Harm reduction in undergraduate and graduate medical education: a systematic scoping review
Abstract Background Substance use increasingly contributes to early morbidity and mortality, which necessitates greater preparation of the healthcare workforce to mitigate its harm. The purpose of this systematic scoping review is to: 1) review published curricula on harm reduction for substance use...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04931-9 |
| _version_ | 1797376895515361280 |
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| author | Kelsey R. Smith Nina K. Shah Abby L. Adamczyk Lara C. Weinstein Erin L. Kelly |
| author_facet | Kelsey R. Smith Nina K. Shah Abby L. Adamczyk Lara C. Weinstein Erin L. Kelly |
| author_sort | Kelsey R. Smith |
| collection | DOAJ |
| description | Abstract Background Substance use increasingly contributes to early morbidity and mortality, which necessitates greater preparation of the healthcare workforce to mitigate its harm. The purpose of this systematic scoping review is to: 1) review published curricula on harm reduction for substance use implemented by undergraduate (UME) and graduate medical education (GME) in the United States and Canada, 2) develop a framework to describe a comprehensive approach to harm reduction medical education, and 3) propose additional content topics for future consideration. Methods PubMed, Scopus, ERIC: Education Resources Information Center (Ovid), and MedEdPORTAL were searched. Studies included any English language curricula about harm reduction within UME or GME in the United States or Canada from 1993 until Nov 22, 2021. Two authors independently reviewed and screened records for data extraction. Data were analyzed on trainee population, curricula objectives, format, content, and evaluation. Results Twenty-three articles describing 19 distinct educational programs across the United States were included in the final sample, most of which created their own curricula (n = 17). Data on educational content were categorized by content and approach. Most programs (85%) focused on introductory substance use knowledge and skills without an understanding of harm reduction principles. Based on our synthesis of the educational content in these curricula, we iteratively developed a Harm Reduction Educational Spectrum (HRES) framework to describe curricula and identified 17 discrete content topics grouped into 6 themes based on their reliance on harm reduction principles. Conclusions Harm reduction is under-represented in published medical curricula. Because the drug supply market changes rapidly, the content of medical curricula may be quickly outmoded thus curricula that include foundational knowledge of harm reduction principles may be more enduring. Students should be grounded in harm reduction principles to develop the advanced skills necessary to reduce the physical harm associated with drugs while still simultaneously recognizing the possibility of patients’ ongoing substance use. We present the Harm Reduction Educational Spectrum as a new framework to guide future healthcare workforce development and to ultimately provide the highest-quality care for patients who use drugs. |
| first_indexed | 2024-03-08T19:45:11Z |
| format | Article |
| id | doaj.art-25fbfd19c3354117805929edadfdd147 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-08T19:45:11Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-25fbfd19c3354117805929edadfdd1472023-12-24T12:22:10ZengBMCBMC Medical Education1472-69202023-12-0123112210.1186/s12909-023-04931-9Harm reduction in undergraduate and graduate medical education: a systematic scoping reviewKelsey R. Smith0Nina K. Shah1Abby L. Adamczyk2Lara C. Weinstein3Erin L. Kelly4University of California San Diego School of MedicineSidney Kimmel Medical College, Thomas Jefferson UniversityScott Memorial Library, Thomas Jefferson UniversityDepartment of Family and Community Medicine, Thomas Jefferson UniversityDepartment of Family and Community Medicine, Thomas Jefferson UniversityAbstract Background Substance use increasingly contributes to early morbidity and mortality, which necessitates greater preparation of the healthcare workforce to mitigate its harm. The purpose of this systematic scoping review is to: 1) review published curricula on harm reduction for substance use implemented by undergraduate (UME) and graduate medical education (GME) in the United States and Canada, 2) develop a framework to describe a comprehensive approach to harm reduction medical education, and 3) propose additional content topics for future consideration. Methods PubMed, Scopus, ERIC: Education Resources Information Center (Ovid), and MedEdPORTAL were searched. Studies included any English language curricula about harm reduction within UME or GME in the United States or Canada from 1993 until Nov 22, 2021. Two authors independently reviewed and screened records for data extraction. Data were analyzed on trainee population, curricula objectives, format, content, and evaluation. Results Twenty-three articles describing 19 distinct educational programs across the United States were included in the final sample, most of which created their own curricula (n = 17). Data on educational content were categorized by content and approach. Most programs (85%) focused on introductory substance use knowledge and skills without an understanding of harm reduction principles. Based on our synthesis of the educational content in these curricula, we iteratively developed a Harm Reduction Educational Spectrum (HRES) framework to describe curricula and identified 17 discrete content topics grouped into 6 themes based on their reliance on harm reduction principles. Conclusions Harm reduction is under-represented in published medical curricula. Because the drug supply market changes rapidly, the content of medical curricula may be quickly outmoded thus curricula that include foundational knowledge of harm reduction principles may be more enduring. Students should be grounded in harm reduction principles to develop the advanced skills necessary to reduce the physical harm associated with drugs while still simultaneously recognizing the possibility of patients’ ongoing substance use. We present the Harm Reduction Educational Spectrum as a new framework to guide future healthcare workforce development and to ultimately provide the highest-quality care for patients who use drugs.https://doi.org/10.1186/s12909-023-04931-9Harm reductionSubstance useOpioid use disorderUndergraduate medical educationGraduate medical education |
| spellingShingle | Kelsey R. Smith Nina K. Shah Abby L. Adamczyk Lara C. Weinstein Erin L. Kelly Harm reduction in undergraduate and graduate medical education: a systematic scoping review BMC Medical Education Harm reduction Substance use Opioid use disorder Undergraduate medical education Graduate medical education |
| title | Harm reduction in undergraduate and graduate medical education: a systematic scoping review |
| title_full | Harm reduction in undergraduate and graduate medical education: a systematic scoping review |
| title_fullStr | Harm reduction in undergraduate and graduate medical education: a systematic scoping review |
| title_full_unstemmed | Harm reduction in undergraduate and graduate medical education: a systematic scoping review |
| title_short | Harm reduction in undergraduate and graduate medical education: a systematic scoping review |
| title_sort | harm reduction in undergraduate and graduate medical education a systematic scoping review |
| topic | Harm reduction Substance use Opioid use disorder Undergraduate medical education Graduate medical education |
| url | https://doi.org/10.1186/s12909-023-04931-9 |
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