Impact of cuddler service-learning program in medical student education of opioid use disorder in pregnancy and neonatal opioid withdrawal syndrome

Abstract

Background: Given the increasing incidence of neonatal opioid withdrawal syndrome (NOWS), medical student training on substance use disorders (SUDs) and opioid use disorder (OUD) in pregnancy must be augmented. Through the Cuddling Assists in Lowering Maternal and Infant Stress (CALM) service-learning program, medical students attend SUD-related didactics and provide monthly cuddling services to infants with NOWS. Objective: This study examines the impact of CALM on medical students’ attitudes toward individuals with SUDs and self-reported comfort with clinical skills related to caring for this population. Methods: Self-reported pre- and post-survey data was collected at the beginning and end of an academic year from the intervention group, CALM cuddlers, and the control group, non-cuddlers for 2 years. Mean total survey scores and individual survey questions using a 3-point Likert scale were compared before and after 1 year of participation for cuddlers and for non-cuddlers using paired t-tests and two sample t-tests. Results: The mean total score increased for cuddlers after participation in the intervention (MD 0.13, SD 0.26, p = 0.03). Mean scores for the comfort-related subset of questions also increased significantly for cuddlers after participation in the intervention (MD 0.22, SD 0.41, p = 0.01). Cuddlers felt more comfortable discussing substance use with appropriate language (72.0% vs 51.5%, p = 0.03), talking with patients about substance use (72.0% vs 36.0%, p = 0.01), and asking about substance use or recovery (80.0% vs 48.0%, p = 0.01). Conclusion: OUD- and NOWS-related service-learning positively impacts student attitudes and self-reported comfort with skills related to caring for individuals with SUDs, such as communicating about substance use.

Keywords:

• Neonatal opioid withdrawal syndrome
• service learning
• medical education
• students
• attitudes

Acknowledgements

We would like to thank the Boston University School of Medicine, Boston Medical Center, and the Boston Medical Center Department of Pediatrics for supporting the CALM program. We would also like to thank Macy Reed and Boston Medical Center Department of Volunteer Services for their continued logistical support for CALM. We would also like to acknowledge Dr. Davida Schiff, Tithi Baul, David Silverman, Erin Smith, Ian Benjamin for their continued support with this study.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Author contributions

E.W. conceived the intervention. N.G. conceived the research study. N.G., L.H and M.D. designed the study and measurement tools with supervision from E.W. N.G., L.H., M.D., P.C., J.K, and H.M. collected the data with supervision from C.B. and E.M. M.M performed the data analysis with feedback from N.G., C.B., and E.W. N.G. drafted the manuscript with contributions from M.D., M.M., P.C., J.K., and H.M. All authors provided feedback on the manuscript. E.W. supervised the project.