Design & Methods: A one group pretest-posttest design was used to ascertain the impact of participating in a collaborative SBIRT training on knowledge and importance of and confidence in ability to use SBIRT in future practice with clients. Eleven training sessions were held for BSN and BSW students (N= 247) at a public university in the Southeastern United States. The sessions were jointly conducted by a Psychiatric Mental Health Nurse Practitioner faculty member and two Certified Social Workers who are faculty in a BSW program. Institutional Review Board approval was obtained before students participated in the study, and funding for the trainings and educational materials was provided by a grant from SAMSHA. Nursing students who participated in the study were in their second semester of course work and were currently enrolled in a Mental Health Nursing course. The BSW students were in their field practicum course in the last semester before graduation. All students in those courses were provided education on SBIRT; however, only those willing to participate in the study signed informed consent and completed questionnaires.
The trainings took place between April 2016 and August 2017, and sessions utilized didactic lecture, skill building practice on conducting screening assessments with validated instruments, and videos demonstrating how to conduct an entire SBIRT intervention. Sessions lasted three hours and were completed during regularly scheduled class and/or clinical blocks. During the trainings, students were taught how to intervene with clients at risk for SUDS in less than five minutes to increase insight and awareness regarding substance use and motivation toward behavioral change (SAMHSA, 2015). Additionally, students were introduced to basic Motivational Interviewing techniques to use during the screening and brief intervention process. Students were also familiarized on standardized screening tools and techniques to use in referring clients to further treatment in their community.
Students were assessed for knowledge acquisition and feelings related to importance and confidence after the training program. Participants received a knowledge pretest and demographic questionnaire in one of their class meetings before the SBIRT content was presented. The pretest measured knowledge of substance use screening and interventions, and included questions asking about items such as recommended maximum drinking levels and criteria for diagnosis of a SUD. After the didactic and interactive training on SBIRT, students were re-administered the knowledge test to measure knowledge acquisition. They were also given a questionnaire assessing their feelings on the importance of using SBIRT as a model and their confidence in applying the techniques learned in training with future clients. Scores on the pre and posttest ranged from 0-100%, and scores on the importance and confidence scores could range from 9-90.
Results: Data from the demographic questionnaire, knowledge pre and posttests and importance and confidence questionnaire were analyzed using SPSS v. 25. Descriptive statistics were calculated for the demographic data and paired t-tests analyses were conducted to determine change in knowledge within the BSN and BSW student groups. Independent t-tests were used to determine differences in knowledge between BSN and BSW students and to assess differences in views on importance and confidence in using SBIRT techniques. The sample was comprised on predominantly females students (n=214; 86.6%) and Caucasian (n=218, 88.3%). The mean knowledge score increased significantly from the pretest to the posttest (p <.05) for both disciplines independently. There was no significant difference between the knowledge scores for either the pre or posttest scores between the BSN and BSW students. Independent t-test analyzes revealed a significantly higher level of confidence in the BSN students in regards to their ability to screen and intervene with future clients who may have alcohol and drug problems (p<.05). There were no statistically significant differences related to confidence with both nursing and social work students reported high mean scores on the importance of screening for alcohol and drug problems in their future practice. The BSW students reported statistically significantly higher scores on feelings of work related satisfaction when working with those suffering from alcohol or drug issues (p<.05), although scores were low for both groups as neither was licensed to practice in their discipline at the time of training.
Conclusions: Given the current level of SUDS in the United States (SAMHSA, 2015), it is important to better prepare nurses and social workers before they go to work in clinical settings with clients who are abusing drugs, as well as alcohol. Collaborative education provided by both nurses and social work faculty provides students with a wealth of clinical knowledge to aid their learning of standardized models such as SBIRT and can enhance the understanding of the collaboration that must occur in practice between disciplines when working with SUDs. In addition, training health profession students to use SBIRT has several benefits including promoting the use of standardized screening tools and brief interventions based on motivational interviewing techniques (Kane et al., 2014). The collaborative training design used in this study demonstrated in increase in knowledge of SUD content and SBIRT use, as well as increases in understanding the importance of using SBIRT. Most importantly, increases in confidence in using SBIRT as a future health professional was seen in both the BSN and BSW students in this study.