ABSTRACT #20

INFECTIOUS DISEASES FELLOWSHIP EDUCATION IN CARING FOR PEOPLE WHO USE DRUGS: A HEALTH SYSTEM-BASED NEEDS ASSESSMENT AND PILOT CURRICULUM

Shilpa Vasishta, Linda Wang, Giorgio Handman, David Perlman, Mikyung Lee

PURPOSE AND GOALS: The intersection of infections and substance use constitutes a high-priority area of practice development in the field of Infectious Diseases (ID). Given rising rates of injection-associated infections, and the unique role of ID physicians as direct clinical providers with potential to offer preventive health and harm reduction guidance, national professional societies have encouraged incorporation of integrated substance use care as a core competency in ID practice. Though some ID training programs have developed addiction medicine tracks or rotations for fellows with dedicated interest, implementation of general curriculum around substance use remains inconsistent. Here we present a needs assessment and pilot curriculum among Mount Sinai Health System (MSHS) adult ID fellowship programs.

METHODS: This project was developed using the Kern framework for curriculum development. Needs assessment was conducted through a survey of current fellows and past five years’ graduates of the MSHS adult ID programs.

Curriculum was developed based on survey findings in conjunction with interdisciplinary input from the MSHS ID and addiction medicine divisions. A didactic session was delivered in December 2022 covering approaches to care for individuals with infections and substance use, including non-stigmatizing language, risk mitigation strategies during substance use, and community harm reduction resources. A toolkit for use during clinical encounters was distributed through the MSHS Inpatient App and as an Epic smartphrase. Further programming in spring 2023 will address medications for substance use disorders and care coordination for complex infections.

EVALUATION PLAN: Please see below.

SUMMARY OF RESULTS: Among current and former MSHS adult ID fellows (n=32, response rate 65%), 94% reported caring for people who use drugs as part of their ID clinical practice. A majority of respondents reported typically screening for blood borne viral infections and immunizing against vaccine-preventable infections (78% each), while a minority reported counseling on safe injection strategies (44%), prescribing HIV pre-exposure prophylaxis (34%), referring to community harm reduction resources (28%), and prescribing naloxone (13%). Regarding fellowship training, 15% recalled receiving formal curriculum on this topic, while 78% reported that formal curriculum would have been beneficial.

REFLECTIVE CRITIQUE: Based on input from current and former fellows, we have implemented a pilot curriculum addressing infections and substance use in the MSHS adult ID fellowship programs. The curriculum consists of didactics from members of the MSHS ID and addiction programs, and asynchronous reference materials for common clinical scenarios. A post-curriculum survey will be distributed to collect qualitative and quantitative data regarding perceptions of the curriculum and impacts on clinical knowledge, comfort, and self-reported practices. Findings will inform future educational initiatives within the MSHS ID fellowships and partnering programs.