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Report of the Substance Misuse in the Undergraduate Medical Curriculum Project in England

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Title: Report of the Substance Misuse in the Undergraduate Medical Curriculum Project in England
Language: English
Authors: Notley, Caitlin, Goodair, Christine, Chaytor, Andrew, Carroll, Janine, Ghodse, Hamid, Kopelman, Peter
Source: Drugs: Education, Prevention & Policy. 2014 21(2):173-176.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 4
Publication Date: 2014
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Descriptors: Substance Abuse, Medical Education, Drug Addiction, Foreign Countries, Program Descriptions, Undergraduate Students, Medical Schools, Outcomes of Education, Professionalism, Social Bias, Student Attitudes, Self Efficacy, Patients, Drug Rehabilitation, Therapy, Curriculum Development, Knowledge Level, Instructional Materials, Help Seeking, Referral, Medical Evaluation, Physician Patient Relationship
Geographic Terms: United Kingdom
DOI: 10.3109/09687637.2013.792788
ISSN: 0968-7637
Abstract: Introduction: This article reports on a Department of Health UK funded project to implement consensus substance misuse teaching in undergraduate curricula in medical schools in England. The aim was to better equip practising doctors of the future to deal with substance misuse issues. Method: A project coordinator worked with local curriculum coordinators and academic champions in 19 participating medical schools. Substance misuse teaching was mapped using a toolkit outlining national learning outcomes as specified in Tomorrow's Doctors. This enabled a detailed overview of current substance misuse teaching, and identified gaps. Results: Common areas for all schools requiring further development included iatrogenic addiction, professionalism, fitness to practice, attitudes and issues relating to stigma, child-related issues, and social consequences of substance misuse. Students reported lacking confidence in performing key skills, including substance use history taking, discussing options for patients wishing to reduce or stop use, and recommending appropriate help organisations. This led to medical schools developing new or enhanced learning outcomes and teaching materials. Discussion: The project has, through national guidance and changes, enhanced the training and education of student doctors, and established a basis for substance misuse teaching that has already influenced the learning of our future doctors.
Abstractor: As Provided
Number of References: 17
Entry Date: 2018
Accession Number: EJ1191104
Database: ERIC
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  Value: <anid>AN0094870894;5f101apr.14;2019Mar26.12:35;v2.2.500</anid> <title id="AN0094870894-1">Report of the substance misuse in the undergraduate medical curriculum project in England. </title> <sbt id="AN0094870894-2">Introduction</sbt> <p>Introduction: This article reports on a Department of Health UK funded project to implement consensus substance misuse teaching in undergraduate curricula in medical schools in England. The aim was to better equip practising doctors of the future to deal with substance misuse issues. Method: A project coordinator worked with local curriculum coordinators and academic champions in 19 participating medical schools. Substance misuse teaching was mapped using a toolkit outlining national learning outcomes as specified in Tomorrow's Doctors. This enabled a detailed overview of current substance misuse teaching, and identified gaps. Results: Common areas for all schools requiring further development included iatrogenic addiction, professionalism, fitness to practice, attitudes and issues relating to stigma, child-related issues, and social consequences of substance misuse. Students reported lacking confidence in performing key skills, including substance use history taking, discussing options for patients wishing to reduce or stop use, and recommending appropriate help organisations. This led to medical schools developing new or enhanced learning outcomes and teaching materials. Discussion: The project has, through national guidance and changes, enhanced the training and education of student doctors, and established a basis for substance misuse teaching that has already influenced the learning of our future doctors.</p> <p>The use and misuse of alcohol, drugs (licit and illicit), and tobacco impacts on individual patients, their families, and communities. Substance misuse is a major public health challenge, nationally and globally. In the United Kingdom, approximately 81,700 adults aged over 35 die annually through smoking (The Health and Social Care Information Centre, [<reflink idref="bib16" id="ref1">16</reflink>]). Costs for the NHS for alcohol misuse are estimated by the Department of Health at £2.7 billion per year (The Health and Social Care Information Centre, [<reflink idref="bib17" id="ref2">17</reflink>]). About 3 million people in the United Kingdom use illicit drugs and over 300,000 are classed as problem drug users (opioid and crack cocaine users; Home Office, [<reflink idref="bib7" id="ref3">7</reflink>]). Doctors within all branches of medicine are very likely to encounter individuals with substance-related health problems.</p> <p>In the United Kingdom, it is estimated that General Practitioners (GPs) come across over 350 heavy drinkers each year among their patients (Department of Health, [<reflink idref="bib4" id="ref4">4</reflink>]), a trend which has continued year on year. Hospital doctors will see the impact of alcohol misuse in virtually every department. Alcohol-related illness or injury accounts for over 945,000 hospital admissions per year (John Moores University, [<reflink idref="bib12" id="ref5">12</reflink>]). Alcohol is responsible for around 25% of all hospital admissions in the United Kingdom (Lind et al., [<reflink idref="bib14" id="ref6">14</reflink>]) and around 35% of Accident and Emergency Department attendances (Department of Health, [<reflink idref="bib5" id="ref7">5</reflink>]), increasing to 70% during peak times (Cabinet Office – the Prime Ministers Strategy Unit, [<reflink idref="bib2" id="ref8">2</reflink>]). The medical profession has a key role in improving not only the health of patients but also the nation's public health. This has been recognised by both the World Health Organization and the United Nations who have recommended to governments that substance misuse should be included in medical teaching (International Narcotics Control Board, [<reflink idref="bib10" id="ref9">10</reflink>], [<reflink idref="bib11" id="ref10">11</reflink>]).</p> <p>In the late 1990s, research demonstrated very low levels of exposure of future doctors to substance misuse teaching within UK medical schools (Crome, [<reflink idref="bib3" id="ref11">3</reflink>]). This led to the development of the 'Substance Misuse in the Undergraduate Medical Curriculum Project' funded by the Department of Health, which comprised of two phases. Phase 1 (2005–2007), involving a total sample of all UK medical schools, reviewed the state of teaching of substance misuse in medical schools, which led to the development of UK corporate guidance on the integration of alcohol, drugs and tobacco training in medical undergraduate curricula. The guidance 'Substance Misuse in the Undergraduate Medical Curriculum' (International Centre for Drug Policy, [<reflink idref="bib9" id="ref12">9</reflink>]) and its associated tool-kit sets out key objectives and learning outcomes for undergraduate curricula training and assessment. It is referenced in 'Tomorrow's Doctors', the GMC's guidance on standards for undergraduate medical education (General Medical Council, [<reflink idref="bib6" id="ref13">6</reflink>]). Phase 2 (2008–2011) was funded specifically to implement the guidance within English medical schools.</p> <hd id="AN0094870894-3">Objective</hd> <p>Phase 2 of the project (2008–2011) involved supporting the participating medical schools in England in integrating and implementing the Substance Misuse in the Undergraduate Medical Curriculum guidance (International Centre for Drug Policy, [<reflink idref="bib9" id="ref14">9</reflink>]) into their curricula, as well as assisting with developing a self-sustaining network of English medical schools. This phase of the project is described in this article. All 24 medical schools in England were invited to take part in the project, with 19 formally accepting (79% response rate). Schools came from a geographical spread across England and included new schools, long established schools and those with differing approaches to curricula and teaching.</p> <hd id="AN0094870894-4">Method</hd> <p>This second curriculum development phase involved the funding and appointment of a national co-ordinator and curriculum coordinators in the 19 participating English medical schools. The co-ordinators worked with local academic champions who held clinical or teaching roles in substance misuse to identify the suitability of the current substance misuse teaching and to recommend and support changes.</p> <p>Co-ordinators mapped the curriculum using a toolkit outlining substance misuse national learning outcomes as specified in Tomorrow's Doctors, enabling them to construct a detailed overview of current teaching. Working with academic champions, co-ordinators were able to identify gaps in the teaching of substance misuse in their respective medical schools. This process was facilitated by regular meetings of the national project co-ordinator and the curriculum co-ordinators and academic champions to share best practice. The development of a series of substance misuse Fact Sheets aided co-ordinators in their role of implementing curriculum change. Curriculum changes were implemented across all years of undergraduate teaching. Students were actively engaged in the process, as some medical schools conducted surveys to assess students' views on substance misuse teaching.</p> <hd id="AN0094870894-5">Results</hd> <p>When compared with earlier research into the teaching of substance misuse in UK medical schools, findings suggested a positive impact following the process of agreement and publication of the UK-wide curriculum from Phase 1 (Audhali & Checinski, [<reflink idref="bib1" id="ref15">1</reflink>]). However, curriculum mapping also pointed to clear variation in teaching delivery between schools and across different learning objectives. There was therefore a need to focus on building a consensus approach to teaching substance misuse related topics. Although not directly comparable, the analysis of the new data collected at the beginning of Phase 2 did show convincing evidence of a quite substantial increase in delivery of what was previously a very low level of suitable teaching of substance misuse topics, and this had occurred after publication of the UK curriculum guidance from Phase 1.</p> <p>Table I shows the number of teaching sessions that were found to occur for each of the overarching learning outcomes following completion of the mapping exercise and the mean across the 17 medical schools that contributed to this analysis. Two of the participating medical schools were unable to contribute data to the project final report due to organisational changes.</p> <p>Table I.  Teaching sessions across curriculum learning outcomes</p> <p> <ephtml> <table><thead valign="middle"><tr><td>Learning outcomes area</td><td>Number of teaching sessions*</td><td>Mean number of teaching sessions per school (17)</td><td>Range of teaching sessions per school</td></tr></thead><tbody valign="top"><tr><td>Bio-psycho-social models of addiction</td><td char=".">944</td><td char=".">55</td><td char=".">5–394</td></tr><tr><td>Professionalism, fitness to practice, and students' own health</td><td char=".">408</td><td char=".">24</td><td char=".">1–89</td></tr><tr><td>Clinical assessment of patients</td><td char=".">929</td><td char=".">54</td><td char=".">3–330</td></tr><tr><td>Treatment interventions</td><td char=".">911</td><td char=".">53</td><td char=".">5–166</td></tr><tr><td>Epidemiology, public health, and society</td><td char=".">578</td><td char=".">32</td><td char=".">5–137</td></tr><tr><td>Specific disease and speciality topics</td><td char=".">825</td><td char=".">48</td><td char=".">6–187</td></tr></tbody></table> </ephtml> </p> <p>1 *Teaching sessions are defined as the number of occasions some formal or timetabled teaching/learning occurs that feature issues relating to substance misuse (such as a lecture, a seminar, a problem-based learning case, special study modules etc.).</p> <p>There was significant variation across medical schools in the total number of teaching sessions across each learning outcome area. Within these areas, common topics for all schools requiring further development included iatrogenic addiction; professionalism, self-care and fitness to practice; attitudes and issues relating to stigma; child-related issues and social consequences.</p> <p>Changes implemented by the schools following this mapping exercise ranged from the re-writing of learning objectives to the development of problem-based learning scenarios. Changes were implemented across all years of education, to reflect the embeddedness of substance misuse issues across all areas of healthcare practice. Workshops and symposiums were developed that covered ethical issues of substance misuse including discussion of the misuse of substances by the medical profession itself. Teaching resources were developed or enhanced using web resources such as virtual patient tutorials and video resources of clinical scenarios. Independent learning resources were also developed, such as an online addictions study guide, and in one school students organised an 'Alcohol Awareness Week'.</p> <hd id="AN0094870894-6">Student views of substance misuse teaching</hd> <p>Co-ordinators were encouraged to gather as much data about their school in ways which fitted best with their local situation. Nine of the co-ordinators chose to conduct surveys with students to gather their perceptions of substance misuse teaching. Although the surveys were tailored to individual curricula, some questions were generic across the schools and these are reported below. A total of 2133 students completed the generic questions with some providing further detailed views through focus groups and qualitative open-ended questions.</p> <p>Student feedback revealed three key themes:</p> <p></p> <ulist> <item> Trainee doctors consider substance misuse an important aspect of undergraduate medical education, and they have a high level of interest in this.</item> <p></p> <item> Opportunities to prioritise further learning on substance misuse through special study modules are popular.</item> <p></p> <item> Direct contact with patients and services through placement are considered the most useful way to learn about the management of substance misuse.</item> </ulist> <p>Students reported a lack of confidence in performing key skills with those who misuse substances, including taking a history of illicit substance use, discussing the range of options for patients wishing to cut down or stop use, and being able to recommend appropriate organisations that could help patients.</p> <hd id="AN0094870894-7">Discussion</hd> <p>As part of the background work for phase one of the project, a review of published literature (International Centre for Drug Policy, [<reflink idref="bib8" id="ref16">8</reflink>]) in the area of substance misuse in undergraduate medical education was undertaken. Key messages from this review were the need for more systematic approaches to substance misuse medical education and that the most important aspect of managing substance misuse in the undergraduate curriculum is that of co-ordinating the content, delivery, and assessment. While there were initiatives in North America to develop teaching and learning, very little was happening in the United Kingdom. More recently, a review of the literature was undertaken in the United States (Kothari et al., [<reflink idref="bib13" id="ref17">13</reflink>]), which concluded that medical educators must define, design, implement, and evaluate curricula to ensure that all medical graduates, across disciplines, have the basic skills to address substance abuse disorders with patients. (Strobel et al., [<reflink idref="bib15" id="ref18">15</reflink>]) in a survey of German medical students, found a lack of knowledge of how to treat smoking and problem drinking. These and earlier studies have shown that substance misuse has to be integrated in to the curriculum of medical students, and it has to be a topic introduced from the very beginning of the course – not least for students' own health and professional behavior.</p> <p>The 'Substance Misuse in the Undergraduate Curriculum' initiative appears to have enhanced the training and education of student doctors, and established a solid basis for substance misuse teaching. The project has for the first time produced an agreed high-level curriculum that is now established in the majority of English medical schools. It has contributed to substantial improvements in the extent and quality of teaching across a wide range of drug and alcohol issues. This has been facilitated by the development of a package of high quality, practical and flexible teaching tools validated by experts.</p> <p>The key limitation of the curriculum development project was that it was not formally evaluated. Due to the nature of curriculum development and change implementation, it was difficult to arrange for baseline 'measures' against which change could be assessed. However, the fluid and ever changing nature of medical curricula lent itself to the consensus guidance implementation approach, and the mapping process allows scope for individual medical schools to re-map learning objectives and assess change. Furthermore, the gathering of student views on substance misuse teaching can be repeated over time. A further limitation of the project concerns the Medical School response rate of 79%. Although this might be considered a high participation rate, it does however mean that for a total of 5 English Medical schools we have no evidence of curriculum change in line with the corporate curriculum.</p> <p>The development of 'curriculum champions' in participating English medical schools has promoted a raised awareness across medical curriculum committees of the importance of including learning about substance misuse within all disciplines of medicine. The project has therefore, through the national guidance and changes, enhanced the training and education of student doctors, and established a basis for substance misuse teaching that has already influenced the learning of at least 47,000 future doctors in participating medical schools.</p> <p> <bold> <emph>Declaration of interest</emph> </bold>: The authors report no declaration of interest. The authors alone are responsible for the content and writing of the article.</p> <ref id="AN0094870894-8"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref15" type="bt">1</bibl> <bibtext> <sups>†</sups>Professor Ghodse was a Professor of Psychiatry and International Drug Policy at St George's, University of London. He was also the head of the renowned International Centre for Drug Policy (ICDP), which he established at St George's. Originally from Iran, where he qualified in medicine in 1965, he came to St George's in 1978 and was appointed to the country's first chair in addictive behavior in 1987. Through his work at St George's, he established himself as a leading figure in addiction science, the development of treatment services, and the expansion of professional training. The Academic Department of Addictive Behavior that he established comprised hospital-based out-patient clinics, in-patient assessment, detoxification, recovery and rehabilitation wards, and community-based multidisciplinary therapeutic teams. In medical education, he led the establishment of a range of undergraduate, postgraduate, and multi-professional training programs in addiction. He was responsible for setting up the first MSc course on addictive behavior, which led to other courses for different health disciplines and set the standard for academic addiction education and training. A major achievement of his was the development and leadership of the national Substance Misuse in the Undergraduate Medical Curriculum project. Professor Ghodse sadly passed away in December 2012.</bibtext> </blist> </ref> <ref id="AN0094870894-9"> <title> References </title> <blist> <bibtext> Audhali, N, & Checinski, K. (2010). Substance misuse on the curriculum. Student BMJ, 18 (c2746). DOI: 10.1136/sbmj.c2746.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref8" type="bt">2</bibl> <bibtext> Cabinet Office – the Prime Ministers Strategy Unit. (2004). Alcohol harm reduction strategy. Retrieved from http://webarchive.nationalarchives.gov.uk/20130128101412/<ulink href="http://www.cabinetoffice.gov.uk/strategy/work%5fareas/alcohol%5fmisuse.aspx">http://www.cabinetoffice.gov.uk/strategy/work%5fareas/alcohol%5fmisuse.aspx</ulink></bibtext> </blist> <blist> <bibl id="bib3" idref="ref11" type="bt">3</bibl> <bibtext> Crome IB. The trouble with training: Substance misuse education in British Medical Schools revisited. What are the issues?. Drugs: Education, Prevention and Policy 1999; 6 : 111 – 123</bibtext> </blist> <blist> <bibl id="bib4" idref="ref4" type="bt">4</bibl> <bibtext> Department of Health. (2004). Chief Medical Officer's Update; 38, May 2004. Retrieved from <ulink href="http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/CMOupdate/DH%5f4081831">http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/CMOupdate/DH%5f4081831</ulink></bibtext> </blist> <blist> <bibl id="bib5" idref="ref7" type="bt">5</bibl> <bibtext> Department of Health. (2005). Choosing Health – Making healthy choices easier. Retrieved from <ulink href="http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH%5f4094550">http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH%5f4094550</ulink></bibtext> </blist> <blist> <bibl id="bib6" idref="ref13" type="bt">6</bibl> <bibtext> General Medical Council. (2009). Tomorrow's Doctors: Outcomes and standards for undergraduate medical education. Retrieved from <ulink href="http://www.gmc-uk.org/education/undergraduate/tomorrows%5fdoctors%5f2009.asp">http://www.gmc-uk.org/education/undergraduate/tomorrows%5fdoctors%5f2009.asp</ulink></bibtext> </blist> <blist> <bibl id="bib7" idref="ref3" type="bt">7</bibl> <bibtext> Home Office. (2010). Drug strategy 2010 reducing demand, restricting supply, building recovery: Supporting people to live a drug free. Retrieved from https://<ulink href="http://www.gov.uk/government/uploads/system/uploads/attachment%5fdata/file/98026/drug-strategy-2010.pdf">www.gov.uk/government/uploads/system/uploads/attachment%5fdata/file/98026/drug-strategy-2010.pdf</ulink></bibtext> </blist> <blist> <bibl id="bib8" idref="ref16" type="bt">8</bibl> <bibtext> International Centre for Drug Policy. (2006). Substance misuse in the undergraduate medical curriculum project background: A survey of recent literature. Retrieved from <ulink href="http://www.sgul.ac.uk/research/projects/icdp/our-work-programmes/substance-misuse-in-the-undergraduate-medical-curriculum">http://www.sgul.ac.uk/research/projects/icdp/our-work-programmes/substance-misuse-in-the-undergraduate-medical-curriculum</ulink></bibtext> </blist> <blist> <bibl id="bib9" idref="ref12" type="bt">9</bibl> <bibtext> International Centre for Drug Policy. (2007). Substance misuse in the undergraduate curriculum. Retrieved from <ulink href="http://www.sgul.ac.uk/research/projects/icdp/our-work-programmes/substance-misuse-book.pdf">http://www.sgul.ac.uk/research/projects/icdp/our-work-programmes/substance-misuse-book.pdf</ulink></bibtext> </blist> <blist> <bibtext> International Narcotics Control Board. Annex IV Letter from the President of the International Narcotics control Board to all countries' in Report of the International Narcotics Control Board on the Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes. United Nations, New York 2010a</bibtext> </blist> <blist> <bibtext> International Narcotics Control Board. Europe National legislation, policy and action paragraph 699' in Report of the International Narcotics Control Board 2009. United Nations, New York 2010b</bibtext> </blist> <blist> <bibtext> John Moores University, C. F. P. H., & North West Public Health Observatory. New alcohol profiles for England provide national map of alcohol-related harms, press release, 31 August 2010. John Moores University and North West Public Health Observatoryo, Liverpool 2010, Document Number)</bibtext> </blist> <blist> <bibtext> Kothari D, Gourevitch M, Lee JD, Grossman E, Truncali A, Tavinder A, Kalet A. Undergraduate medical education in substance abuse: A review of the quality of the literature. Academic Medicine 2011; 86 : 98 – 112</bibtext> </blist> <blist> <bibtext> Lind J, Kouimtsidis C, Reynolds M, Hunt M, Drummond C, Ghodse H. Drug misuse among patients admitted to a general hospital. Journal of Substance Use 2003; 8 : 186 – 190</bibtext> </blist> <blist> <bibtext> Strobel L, Schneider NK, Krampe H, Beibarth T, Pukrop T, Anders S,, Raupach T, et al. German medical students lack knowledge of how to treat smoking and problem drinking. Addiction 2012; 107 : 1878 – 1882</bibtext> </blist> <blist> <bibtext> The Health and Social Care Information Centre. (2011a). Statistics on smoking: England, 2011.</bibtext> </blist> <blist> <bibtext> The Health and Social Care Information Centre. (2011b). Statistics on alcohol England, 2011.</bibtext> </blist> </ref> <aug> <p>By Caitlin Notley; Christine Goodair; Andrew Chaytor; Janine Carroll; Hamid Ghodse and Peter Kopelman</p> <p>Reported by Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib16" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib17" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref5"></nolink> <nolink nlid="nl4" bibid="bib14" firstref="ref6"></nolink> <nolink nlid="nl5" bibid="bib10" firstref="ref9"></nolink> <nolink nlid="nl6" bibid="bib11" firstref="ref10"></nolink> <nolink nlid="nl7" bibid="bib13" firstref="ref17"></nolink> <nolink nlid="nl8" bibid="bib15" firstref="ref18"></nolink>
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  Data: <searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.3109/09687637.2013.792788
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0968-7637
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: This article reports on a Department of Health UK funded project to implement consensus substance misuse teaching in undergraduate curricula in medical schools in England. The aim was to better equip practising doctors of the future to deal with substance misuse issues. Method: A project coordinator worked with local curriculum coordinators and academic champions in 19 participating medical schools. Substance misuse teaching was mapped using a toolkit outlining national learning outcomes as specified in Tomorrow's Doctors. This enabled a detailed overview of current substance misuse teaching, and identified gaps. Results: Common areas for all schools requiring further development included iatrogenic addiction, professionalism, fitness to practice, attitudes and issues relating to stigma, child-related issues, and social consequences of substance misuse. Students reported lacking confidence in performing key skills, including substance use history taking, discussing options for patients wishing to reduce or stop use, and recommending appropriate help organisations. This led to medical schools developing new or enhanced learning outcomes and teaching materials. Discussion: The project has, through national guidance and changes, enhanced the training and education of student doctors, and established a basis for substance misuse teaching that has already influenced the learning of our future doctors.
– Name: AbstractInfo
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  Data: As Provided
– Name: Ref
  Label: Number of References
  Group: RefInfo
  Data: 17
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2018
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1191104
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1191104
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.3109/09687637.2013.792788
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 4
        StartPage: 173
    Subjects:
      – SubjectFull: Substance Abuse
        Type: general
      – SubjectFull: Medical Education
        Type: general
      – SubjectFull: Drug Addiction
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Program Descriptions
        Type: general
      – SubjectFull: Undergraduate Students
        Type: general
      – SubjectFull: Medical Schools
        Type: general
      – SubjectFull: Outcomes of Education
        Type: general
      – SubjectFull: Professionalism
        Type: general
      – SubjectFull: Social Bias
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Self Efficacy
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Drug Rehabilitation
        Type: general
      – SubjectFull: Therapy
        Type: general
      – SubjectFull: Curriculum Development
        Type: general
      – SubjectFull: Knowledge Level
        Type: general
      – SubjectFull: Instructional Materials
        Type: general
      – SubjectFull: Help Seeking
        Type: general
      – SubjectFull: Referral
        Type: general
      – SubjectFull: Medical Evaluation
        Type: general
      – SubjectFull: Physician Patient Relationship
        Type: general
      – SubjectFull: United Kingdom
        Type: general
    Titles:
      – TitleFull: Report of the Substance Misuse in the Undergraduate Medical Curriculum Project in England
        Type: main
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            NameFull: Notley, Caitlin
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            NameFull: Goodair, Christine
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            NameFull: Chaytor, Andrew
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            NameFull: Carroll, Janine
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            NameFull: Ghodse, Hamid
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            NameFull: Kopelman, Peter
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            – D: 01
              M: 01
              Type: published
              Y: 2014
          Identifiers:
            – Type: issn-print
              Value: 0968-7637
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              Value: 21
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              Value: 2
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            – TitleFull: Drugs: Education, Prevention & Policy
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