This chapter considers social constructivism as an educational theory for the development of multimedia content to assist primary-care providers, particularly those in HIV clinics and other clinicians, and support staff involved in the care of patients with substance use disorders in better understanding the intake processes at the Methadone clinics. Main aspects of social constructivism with its focus on the collaborative and generative learning and the importance of a cultural and social context are elaborated within the framework of the multimedia design. A series of four videos were developed that feature interviews with patients who describe their experience on Methadone. In addition, medical providers and medical staff describe the intake procedures for Methadone. Also discussed is the instructional design process and the Bergman and Moore instructional design model that informed the design.
TopIntroduction
The COVID-19 pandemic resulted in increased drug use and overdose deaths, which escalated the demand for Methadone services (Holland et al., 2021). Most states witnessed large-scale increases, with the highest in West Virginia, Kentucky, and Tennessee (Friedman & Akre, 2021). The Connecticut Office of the Chief Medical Examiner reported 1,378 confirmed drug overdose deaths in 2020 in Connecticut, an increase of 14.3% compared to 2019. As of the second week of August, there were 878 confirmed drug overdose deaths in Connecticut in 2021 (Clinton, 2021).
Methadone is a full opioid agonist1 and the oldest of the medications used to treat opioid use disorder. It has been in use since 1972 (Cooper et al., 2020). Methadone controls cravings and prevents opioid withdrawal. It has been effective in reducing opioid use as well as the harms associated with opiate use disorders (OUD) such as fatal overdose, acquisition of HIV, and hepatitis C (HCV) infection. Additionally, Methadone has been linked to a reduction of incarceration rates and improving employment (Cooper et al., 2020). Other medications approved by the Food and Drug Administration (FDA) for opioid use disorder include buprenorphine and naltrexone (Cooper et al., 2020; Seval et al., 2020).2 All medications must be prescribed by licensed healthcare providers.
Given the opioid epidemic, the need to expand referrals to substance use disorder (SUD) clinics that are licensed to dispense Methadone for OUD prompted an examination of provider-identified gaps in knowledge. The synthesis of HIV, HCV, and opioid use disorders has raised questions surrounding improved collaboration between providers of HIV and OUD services. Specifically, providers of HIV clinical services were generally not co-located with providers of OUD services in Connecticut, leading to suboptimal bidirectional referrals.
As part of our grant-funded project to optimize the treatment of HCV for persons with HIV, improving communication between HIV and OUD providers who operated in siloed institutions became an important goal. During the project, it was identified that HIV providers and support personnel within HIV clinics lacked a full understanding of the processes surrounding Methadone treatment. Thus, the authors embarked on creating a series of videos to fill this gap.
The COVID-19 pandemic has had a major impact on traditional in-person teaching, assessment methods, student–teacher relationships, and student and teacher well-being leading the authors to choose video intervention as an instructional method (Smith & Boscak, 2021; Kaini & Motie, 2021; Wong, 2020). The pandemic accelerated the global use of online learning platforms (e-learning). Due to the disruption of health services and health education, many institutes that offer advanced degrees in medical education have shifted from in-person to virtual learning, using technologies such as artificial intelligence for adaptive learning, virtual reality, and e-learning (Dhawan, 2020; Peisachovich et al., 2020; Sandars et al., 2020). A recent call for a national, virtual, video-based curriculum for urology residents to design surgical skill training is a perfect illustration of those changes (Tabakin et al., 2021).
Health care conferences have also adapted quickly to the pandemic by shifting to e-learning. E-learning has redefined the standard presentation and poster formats, as organizers adapted to the needs of attendees who no longer could participate in person. Thus, multiple conference planning committees switched to virtual conference models or offered alternative formats such as pre-recorded sessions with live question forums. Currently, two years into the pandemic, hybrid sessions are still in place.