Greater physician confidence in treating alcoholism is associated with a higher frequency of referring alcoholic patients for treatment, but many physicians have limited experience with Alcoholics Anonymous. We implemented a brief, didactic and experiential educational intervention about AA and evaluated its effect on knowledge and attitudes, using a before-after repeated measures study design. Thirty-six first-year internal medicine resident physicians received an educational intervention, which consisted of a 45-minute lecture about AA, a visit to an AA meeting, and a 30-minute debriefing session the next day. Residents’ knowledge and attitudes were assessed by a brief written anonymous survey before and after the educational intervention. Residents reported increases in self-perceived knowledge about AA and had more favorable attitudes towards AA after the intervention. Our pilot study shows that a brief, didactic and experiential course can improve physician knowledge and attitudes about AA, and holds promise for improving physician interface with this commonly used intervention.
MooreR D, BoneL R, GellerG, MamonJ A, StokesE J and LevineD M. 1989. Prevalence, detection, and treatment of alcoholism in hospitalized patients. JAMA, 261(3): 403–7.
Substance Abuse and Mental Health Services Administration. Results from the 2004 National Survey on Drug Use and Health: National FindingsRockville, MD(Office of Applied Studies, NSDUH Series H-28, DHHS Publication No. SMA 05–4062.)
4.
McGlynnE A, AschS M, AdamsJ, KeeseyJ, HicksJ, DeCristofaroA and KerrE A. 2003. The quality of health care delivered to adults in the United States. N Engl J Med, 348(26): 2635–45.
5.
MorgensternJ, LabouvieE, McCradyB S, KahlerC W and FreyR M. 1997. Affiliation with Alcoholics Anonymous after treatment: a study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol, 65(5): 768–77.
6.
WalshD C, HingsonR W, MerriganD M, LevensonS M, CupplesL A, HeerenT, CoffmanG A, BeckerC A, BarkerT AHamiltonS K. 1991. A randomized trial of treatment options for alcohol-abusing workers. N Engl J Med, 325(11): 775–82.
7.
LewisD C. 1996. The role of internal medicine in addiction medicine. J Addict Dis, 15(1): 1–17.
8.
FriedmannP D, McCulloughD, ChinM H and SaitzR. 2000. Screening and intervention for alcohol problems. A national survey of primary care physicians and psychiatrists. J Gen Intern Med, 15(2): 84–91.
9.
KanerE F, HeatherN, McAvoyB R, LockC A and GilvarryE. 1999. Intervention for excessive alcohol consumption in primary health care: attitudes and practices of English general practitioners. Alcohol Alcohol, 34(4): 559–66.
10.
RocheA M, ParleM D, StubbsJ M, HallW and SaundersJ B. 1995. Management and treatment efficacy of drug and alcohol problems: what do doctors believe?. Addiction, 90(10): 1357–66.
11.
RohmanM E, ClearyP D, WarburgM, DelbancoT L and AronsonM D. 1987. The response of primary care physicians to problem drinkers. Am J Drug Alcohol Abuse, 13(1–2): 199–209.
12.
SaitzR, FriedmannP D, SullivanL M, WinterM R, Lloyd-TravagliniC, MoskowitzM A and SametJ H. 2002. Professional satisfaction experienced when caring for substance-abusing patients: faculty and resident physician perspectives. J Gen Intern Med, 17(5): 373–6.
13.
GellerG, LevineD M, MamonJ A, MooreR D, BoneL R and StokesE J. 1989. Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism. JAMA, 261(21): 3115–20.
14.
D'OnofrioG, NadelE S, DegutisL C, SullivanL M, CasperK, BernsteinE and SametJ H. 2002. Improving emergency medicine residents’ approach to patients with alcohol problems: a controlled educational trial. Ann Emerg Med, 40(1): 50–62.
15.
HanlonM J. 1985. A review of the recent literature relating to the training of medical students in alcoholism. J Med Educ, 60(8): 618–26.
16.
KarnitschnigA. 1989. Alcoholics anonymous in medical school education. Fam Med, 21(2): 146–7.
17.
KinneyJ, BergenB J and PriceT R. 1982. A perspective on medical students’ perceptions of alcoholics and alcoholism. J Stud Alcohol, 43(5): 488–96.
18.
WalshR A. 1995. Medical education about alcohol: review of its role and effectiveness. Alcohol Alcohol, 30(6): 689–702.
19.
SaitzR, SullivanL M and SametJ H. 2000. Training community-based clinicians in screening and brief intervention for substance abuse problems: Translating evidence into practice. Subst Abus, 21(1): 21–31.
20.
ParishS J, RamaswamyM, SteinM R, KachurE K and ArnstenJ H. 2006. Teaching about substance abuse with objective structured clinical exams. J Gen Intern Med, 21: 453–59.
21.
WarburgM M, ClearyP D, RohmanM, BarnesH N, AronsonM and DelbancoT L. 1987. Residents’ attitudes, knowledge, and behavior regarding diagnosis and treatment of alcoholism. J Med Educ, 62(6): 497–503.
22.
KahanM, WilsonL, MidmerD, BorsoiD and MartinD. 2003. Randomized controlled trial on the effects of a skills-based workshop on medical students’ management of problem drinking and alcohol dependence. Subst Abus, 24(1): 5–16.
23.
OckeneJ K, WheelerE V, AdamsA, HurleyT G and HebertJ. 1997. Provider training for patient-centered alcohol counseling in a primary care setting. Arch Intern Med, 157(20): 2334–41.
24.
GoldfarbL M, GalanterM, McDowellD, LifshutzH and DermatisH. 1996. Medical student and patient attitudes toward religion and spirituality in the recovery process. Am J Drug Alcohol Abuse, 22(4): 549–61.
25.
FazzioL, GalanterM, DermatisH and LevounisP. 2003. Evaluation of medical student attitudes toward alcoholics anonymous. Subst Abus, 24(3): 175–85.
26.
ChibnallJ T and DuckroP N. 2000. Does exposure to issues of spirituality predict medical students’ attitudes toward spirituality in medicine?. Acad Med, 75(6): 661
27.
FriedmannP D, SaitzR and SametJ H. 1998. Management of adults recovering from alcohol or other drug problems: relapse prevention in primary care. JAMA, 279(15): 1227–31.
28.
ChappelJ N, VeachT L and KrugR S. 1985. The Substance Abuse Attitude Survey: An instrument for measuring attitudes. J Stud Alcohol, 46(1): 48–52.
29.
SAS Version 9.1, Cary, NC: SAS Institute.
30.
IsaacsonJ H, FlemingM, KrausM, KahnR and MundtM. 2000. A national survey of training in substance use disorders in residency programs. J Stud Alcohol, 61(6): 912–5.
