1. Oermann, Marilyn H. PhD, RN, ANEF, FAAN

Article Content

Rarely does a week go by without some news item about the opioid crisis. The Centers for Disease Control and Prevention reported in February 2018 that more than 115 Americans die every day from overdosing on opioids.1 Addiction to and misuse of opioids is a national public health crisis that affects not only patients but also their families and communities and our health system as a whole. Nurse educators respond quickly to societal health needs by integrating new content in curricula and developing learning activities to ensure students are prepared to address these needs in their future practice. Articles in this issue of Nurse Educator offer examples of how faculty integrated content on substance use in their programs. This content can no longer be addressed through a lecture in the mental health course or 1-time exposure somewhere else in the curriculum. Authors share how they carefully developed teaching strategies to build students' skills in screening, motivational interviewing, and intervening not only with patients but also with nurses with a substance use disorder.


Nurses and other health care professionals need to know how to screen for substance use in their clinical practice and what to do next. The screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice model for screening and intervening with patients using risky or harmful substances.2 Recognizing the need for nursing students to be competent in SBIRT, faculty evaluated various methods for integrating this content and development of skills in their nursing program. Some students had instruction in the classroom on SBIRT and on the continuum of substance use and addiction; they engaged in role play and practiced with standardized patients (SPs). Another group of students received their instruction on the same content via asynchronous, narrated slides. Those students also practiced their skills through role play and with SPs. A third group of students had a 4-hour, asynchronous online course, which included interactive activities. The 3 groups gained similar levels of knowledge of SBIRT and competencies. The teaching methods that provided active learning, though, were more effective in changing students' attitudes about their role in screening and intervening for substance use than the narrated slides group. Read the article by Knopf-Amelung et al2 and then share it with your faculty (the article is Open Access and can be distributed to other faculty in your school). Two of the key takeaways for me were that multiple teaching methods for learning this content were effective, providing flexibility for how you integrate it in your curriculum, and students need to practice these skills (learning about SBIRT in lecture is not enough).


In another article in this issue, Finnell et al3 provide the step-by-step approach they used to integrate substance use-related content into their prelicensure and master's programs. You will find this article helpful because this approach is adaptable to all program levels and types of curricula. In this school, the faculty decided to provide the content and learning activities via modules, which they carefully integrated in courses, beginning with an introduction to SBIRT, screening for substance use, and motivational interviewing in the health assessment course. Other modules were woven in clinical courses; medications for alcohol use, opioid use disorders, and overdose were added to the pharmacology course; and the use of SBIRT in students' future practice was incorporated in the final course in the curriculum. Another strength of this article is that the authors identify strategies to prepare faculty for this integration and share tools you can use in your own programs, such as an example of the crosswalk they did and pocket reference cards they developed for students.3


Issues with substance use are not only patient problems-this is a problem among nurses and other health care professionals. Nurses with a substance use issue place patients and their own health at risk. Stewart and Mueller4 outline their education strategy to improve nursing students' knowledge, skills, and attitudes about substance use disorder among nurses. They developed a module on key aspects of substance use disorder among nurses and added it to their prelicensure and master's programs for completion in the final year of the program. I think you will find this article valuable because the authors explain how they developed the module and selected the teaching methods, readings, and learning activities, which included videos and case studies and provided for active student learning.


Recognizing the importance of addressing the well-being of nurses in the prelicensure curriculum, Ashcraft and Gatto5 developed interventions for students to develop their self-care behaviors and integrated these in each level of their nursing curriculum. Self-care is a critical component of the role of the professional nurse, and students need to understand this and to develop their own healthy behaviors before they graduate. A healthy team in the workplace requires healthy individuals.6


As you integrate content and learning activities on substance use in your curriculum, make the most of this integration. Ask yourself: what other content is relevant? This issue marks the beginning of a new Department in Nurse Educator to share teaching strategies and ideas on integrating Quality and Safety Education for Nurses (QSEN) in your program and developing students' competencies. The QSEN competencies can be woven in easily with content and learning activities on substance use. Develop your role play, scenarios, and case studies with a situation in which students need to address patient- and family-centered care. To link to evidence-based practice, have students search for evidence to support the SBIRT model and write a short paper summarizing the evidence and resources used for the search. Show a video portraying a nurse or other health care providers with signs and symptoms of a substance use disorder and discuss options for reporting and intervening and the potential effects on patient safety. Weave in the concept of just culture. Practice strategies for screening, motivational interviewing, and intervening in role play and simulation. If you are using SPs, have students practice these skills with SPs who can give immediate feedback. Develop a simulation in which students work as a team in admitting a patient; screening, interviewing, and interacting with family members; and planning care including transition to home.


If you are thinking about adding or strengthening content on substance use in your curriculum, there is no need to look further: the articles in this issue map out content to include and share multiple strategies for integrating it across the curriculum. Be sure to add learning activities that allow students to practice skills more than once so they develop their competencies and confidence.




1. Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics. National Vital Statistics System, Mortality. Atlanta, GA: US Department of Health and Human Services, CDC; 2017. Available at [Context Link]


2. Knopf-Amelung S, Gotham H, Kuofie A, et al. Comparison of instructional methods for screening, brief intervention, and referral to treatment for substance use in nursing education. Nurse Educ. 2017;43(3):123-127. [Context Link]


3. Finnell DS, Savage CL, Hansen BR, et al. Integrating substance use content in an "overcrowded" nursing curriculum. Nurse Educ. 2017;43(3):128-131. [Context Link]


4. Stewart DM, Mueller CA. Substance use disorder among nurses: a curriculum improvement initiative. Nurse Educ. 2017;43(3):132-135. [Context Link]


5. Ashcraft PF, Gatto SL. Curricular interventions to promote self-care in prelicensure nursing students. Nurse Educ. 2017;43(3):140-144. [Context Link]


6. Richards K. Self-care is a lifelong journey. Nurs Econ. 2013;31(4):198-202. [Context Link]