Purpose: Our United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. Unfortunately, medical school curriculum material designated to prepare students for opioid prescribing and pain management is often underdeveloped in the context of crisis severity due to a lack of adequately trained faculty with the expertise and subsequent ability to assess students on content delivery. An additional challenge is the lack of standardization in content delivery between medical schools which burdens residency programs with addressing educational gaps. In response to this curriculum deficit, the authors of this study aimed to investigate the impact of an online educational intervention targeting fourth-year medical student knowledge, attitudes, and perceived competency of opioid prescribing and pain management.
Methods: Graduating students completing their final year of medical education at Sidney Kimmel Medical College of Thomas Jefferson University and intending to begin training at a residency program in 2021 were sent an e-mail invitation to complete an online opioid and pain management module built on a virtual educational platform. The final module consisted of eight interactive patient cases and encompassed a wide range of fundamental opioid and pain management topics. Educational topics were introduced through a case-based learning system, challenging students to make decisions and answer knowledge questions about the patient care management process. To promote reinforcement of learning objectives and practice applying new concepts to patient management, patient cases were designed sequentially with key concepts repeated throughout the module. An identical pre- and posttest utilizing Likert scale responses were built into the module to measure general and case-specific learning objectives. A modified Perceived Competence Scale (PCS) was included in the survey design to assess changes in student perceived competency. Pre- and posttest paired student responses were 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 at a p < 0.05 level of statistical significance. 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 PCS metrics on opioid management specifically, perceived student confidence, capability and ability increased from “disagree” (2) to “agree” (4) (p < 0.001), and student ability to meet the challenge increased from “neither agree nor disagree” (3) to “agree” (4) (p < 0.001). Additionally, while 77% of students reported receiving opioid prescribing training in medical school, 21% reported no prior history of training.
Conclusion: Implementation of a virtual, interactive module with clinical context is an effective intervention for improving the opioid and pain management knowledge, attitudes, and perceived competency of fourth-year medical students. Given the identified deficit of these concepts in medical school curricula and the severity of the U.S. opioid epidemic, this method may be an important vehicle for disseminating a generalized resource to augment existing medical school curricula and standardize student exposure to opioid prescribing.
Adalbert, Jenna, "The Future of Opioid Prescribing: Implementation of a Virtual Opioid & Pain Management Module for Medical Students" (2021). Master of Public Health Capstone Presentations. Presentation 367.