Virginia Research Day 2021

PROVIDING NALOXONE TRAINING TO FIRST-YEAR MEDICAL STUDENTS: A WORK IN PROGRESS Hannah B. DePoy, OMS-III; Ami P. Shah, MPH, OMS-II; Hunter C. Funk, OMS-II; Katlyn M. Logsdon, OMS-II; Jessica M. Higgins, OMS-II; Theresa J. McCann, PhD, MPH Edward Via College of Osteopathic Medicine – Virginia Campus

RESULTS

RESULTS

BACKGROUND

Though previously down-trending, opioid overdose deaths are on the rise in the wake of the COVID-19 pandemic, evidence that the opioid crisis is far from over in the United States. Naloxone is the only reversal agent for opioid overdose, and as such, this training is an important adjunct to medical education. Furthermore, stigma reduction surrounding Opioid Use Disorder (OUD) is paramount in training holistically-minded future physicians poised to care for those affected by the opioid crisis. We hypothesize that one-hour long naloxone training will increase students’ self -perceived ability to intervene in an overdose situation while also decreasing stigma towards individuals with OUD. A long-term objective of this project is to advocate for the inclusion of naloxone training in medical education, specifically the addition of REVIVE! naloxone training in Virginia medical curricula. HYPOTHESIS AND PURPOSE ▪ Target population: All first-year (OMSI) medical students attending VCOM-VA. ▪ Students who voluntarily participated in REVIVE! naloxone training were invited to respond to anonymous pre- and post- training surveys. ▪ Pre- and post-surveys were anonymous and identical in content. ▪ Demographic characteristics of participants were collected by categorical responses. ▪ Surveys utilized previously validated questions from the Opioid Overdose Attitudes Scale (OOAS) 1 and Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) 2 in order to address four domains: Competence, Concerns, Readiness, and Stigma. ▪ Likert Scale questions were used to elicit the extent of agreement or disagreement with each statement. ▪ Qualtrics was used to collect anonymous data which was then exported to Excel. ▪ Preliminary data was analyzed using numbers and percentages. ▪ Percent change in participant agreement vs disagreement to statements was used to evaluate the effects of training. MATERIALS AND METHODS

As this project is ongoing, current analysis consisted of data collected prior to 1/17/2021. Prior to this date, 139 students participated in naloxone training. As seen in Figure 1, most respondents were age 18-24, female, and had no previous naloxone training experience. Tables 1 and 2 reflect analysis of student responses to two statements extracted from the pre- and post-training surveys. Statement 1 : I will need more training before I would feel confident to help someone who had overdosed. Statement 2 : I struggle to feel compassion for a person with opioid use disorder. As shown in Table 1, the percentage of students who indicated that they would need additional training in order to feel confident in an overdose situation dropped 74.9% from the pre- to post-training responses, while the percentage of students who felt they would NOT need additional training prior to helping in an overdose situation increased by 994.3%. Table 2 shows that the percentage of students who indicated that they struggle to feel compassion for those with opioid disorder decreased by 26.9% after participating in naloxone training. Additionally, students indicating that they do NOT struggle to feel compassion towards those with OUD increased by 5.1%.

Table 1. Percentage of responses to Statement 1. Percent change to analyze the difference in response rate from the pre- training survey to the post-training survey for each category are shown. A total of 101 pre-training and 77 post-training survey responses were counted in this data set.

Statement Response

Pre-Training Total (%)

Post-Training Total (%)

Percent Change* (%)

Unsure, Agree, Completely Agree

93.1

23.4

-74.9

Disagree, Completely Disagree 7.0

76.6

+994.3

Table 2. Percentage of responses to Statement 2. Percent change to analyze the difference in response rate from the pre- training survey to the post-training survey for each category are shown. A total of 100 pre-training and 77 post-training survey responses were counted in this data set.

Statement Response

Pre-Training Total (%)

Post-Training Total (%)

Percent Change* (%)

Unsure, Agree, Completely Agree

16.0

11.7

-26.9

Disagree, Completely Disagree 84.0

88.3

+5.1

* Percent change calculation: [((post-training%)-(pre-training%))/(pre-training%)] * 100

CONCLUSIONS

The researchers would like to acknowledge the Virginia Department of Behavioral Health & Developmental Services for the use of their REVIVE! naloxone training curriculum and materials. They would also like to thank Dr. Edward Magalhaes for his student support resources, as well as the VCOM Research Department for their support of the project. Thank you to the original authors of the peer-reviewed surveys utilized. Preliminary results suggest a large positive shift in the “competence” domain and a modest positive change in the “stigma” domain, pending full analysis. These initial findings support our hypothesis that naloxone training increases self- perceived ability to intervene in an overdose situation and reduces stigma held towards persons with OUD. Further analysis of our data will allow us to more fully illustrate the effect of naloxone training on the competence and compassion of our first-year medical students. ACKNOWLEDGEMENTS

REFERENCES

1. Williams AV, Strang J & Marsden J (2013). Development of Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales for take-home naloxone training evaluation. Drug Alcohol Dependence.132(1-2):383-6. 2. Haley DF, Saitz R. The Opioid Epidemic During the COVID-19 Pandemic. JAMA. 2020;324(16):1615 – 1617. doi:10.1001/jama.2020.18543

Figure 1. Demographics of pre- and post-training survey respondents. Reflects data collected prior to 1/17/2021 and includes 189 total survey submissions.

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