With the United States in a public health crisis related to opioid addiction and abuse,1 health care providers must be educated to care for those entering the health care system with this disorder. To educate nursing students to care for those with an addiction to opioids, a multicomponent interactive learning experience (MILE) was developed to improve nursing care delivered to people with a substance use disorder (SUD) and co-occurring disorder. Following the MILE, a formative evaluation was conducted, and results are described. The MILE included 3 components: a lecture; a simulation using a standardized patient, which was created in collaboration with a nationally recognized simulation expert, someone with a former SUD, and a professional nurse with current experience working with those with a SUD; and an interactive session with 2 peer recovery specialists (PRSs). The session with the PRSs is described in this department.

Peer recovery specialists are people with "2 years of lived experience in the guiding principles of recovery."2 They are people with a former SUD or co-occurring disorder who have had success in recovery and have received special training so they can guide others toward recovery. Peer recovery specialists bring a unique perspective to the team working with those with a SUD; because of their own experiences, they can offer hope and role model recovery.3

Before the initiation of this program, it was recognized that there was a need to expand the exposure of nursing students to treatment and recovery, specific to SUDs and co-occurring disorders. Faculty partnered with a large behavioral health care organization that provided a significant number of services dedicated to alcohol and substance abuse and recovery. This agency provided PRSs who were interested in partnering with faculty on this project. The agency carefully selected 2 PRSs who were comfortable speaking in front of large groups and believed they could manage questions from prelicensure nursing students. While integrating SUD education into nursing curricula has been described in the literature,4-6 none have included the use of PRSs.

Objectives of the PRS component of the MILE included to (a) identify the role of the PRS as a member of the health care team, (b) develop an understanding of the lived experience of someone with a SUD, (c) develop an awareness of one's unconscious biases, (d) identify myths and misconceptions about treatment and recovery, and (e) develop an understanding of the principles of co-occurring disorders. Objectives were shared with the PRSs before the session. The PRSs were accompanied by a registered nurse (RN) from the facility who answered questions that were within the RN's scope of practice, which tended to be more clinical in nature. The session lasted nearly 3 hours, which included a question-and-answer session of approximately 60 minutes.

Evaluation

Six weeks after the presentation, a 3-question survey was distributed to attendees (n = 63). The survey contained 2 open-ended questions, and the third question asked them to rank components of the MILE in terms of impact on their confidence in providing nursing care to the client with a SUD or cooccurring disorders. The first open-ended question was "Describe your experience of the PRSs presentation," and the second one was "Explain how the PRSs presentation impacted your knowledge, skills, and attitudes toward treating clients with a SUD or co-occurring disorder." The third question asked participants to rank order the impact of the components of the MILE as they relate to their perceived ability to work with those with SUD.

The project had institutional review board approval from the authors' university. Data were organized using NVivo 12. A descriptive thematic analysis was conducted to identify recurring words, phrases, or concepts, which were further analyzed to determine themes related to the participant perspective of the session with the PRSs. The authors initially worked separately, but then together to resolve differences and develop the final themes.

The themes that emerged from the data included the following: interest, learning, communication skills, and attitude/perspective change. The presentation by the PRSs piqued the interest of the students as the speakers were charismatic and honest about their experience: "Hearing the raw, personal stories of the guest speakers really piqued my interest, and in retrospect, I feel the information they shared was more impactful and will stay with me more because of how it was delivered." The most frequently used term was "eye-opening." One aspect that made it eye-opening was that the PRSs communicated that a person with a SUD could be anyone. Participants often reflected on this statement that someone with a SUD was not very different from the students, but circumstances, environment, and life experiences varied and ability to cope with adversity.

When students described their learning, they used phrases such as "strengthened my knowledge." As 1 participant noted, "The presentation impacted my knowledge in terms of the process of rehabilitation and what recovering abusers can expect to go through after they have control over their disorder." Many participants indicated this was the first time they interacted with a person in recovery and through this experience learned how a SUD affected the individual as well as the people in their lives. Students learned about the role of a PRS as part of the health care team, resources, that recovery is a process and not an endpoint, and the possibility of transformation. One participant captured the sentiment that the talk was informative with the following quote: "I think that the discussions prompted throughout this presentation were respectful and candid, which allowed everyone to gain new insight and understanding of addiction."

Participants described the presentation as being helpful in terms of improving their ability to communicate with someone with a SUD. They reported an enhanced ability to approach and communicate with people with substance use and co-occurring disorders. Students also described how the experience changed their attitude and perspective toward people with a SUD, increasing their compassion and empathy. Hearing from PRSs allowed students to gain insight into having a SUD and to view the PRS as a resource for their future care of patients with SUD. One participant wrote, "A presentation like this truly humanizes the concept of addiction and SUD when such disorders are so heavily stigmatized."

Discussion

The most noteworthy finding from the survey was that interacting with PRSs led students to learn "real-world" strategies to help those they are likely to encounter in their practice. It is recommended to include PRSs in the nursing curriculum and to strategically schedule a learning experience such as this one before students have clinical experiences with patients with a SUD. A formal debrief after the interaction with the PRS would be helpful to allow students to freely discuss what they heard, seek clarification from their instructor, and have a full understanding of how to work with those with a SUD.

Many participants described this experience as inspirational and one stated "hearing that it took him [the PRS] many years to achieve sobriety makes me not want to give up on my patients." Comments like this show the worth of the presentation and support the work of faculty to bring this experience to the students. Including PRSs in nursing education can increase awareness, spark interest, address preconceptions and biases, and ultimately improve patient outcomes. Having thoughtful, well-educated nurses caring for those with a SUD is important as the country moves forward toward helping those with a SUD recover.

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