Abstract
BackgroundThe United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. While the next generation of prescribers is crucial to the trajectory of the epidemic, medical school curricula designated to prepare students for opioid prescribing (OP) and pain management is often underdeveloped. In response to this deficit, we aimed to investigate the impact of an online opioid and pain management (OPM) educational intervention on fourth-year medical student knowledge, attitudes, and perceived competence.MethodsGraduating students completing their final year of medical education at Sidney Kimmel Medical College of Thomas Jefferson University were sent an e-mail invitation to complete a virtual OPM module. The module consisted of eight interactive patient cases that introduced topics through a case-based learning system, challenging students to make decisions and answer knowledge questions about the patient care process. An identical pre- and posttest were built into the module to measure general and case-specific learning objectives, with responses subsequently analyzed using the Wilcoxon matched-pairs signed-rank test.ResultsForty-three students (19% response rate) completed the module. All median posttest responses ranked significantly higher than paired median pretest responses (p < 0.05). Comparing the paired overall student baseline score to module completion, median posttest ranks (Mdn = 206, IQR = 25) were significantly higher than median pretest ranks (Mdn = 150, IQR = 24) (p < 0.001). Regarding paired median Perceived Competence Scale metrics specifically, perceived student confidence, capability, and ability in opioid management increased from “disagree” (2) to “agree” (4) (p < 0.001), and student ability to meet the challenge of opioid management increased from “neither agree nor disagree” (3) to “agree” (4) (p < 0.001). Additionally, while 77% of students reported receiving OP training in medical school, 21% reported no history of prior training.ConclusionImplementation of a virtual, interactive module with clinical context is an effective framework for improving the OPM knowledge, attitudes, and perceived competence of fourth-year medical students. This type of intervention may be an important method for standardizing and augmenting the education of future prescribers across multiple institutions.
Highlights
The United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing
We instructed students to select all sources of opioid prescribing (OP) training prior to their completion of the educational module: 33 (77%) reported that training was received in medical school, 16 (37%) reported exposure through personal reading, 13 (30%) reported experience through extracurriculars, 4 (9%) reported exposure through “other” sources, 1 (2%) reported experiences during undergraduate education, and 9 (21%) reported no history of any type of formal training
All median posttest responses ranked significantly higher than paired median pretest responses at a p < 0.05 level of statistical significance, demonstrating improvement in student knowledge and attitudes for each general and case-specific learning objective
Summary
The United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. While the generation of prescribers is crucial to the trajectory of the epidemic, medical school curricula designated to prepare students for opioid prescribing (OP) and pain management is often underdeveloped. The response of medical schools in adapting curricula to train medical students has been underwhelming in the context of the crisis severity, limited by a lack of standardized curricula and adequately trained faculty to teach and assess learning surrounding these concepts [4, 6] Given this identified deficit in preparing medical students for their impending role as prescribers, creating a resource to address gaps in opioid and pain management (OPM) knowledge is an educational imperative
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