Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors
Abstract Background Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has...
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doaj-5a74ebfbdcc24759ae9be254b69ac9622020-11-24T22:06:52ZengBMCAddiction Science & Clinical Practice1940-06402017-09-0112111010.1186/s13722-017-0086-9Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptorsJ. Klimas0W. Small1K. Ahamad2W. Cullen3A. Mead4L. Rieb5E. Wood6R. McNeil7Department of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaSchool of Medicine, Coombe Healthcare Centre, University College DublinDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaDepartment of Medicine, B.C. Centre on Substance Use, St. Paul’s Hospital, University of British ColumbiaAbstract Background Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships. Methods We interviewed trainees and faculty from clinical and research training programmes in addiction medicine at St Paul’s Hospital in Vancouver, Canada (N = 26) about barriers and facilitators to implementation of physician training in addiction medicine. We included medical students, residents, fellows and supervising physicians from a variety of specialities. We analysed interview transcripts thematically by using NVivo software. Results We identified six domains relating to training implementation: (1) organisational, (2) structural, (3) teacher, (4) learner, (5) patient and (6) community related variables either hindered or fostered addiction medicine education, depending on context. Human resources, variety of rotations, peer support and mentoring fostered implementation of addiction training. Money, time and space limitations hindered implementation. Participant accounts underscored how faculty and staff facilitated the implementation of both the clinical and the research training. Conclusions Implementation of addiction medicine fellowships appears feasible, although a number of barriers exist. Research into factors within the local/practice environment that shape delivery of education to ensure consistent and quality education scale-up is a priority.http://link.springer.com/article/10.1186/s13722-017-0086-9AddictionSubstance-related disordersMedical educationQualitative research |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
J. Klimas W. Small K. Ahamad W. Cullen A. Mead L. Rieb E. Wood R. McNeil |
spellingShingle |
J. Klimas W. Small K. Ahamad W. Cullen A. Mead L. Rieb E. Wood R. McNeil Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors Addiction Science & Clinical Practice Addiction Substance-related disorders Medical education Qualitative research |
author_facet |
J. Klimas W. Small K. Ahamad W. Cullen A. Mead L. Rieb E. Wood R. McNeil |
author_sort |
J. Klimas |
title |
Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
title_short |
Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
title_full |
Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
title_fullStr |
Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
title_full_unstemmed |
Barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
title_sort |
barriers and facilitators to implementing addiction medicine fellowships: a qualitative study with fellows, medical students, residents and preceptors |
publisher |
BMC |
series |
Addiction Science & Clinical Practice |
issn |
1940-0640 |
publishDate |
2017-09-01 |
description |
Abstract Background Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships. Methods We interviewed trainees and faculty from clinical and research training programmes in addiction medicine at St Paul’s Hospital in Vancouver, Canada (N = 26) about barriers and facilitators to implementation of physician training in addiction medicine. We included medical students, residents, fellows and supervising physicians from a variety of specialities. We analysed interview transcripts thematically by using NVivo software. Results We identified six domains relating to training implementation: (1) organisational, (2) structural, (3) teacher, (4) learner, (5) patient and (6) community related variables either hindered or fostered addiction medicine education, depending on context. Human resources, variety of rotations, peer support and mentoring fostered implementation of addiction training. Money, time and space limitations hindered implementation. Participant accounts underscored how faculty and staff facilitated the implementation of both the clinical and the research training. Conclusions Implementation of addiction medicine fellowships appears feasible, although a number of barriers exist. Research into factors within the local/practice environment that shape delivery of education to ensure consistent and quality education scale-up is a priority. |
topic |
Addiction Substance-related disorders Medical education Qualitative research |
url |
http://link.springer.com/article/10.1186/s13722-017-0086-9 |
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