Table 5.

Challenges lesson learned, and suggestions for future learning collaborative.

Challenge/lesson learned	Suggestions for future LCs
Developing didactics for a highly heterogeneous audience with varied roles, backgrounds, and training levels	• Minimize medical and psychological jargon • Define all key or unfamiliar terms explicitly • Identify a point person familiar with the audience to review content and guide presenters • Include an introductory session to co-occurring disorders and integrated care concepts • Emphasize concrete, actionable take-home strategies usable across scopes of care • Include both pharmacological and non-pharmacological interventions in each session
Value of shared, peer-based learning that was strengthened by diverse professional backgrounds and lived experience	• Intentionally recruit a diverse group of attendees and presenters • Encourage multidisciplinary participation to support nuanced case discussions • Allocate substantial time for discussion (e.g., at least 50% of each session) in addition to didactics
Community case presentations were a strength, but securing case presenters was difficult	• Engage potential case presenters early in planning • Identify cases first and then tailor didactic topics around them • Encourage team-based case presentations to reduce individual burden • Offer additional support (e.g., practice sessions, slide review) for first-time presenters • Prioritize community presenters, when possible, but continue to include case examples from specialists/didactic presenters when needed
High clinical complexity of patients with OUD and co-occurring mental health conditions	• Address the intersection of addiction, serious mental illness, and structural barriers • Focus on simple, low-resource, immediately actionable strategies (e.g., de-escalation scripts, brief breathing techniques) • Emphasize evidence-based approaches that can be learned quickly and implemented immediately • Include sessions explicitly targeting severe mental health issues and crisis management
Challenges integrating racial and social justice equity within brief sessions	• Provide clear guidance to presenters to include disparities, demographics, and context • Add dedicated sessions focused on racial and social justice equity as part of an ongoing LC series (e.g., housing instability, LGBTQI populations, and other structural determinants of health)