A Transformational Health Approach to Evaluation of the Virginia REVIVE! Course in the Training of First Year Medical Students in Rural Virginia

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Project information

  • Category: Original Research
  • Researchers:: Shenk A., Gordon, A., Nelson, B., Perera, I., Moomaw, E., Johnston, T., Tate, W., Thommason, A., D’Arpa, E., Nguyen, T., Anandakrishnan, R., Martin, R., Callahan, C., Mahaney, J.

Abstract

In 2021, the opioid epidemic in Virginia recorded its highest death toll to date, 2229 deaths. The first three quarters of 2022 totaled 1579 deaths. Concomitantly, states have begun the introduction of Good Samaritan Laws and naloxone distribution programs. A 2014 national study of 30 states with naloxone distribution programs found that these programs resulted in a 14% lower overdose rate when compared to states without similar programs. The Edward Via College of Osteopathic Medicine Virginia Campus (VCOM-VC) Overdose Prevention Task Force (OPTF) has committed to training each incoming first-year medical student in naloxone administration using REVIVE!. REVIVE! is the Commonwealth of Virginia’s standardized Opioid Overdose and Naloxone Education (OONE) program, designed to educate participants in the recognition and response protocol for an opioid overdose emergency. This is the fourth year of successfully training 100% of the first-year class at VCOM-VC. Students who have participated in these programs become certified by the Virginia Department of Health to administer naloxone. This training is standardized and delivered by agents appointed by the state of Virginia; however, the program lacks peer-reviewed evaluation of its objectives: 1. Understand the REVIVE! program and legislation, 2. Understand addiction, 3. Understand how opioid overdose emergencies happen and how to recognize them, 4. Understand how naloxone works, 5. Identify risk factors that may make someone more susceptible to an opioid overdose emergency, 6. Dispel common myths about how to reverse an opioid overdose, and 7. Learn how to respond to an opioid overdose emergency with the administration of naloxone. Students who complete this training are not evaluated for their competency in the listed objectives. This prospective cohort study compares the effectiveness of the didactic REVIVE! course to a REVIVE! course plus simulation-based training. Simulation has been shown to improve student comfort and performance in procedural skills while emphasizing teamwork and communication. The study seeks to elucidate the effectiveness of the course via a standardized post-assessment, simulated assessment of the participant’s ability to recognize and implement the REVIVE! protocol, and evaluation of 6-month retention. This study is currently in the initial data analysis phase as approved by the VCOM IRB, protocol number 2023-132.

References

1. Declaration of Public Health Emergency. Virginia Department of Health. Published November 21, 2016. Accessed November 14, 2023. https://www.vdh.virginia.gov/commissioner/declaration-of-public-health-emergency/

2. REVIVE! Opioid Overdose and Naloxone Education (OONE) program for the Commonwealth of Virginia. Virginia Department of Behavioral Health and Development Services. 2023. Accessed December 8, 2023. https://dbhds.virginia.gov/behavioral-health/substance-abuse-services/revive/

3. Okuda, Y., Bryson, E. O., DeMaria, S., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The utility of simulation in medical education: What is the evidence? Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 76(4), 330–343. https://doi.org/10.1002/msj.20127