Document Type


Publication Date



This article is the author’s final published version in BMC Medical Education, Volume 22, Issue 1, January 2022, Article number 18.

The published version is available at Copyright © Adalbert and Ilyas.

Publication made possible in part by support from the Jefferson Open Access Fund


Background: The 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.

Methods: Graduating 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.

Results: Forty-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.

Conclusion: Implementation 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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.



Included in

Public Health Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.