An Interdisciplinary Simulation Approach to Overdose Prevention for Students Working with Children, Adolescents and Transition-Aged Youth

Background and Purpose: Opioid abuse and overdose are a national problem. According to the New York State Department of Health, there were 211 deaths related to heroin and synthetic opioids use in 2019 for 18 to 24 year olds. Additionally, in 2019, Emergency Medical Services administered naloxone to 1286 children and young adults between 0 to 24. NASW and CSWE have published guides for substance use in social work practice. Nonetheless, researchers have questioned whether social work students are adequately prepared to work with adolescents and young adults who have substance abuse disorders. Nurses and social workers often work together to address problems associated with substance abuse disorders. Nursing education has historically used simulations to supplement student learning. As our profession reflects on the next 30 years of social work science, we acknowledge a need for interdisciplinary collaboration to supplement student education and expand research addressing the intersection between adolescent mental health and substance use disorders.

Methods:The Interdisciplinary Education and Training Experience (IDEATE) is a Health Resources and Services Administration (HRSA) funded integrated behavioral health fellowship that trains master’s level social work and psychiatric nurse practitioner students to work with children, adolescents, and transition age youth at Adelphi University. As a part of this program, we developed a virtual simulation based on a Zero Overdose seminar. We utilized Kolb’s Experiential Learning and Isenberg's Curriculum Integration Framework as guiding theories in case formulation and simulation structure. The simulation case focused on a standardized patient who was an 18-year-old on the LGBTQ spectrum with a history of Major Depressive Disorder, marijuana, and fentanyl use. Students, faculty observers, and student actors were administered a 5-point Likert scale (1=strongly disagree to 5=strongly agree) to assess student ability to (1) recognize signs and symptoms of opioid use, (2) use standardized screening tools to assess for overdose, suicidality, and for safety planning (3) build rapport, educate the patient on overdose risks, (4) discuss harm reduction strategies with them and (5) work with their interdisciplinary partner.

Results: Twenty-four students completed the simulation and evaluation. Students reported high mean scores in all areas, 4.2 - 4.3. In contrast, faculty members reported high means in signs and symptoms (4.5), building rapport (4.4), safety planning (4.0), and education on overdose risk (4.2) and lower mean scores in student use of overdose screening tools (2.9) and interdisciplinary teamwork (3.3). Student actors reported the lowest mean scores in signs and symptoms (4.3) and building rapport with their partner (3.7).

Conclusions and Implications: Specialized professional training programs have the potential to improve student competence in treating children and young adults with substance use disorders. Our data shows the limitations of self-report and the need for triangulation to counter student bias. Additionally, it shows the importance of having different avenues for students to obtain feedback. Future research should include more experimental designed intervention studies to better understand pre and post outcomes of educational interventions and retention of knowledge gained from simulation.