**Albany Medical College**

**Program Description**

The Albany Medical Residency SBIRT Program is training the majority of residents at AMC in SBIRT. Training includes an online interactive module with information on addiction, efficacy and applicability of SBIRT, and specific instruction in the theory and implementation of screening and brief intervention techniques based on motivational interviewing. The module also includes standards and tools for evaluation of practitioner performance of SBIRT, pre- and post-tests, an attitude survey, and overall program evaluation tools for feedback on the entire training process. In addition, important links and resources will be available in the module as well as on a website under construction.

Following completion of the module, residents receive interactive demonstrations of SBIRT with a variety of patients and then proceed to role-plays and standardized patients. To promote integration of SBIRT into practice, on-site mentoring and monitoring for integration into practice will be developed utilizing the SBIRT team and identified “SBIRT Champions” in medical specialties with high applicability. Recertification is planned at one year to evaluate competence, skill and extent of usage as well as retention; and this provides an opportunity for knowledge and skill booster sessions. Demonstrations, role plays and standardized patients will be relevant to specific specialties. Populations served will include patients at medical, surgical, psychiatric, emergency, pediatric and other sites at Albany Medical Center seen by residents. It is expected that 447 resident physicians will be trained over the five years of the training program.  Secondary targets for training include attending physicians, psychologists, psychology interns and allied health professionals in positions to facilitate dissemination and utilization of SBIRT and resident adherence to the program.

**Program Model**

The intended program model incorporates didactic, interactive, experiential practice on live models, mentoring during implementation, and intranet-based availability of information for patients and physicians on addiction and its consequences and methods to reduce risky substance use, including prescription medication misuse. Albany Medical Center’s unique online interactive module allows for training and recertification anywhere residents or other students have computer access. Specialty-specific demonstrations, role plays and standardized patients allow focused, relevant teaching of evidence-based, successful strategies and skills for dealing with a variety of situations, from routine to complex. Residents will have laminated pocket cards containing information on motivational interviewing and brief intervention guidelines, medical illnesses and other consequences associated with the use of specific substances, safe limits on alcohol use, confidence and readiness rulers, and information on agencies for referrals in the counties served by Albany Medical Center.

**Service Features**

Groups targeted for attention comprise medical (including primary and family care settings), surgical, psychiatric, emergency, obstetric and adolescent patients, patients with co-occurring disorders, and patients with chronic pain. We also plan to develop didactic tools and interventions for colleagues with at-risk substance use. The project intends to expand training opportunities beyond the original scope to include other health professionals at Albany Medical Center and surrounding hospitals and health organizations; the training/online module will also be modified for use by the New York State Office of Alcohol and Substance Abuse Services (OASAS) for state-wide implementation at emergency departments and trauma centers. The structure of the module and training program will allow for eventual future integration into medical student education. Collaborations with non-program organizations (local, governmental etc.) include OASAS, the NYS Office of Mental Health, the Capital District Psychiatric Center, the Albany Veterans Administration Medical Center, TIP 42 trainings for Co-Occurring Disorder Conferences, and the Albany County Department of Mental Health. 

**Program Evaluation**

Program evaluation will encompass pre- and post-test scores, physician attitudes toward substance abuse, physician competence in performance of SBIRT using a specific evaluation tool developed for this purpose, incorporation of SBIRT into practice, and referral for patients with high risk use. Resident evaluation of the entire program utilizing the GPRA and a feedback survey on the module will assess training efficacy and suggest methods for improvement. Departmental residency program directors and other faculty will also be surveyed as to the efficacy of training and extent of utilization. The one-year recertification provides an informational and skill “booster” session as well as an assessment of knowledge, competence, and extent of usage and efficacy with patients.****

**Contact Info**

Department of PsychiatryAlbany Medical College47 New Scotland Ave, MC-164Albany, NY 12208Program DirectorVictoria BalkoskiPhone: (518) 262-6121Fax: (518) 262-6111Email: balkosv@mail.amc.edu

Program CoordinatorSandy FitchPhone: (518) 262-2466Fax: (518) 262-6111Email: SBIRT@mail.amc.edu