trained without their mentors. At 6-month follow-up, the co-trained CRs were more likely to meet at least monthly with their mentor (22.7% vs. 9.6%, P < .01) and more likely to identify their mentor as a facilitator for Teaching Project implementation (82.2% vs. 38.5%, P < .01). At 11-month follow-up, a higher percentage of co-trained CRs had completed their Teaching Project (34.0% vs. 15.1%, P < .05). Both CR groups had similarly large increases in other addiction medicine teaching outcomes. Mentors with more experience, including years of teaching, was associated with better CR Teaching Project outcomes. Conclusions: Co-training generalist chief residents with a faculty mentor appeared to facilitate functional mentoring–driven Teaching Project implementation but did not further increase already high levels of other addiction medicine teaching. Faculty mentors with more years of teaching experience were more effective in facilitating Teaching Project implementation.

KEYWORDS:

• Addiction medicine
• mentoring
• program evaluation
• teaching

Acknowledgments

The authors thank Nella Mupier, MPH, Amy Sorensen-Alawad, MSPH, MA, and Danna E. Gobel, LCSW, for their administrative contributions to the CRIT program. Preliminary study results were presented at the 34th annual meeting of the Association for Medical Education and Research in Substance Abuse in Bethesda, Maryland, in November 2010.

Author contributions

All authors had significant contribution to the manuscript. Drs. Alford, Samet, and Jackson and Ms. Carney, Ms. Bridden, and Ms. Brett were involved in program development, implementation, and evaluation. Mr. Winter was responsible for data analysis and interpretation.

Additional information

Funding

Program support was provided by the National Institute on Drug Abuse (NIDA) R25 DA13582. NIDA had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.