"We need all hands on deck": characterizing addiction medicine training in Canada-a mixed methods study of fellowship program directors.

IF 3.2 2区 医学 Q1 SUBSTANCE ABUSE
Clara Lu, Kathryn Chan, Leslie Martin, Nadia Fairbairn
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引用次数: 0

Abstract

Background: Addiction Medicine training in Canada has evolved substantially in the last few years with the establishment of accreditation standards and several new fellowship programs. The novelty of these formal training programs, created in response to complex and ever-expanding clinical needs in Addiction Medicine, creates unique educational circumstances that must be understood to support future growth. This study characterizes the current state of these postgraduate training programs in Canada through the perspectives of Program Directors (PDs).

Methods: This study is a mixed methods study of 12 PDs. In Phase 1, participants completed a quantitative survey analyzed through descriptive statistics. In Phase 2, participants underwent a qualitative semi-structured interview that was coded with a thematic analysis approach. Mixing occurred both during the interim analysis between phases and during the interpretation stage.

Results: 28 trainees enrolled in a fellowship program in 2021-22 across 10 programs, and 27 trainees enrolled in 2022-23 across 11 programs. In each year, there were significantly fewer available spots than applications (31% and 29%, respectively). PDs identified a funding "bottleneck" as the most difficult and important challenge facing programs, with trainees supported by diverse and unstable funding sources. Qualitative analysis highlighted the need for sustainable funding models, flexibility toward alternative training pathways (shorter durations of training and re-entry from practice), and establishment of a national community of practice to support the co-creation of a robust addictions medical education infrastructure.

Conclusion: For Addiction Medicine training to meet workforce demands, PDs stressed that funding was the challenge of prime importance. Future studies should examine the perspectives of Addiction Medicine fellows, the clinical and research impacts of fellowship graduates, and the cost-effectiveness of fellowship funding models.

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“我们需要所有人都在甲板上”:加拿大成瘾药物培训的特征——对奖学金项目主任的混合方法研究。
背景:在过去的几年里,随着认证标准的建立和一些新的奖学金项目的建立,加拿大的成瘾医学培训有了实质性的发展。这些正式培训项目的新颖性,是为了应对成瘾医学中复杂和不断扩大的临床需求而创建的,创造了独特的教育环境,必须理解以支持未来的发展。本研究通过项目主管(pd)的视角描述了加拿大这些研究生培训项目的现状。方法:本研究采用混合方法对12例pd患者进行研究。在第一阶段,参与者完成了一项通过描述性统计分析的定量调查。在第二阶段,参与者进行了定性的半结构化访谈,该访谈采用主题分析方法进行编码。混合发生在阶段之间的临时分析和解释阶段。结果:有28名学员在2021-22年度参加了10个项目的奖学金项目,有27名学员在2022-23年度参加了11个项目的奖学金项目。每年,可用名额都明显少于申请名额(分别为31%和29%)。pd认为资金“瓶颈”是项目面临的最困难和最重要的挑战,学员的资金来源多样且不稳定。定性分析强调需要可持续的供资模式,灵活地采用替代培训途径(缩短培训时间和从实践中重新进入),并建立一个国家实践社区,以支持共同创建一个强大的成瘾医学教育基础设施。结论:对于满足劳动力需求的成瘾医学培训,pd强调资金是最重要的挑战。未来的研究应该检查成瘾医学研究员的观点,奖学金毕业生的临床和研究影响,以及奖学金资助模式的成本效益。
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来源期刊
Addiction Science & Clinical Practice
Addiction Science & Clinical Practice Psychology-Clinical Psychology
CiteScore
3.90
自引率
10.80%
发文量
64
审稿时长
28 weeks
期刊介绍: Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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