Module 2 Pre-Test Substance Use Disorder and Patient Identification

PRE-TEST SURVEY

Please complete the following pre-test to help us assess your knowledge of the course material prior to completing this training session.

IMPORTANT!!
Once you complete the pre-test and FINISHED, you will be able to view your test results. After viewing your results, click DONE.

If you have difficulties completing this survey, please contact Amy Wales at amy.wales@miccsi.org.

Demographics

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* 1. Personal Information

First Name

Last Name

Credential

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* 2. Please choose your organization from the choices below:

Affinia Health Network-Lakeshore (Lakeshore Health Network)

Answer Health (WMPN/POWM)

Borgess Health/Ascension

Bronson Healthcare

Blue Cross Blue Shield of Michigan or Blue Care Network

CIPA

Covenant Healthcare

Genesys

Great Lakes Bay Health

Great Lakes PHO

Henry Ford Health System

Holland PHO

Huron Valley Physicians Association (HVPA)

IHA

Lakeland Care

McLaren Health

Mercy Health Physicians Partners-Grand Rapids

Munson Healthcare

Metro Health

Northern Physician Organization (NPO)

Priority Health

Spectrum Health

Thunder Bay Health Centers

University of Michigan

Upper Peninsula Health System

Wexford PHO

Other (please specify)

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* 3. Please list the name of your practice. If not applicable, type "N/A".

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* 4. Please choose your role in your practice:

Physician

Advanced practice provider (physician assistant, nurse practitioner, etc.)

Nurse care manager/care coordinator

Social worker care manager/behavioral health specialist

Pharmacist

Leadership

Other clinical (CMA, RMA, etc.)

Other non-clinical (support staff, etc.)

Other (please specify)

Pre-Training Confidence Assessment

Please use the following scale to answer questions 5 and 6.

1: Not confident at all
2: Slightly confident
3: Somewhat confident
4: Fairly confident
5: Completely confident

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* 5. On a scale of 1-5 please rate your confidence in managing substance use disorder.

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* 6. On a scale of 1-5 please rate your confidence in identifying patients with substance use disorder.

Pre-Training Knowledge Assessment

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* 7. Which of the following is NOT a component of office-based addiction treatment?

SUD screening

Opioid tapering

Initial provider assessment

Stabilization and maintenance

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* 8. What percentage of people 18-25 years of age are affected by substance use disorder?

< 5%

5-10%

10-20%

> 20%

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* 9. Which of the following is an example of a proactive approach to patient identification for substance use disorder?

Telephonic outreach to patients after an ED visit for an overdose

Universal annual screening

Outreach or in-person screening of patients defined as "high-risk"

Both B and C

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* 10. Which of the following are examples of screening tools for substance use disorder?

Single-question screen

DAST-10

NM ASSIST

All of the above