NAMOur WorkProgramsAction Collaborative on Countering the U.S. Opioid EpidemicCore Competency Implementation Pilot Project

Core Competency Implementation Pilot Project

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The 16 selected implementation sites are conducting tailored implementation activities based on their organizational needs from June through December 2024. Through participation in the Implementation Pilot Project, sites will help to inform and shape the future of health professions education policy and practice; advance workforce competency; address critical education and practice issues; join a dynamic network of educators; and work closely with the Action Collaborative and its members.

At the conclusion of the Implementation Pilot Project, representatives from each site will convene in Washington, D.C. with leaders across health professions education and training, health care delivery, and policy. The convening will showcase key learnings from across the pilot sites, along with discussion on opportunities to expand the project and catalyze broader uptake of the 3Cs Framework.

Impact

Implementation Sites

The Core Competency Implementation Pilot Project’s 16 implementation sites are located across the country in 11 states and Washington, D.C. Implementation projects will take place in a variety of settings, including academic medical centers, a Federally Qualified Health Center, a hospital, an addiction treatment program, a professional association, a fire and EMS department, and schools of nursing, pharmacy, medicine, and public health. Additionally, the pilot projects plan to implement the Framework across the full range of the education, training, and practice continuum, including in undergraduate and graduate education and with practicing health professionals.

The implementation pilot project will focus on integrating the Core Competency Framework into the continuing education programs offered by the American Academy of Orthopaedic Surgeons. The project team will include representatives from relevant departments, such as Education, Learning and Practice Management, Marketing, Government Affairs, and Quality Improvement.

The project design encompasses several key components, including an initial needs assessment of current landscape of opioid management practices within the department, integration of the Action Collaborative’s Framework, pilot revised education programs, evaluation and feedback to assess effectiveness of the Framework and areas for improvement, investment in capacity building to support implementation and sustainability, and continuous engagement of key stakeholders.

This project will provide interdisciplinary experiences to students with a focus on opioid use disorder. In part one of the project, the Framework will help the pilot project team faculty design the reflective paper rubric for undergraduate nursing, undergraduate education, and graduate public health students who attend an IPE panel presentation. The Framework will be shared with students to help them create questions for the speaker panel of individuals with personal experiences with SUD.

For part two of the project, the Framework will provide guidance for revising the patient scenario and the development of an updated rubric for evaluating healthcare professional student participation and performance within the Interprofessional Education activity: Pain Management in the Context of Opioid Use Disorder Simulation. Pharmacy students, medical students, undergraduate nursing, and advanced practice nursing students participate in this activity.

The DC Fire and EMS MOUD buprenorphine project is being conducted in partnership with the DC Department of Behavioral Health (DBH) to bring MOUD therapy to patients in the community through paramedic-initiated buprenorphine therapy. The Framework will give structure to the program’s processes and training requirements and help to identify areas for growth. Specifically, the Framework’s competencies will be used to guide the development of a patient- and family-centered program that addresses team member implicit attitudes and biases.

Additionally, a process is in place to share patient information across a regional health information exchange. The Framework will inform how data should be included in the health information exchange and provide guidance to traditional treatment partners on how to leverage the community MOUD resource in development.

The Caring Together Program (CTP) serves as a model treatment program for women and their families providing evidence based dual diagnosis care. It is focusing on increasing clinical knowledge and skills in trainees, including psychiatric residents, 4th year medical students, psychiatric NP students, addiction counseling students, and family therapy students. The Framework will serve as a curriculum guide, and the project will focus on “microdosing” educational components by adding specific aspects of the Framework to educational activities.

The primary goal of this project will be developing a formal mechanism to evaluate the educational outcome experiences of multidisciplinary trainees, comparing those who have been exposed to the Caring Together Program as part of clinical rotations along with completing the required online modules with those trainees who only complete the online modules. The secondary goal of this project is to create a training module for patients with lived experience to formally share those experiences with healthcare providers and healthcare trainees and assess knowledge, attitudes, and skills in those trainees.

This project will develop a framework, guided by the Core Competency Framework, to evaluate the impact and efficacy of El Rio´s existing, growing SUD treatment program. The El Rio SUD treatment program has recently focused on building systems to be able to better track data and outcomes, with the goal of identifying strengths and areas that need more attention and perhaps new approaches. While the tools within the EHR have been built to extract this information, the framework and parameters to assess current care delivery have not yet been developed. The Core Competency Framework will help to address challenges posed by culture and practice change across a large organization serving a patient population with complex medical and psychosocial needs.

In creating a framework to evaluate this behavioral health-primary care integrated community health SUD treatment program, the model and assessment framework can serve as a model for other community health centers attempting to integrate SUD care into their practice setting.

This project will develop and evaluate the competency, skills, and knowledge of undergraduate nursing students, including nurse practitioners (in collaboration with the Yale School of Nursing Nurse Practitioners Program), in caring for patients with unhealthy substance use. The project champions will develop a course to teach and train students in the core competencies, including assessment skills, planning, implementation, and evaluation, in alignment with the existing nursing process. Micromodules will be embedded in weekly class activities for nursing students taking courses on population health with a practicum component and nursing psychiatric clinical rotation focusing on substance use, misuse, and abuse.

The Framework will also be used to evaluate the students in the undergraduate nursing program and nurse practitioner’s program on their application of knowledge and skills in clinical rotations, including caring for patients in community health centers as primary care settings, as part of their clinical experience.

The goal of this project is to prepare faculty from nursing, medicine, pharmacy, and public health to effectively facilitate interprofessional education (IPE) events focused on caring for patients with opioid use disorder. The Framework will be used to develop faculty training for faculty who facilitate an IPE event focused on opioid use disorder.

This is one of four core IPE events held each year for prelicensure students from the Johns Hopkins School of Medicine, Nursing, and Public Health as well as the Notre Dame of Maryland School of Pharmacy. The event focuses on how social determinants of health and provider bias impact the care of patients with opioid use disorder.

In response to results of a survey of all Ohio health professions schools that identified a need for a uniform approach to teaching about substance use disorder with particular curricular gap areas, the interprofessional program on Opioid Use Disorder was launched. This 10-hour interdisciplinary program to educate healthcare professional students about OUD has been offered to nearly 2,000 healthcare students across Ohio over the last 3 years. The program consists of asynchronous modules and a virtual synchronous escape room event where students work together on a complex patient case.

This project will assess the program against the Core Competency Framework, allowing for collaboration with others in the field and ensuring the program is meeting the current standards and needs of students while using best practices in education and clinical training. The assessment will help to identify areas of strength and opportunity within the program, as planning is underway to expand it outside the state of Ohio.

The goal of this project is to implement the Core Competency Framework into the Internal Medicine-Pediatrics residency at the University of Alabama at Birmingham. The Framework will be incorporated into an existing series of weekly didactics and into inpatient and outpatient clinical opportunities in pediatrics and internal medicine.

Specifically, these didactics will address the subcompetencies contained within the Framework’s competencies of foundational knowledge, team-based care, and health systems and environment. This project will be incorporated into ongoing weekly conferences for Internal Medicine – Pediatrics residents that have been part of the Internal Medicine – Pediatrics curriculum for the last two years. Residents will be expected to apply the knowledge acquired during these sessions to their care of patients with substance use disorders during residents’ clinical rotations.

The purpose of this project is to train current and next-generation healthcare professionals on evidence- and practice-based strategies for addressing pain and unhealthy substance use. The project will use a trauma-informed and culturally and linguistically responsive approach in all aspects of implementation to ensure meaningful engagement of people with lived experience.

This project includes two components. The first will involve enhancing two Opioid IPE events and mapping them to the Framework. The Opioid IPE events include a pre-event survey; a live event that stimulates discussion surrounding issues related to inclusion, diversity, equity, and justice; and a post-event survey. The second component will be creating and hosting an Applied Learning Collaborative which will offer students an activity to apply knowledge learned specifically on screening and brief intervention through an interactive case and role play activity.

This project will apply select competencies from the Framework to planned training activities for the remainder of 2024, including 2-3 Medications for Addiction Treatment (MAT) ECHO clinics and 2-3 ongoing monthly webinars, called the Provider Support Initiative, focused on treating opioid use disorder. The planned content for these sessions and webinars will be reviewed to determine how the core competencies may be included in the identified learning activities. Implementing the core competencies presents opportunities to pilot them in an established training program for interdisciplinary health care providers and to engage in quality improvement in existing and ongoing programs.

The Core Competency Framework will be used to refine and expand existing interprofessional education (IPE) efforts around the opioid crisis, persons with substance misuse, and non-pharmacological approaches to pain. Since 2018, the University of Florida has conducted a required IPE activity for health professions students (e.g., dental, nursing, pharmacy, physical therapy, and veterinary medicine). The activity has evolved to address needed format delivery changes due to Covid-19, and to add further content and skill building learning. 

This project will incorporate the Framework into existing work described below through online modules and learning activities during the workshop. Proposed project activities include: Refinement of existing content and activities to align with the Framework; Adding additional foundational knowledge about pain and substance use; Adding patient/family member perspectives to the activity, Adding content, largely supported by the patient/family member perspectives, related to recognition and elimination of stigma.

The project aims to enhance the competency of interprofessional healthcare teams in managing pain and addressing opioid use disorder (OUD) by implementing an integrated continuing education program. This program combines an online learning module with facilitated interprofessional group discussions. The Department of Continuing Education and Assessment team will align practice gaps and learning objectives for accredited continuing education with the Framework. For existing CME/CPD activities, the Framework will serve as a robust tool for assessing and evaluating the impact of these activities in closing professional practice gaps in OUD/SUD prevention and treatment.

The online continuing education learning module on the Social Determinants of Health and Pain Management was developed by an interprofessional education planning team comprised of subject matter experts (SMEs) from various fields and incorporates the perspectives of these SMEs and real-life patient stories. Designed specifically for an interprofessional healthcare team, the course emphasizes reflective learning, ensuring that participants can reinforce and apply the knowledge gained from the outset. The second phase of the project consists of four facilitated interprofessional discussions for healthcare professionals from various disciplines who have completed the online learning module. These sessions will be led by SMEs involved in the development of the module, in collaboration with the institution’s IPE department. The discussions will incorporate reflective case studies and interactive activities.

This project will support dissemination and use of the Core Competency Framework and competencies through a curriculum mapping process and by designing, implementing, and evaluating an educational intervention teaching the framework through a case-based, web-based, self-learning program at the Vanderbilt University Medical Center (VUMC).

This project has two main goals, 1) to map the competencies with existing teaching activities at VUMC and [within the Vanderbilt University School of Nursing (VUSN)], and 2) to design, implement, and evaluate a case-based, web-based, self-learning program targeting GME trainees (residents and fellows) and faculty members’ knowledge and comfort to teach and assess the framework in the clinical setting.

A recent preliminary needs assessment at Weill Cornell-NYP in the area of substance use disorder and addiction medicine found that multiple departments and disciplines are seeking to increase clinical knowledge and practice, but are using different resources, approaches and/or relying on individual physicians to informally support care. The ongoing, comprehensive needs assessment will involve mapping education resources currently used in different departments and current programming, as well as knowledge/resource gaps.

The Core Competency Framework will provide a structure for the ongoing needs assessment and resource mapping. Additionally, lecturers in the section of Addiction Medicine will implement the Framework to provide consistency around addiction education within the institution for undergraduate medical education; Internal Medicine, Anesthesia, Pediatrics, and OB/GYN residency; and addiction and pain fellowships.

The goal for this implementation project is to robustly enmesh the Core Competency Framework into current addiction medicine workflows. The Framework will be used to enhance both internal and external education efforts related to pain’s interface with SUD including stigma associated with pain and addiction. Via the intentional and explicit education of Core Competency champion clinicians who are already on the forefront of treating patients with SUD, these champion clinicians will support and educate other clinicians, residents, and staff on the Core Competency Framework.

This Framework will support the creation and sustaining of staff education including recognizing and addressing pain issues and any stigma relating to the treatment of patients with pain management concerns and/or substance use disorder. TWCCH initiatives for health equity and trauma-competence will also be enhanced via education and training on effective and evidence-based communication strategies with patients and families, including the use of non-biased, nonjudgmental, non-stigmatizing, nondiscriminatory language and developing awareness of trauma-informed care practices and implementation skills.

Additional Resources

Announcement of Pilot Projects
Core Competency Framework