Pediatric Pain Management: Tools for Resident Education

MacDonell-Yilmaz, Rebecca E.; Anderson, Angela

doi:10.1016/j.acap.2018.04.071

Cited by 2 publications

(4 citation statements)

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“…These barriers were identified through thematic analysis of an earlier survey of pediatrics residents and included misuse, challenges related to dosing and prescribing, side effects, stigma, and difficulty differentiating between physical and emotional pain. 25 Given the evidence that religious beliefs can impact individuals' attitudes regarding pain management and providers' decisions in the setting of serious illness, 26,27 participants were asked to what extent their religious faith impacts their decisions. This question was taken from the Santa Clara Strength of Religious Faith questionnaire, which has been validated in multiple settings.…”

Section: Survey Design (See Appendix S1)mentioning

confidence: 99%

“…Responses were recorded on a 5-point Likert-type scale and categorized into three groups for analysis: comfortable (scores of 1-2), neutral (scores of 3), and uncomfortable (scores of 4-5). The objective knowledge questions have undergone pilot testing, including content validation based on relevance to PHOtrainees as evaluated by a panel of experts in the field, and internal reliability testing, the details of which are reported elsewhere 25.…”

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confidence: 99%

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Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

MacDonell-Yilmaz

Murillo

Panicker

et al. 2020

Pediatric Blood & Cancer

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Background Deficits in knowledge and comfort related to pain management have been demonstrated in adult hematology/oncology fellows. No such evaluation has been undertaken in pediatric hematology/oncology (PHO) trainees. Procedure An IRB‐approved survey was administered to PHO fellows throughout the United States (US) to assess comfort with opioid dosing, attitudes related to the use of opioids, and knowledge of basic concepts including weight‐based dosing, incomplete cross‐tolerance, and management of side effects. Results Email addresses were obtained for 132 fellows from 37 programs. Seventy‐eight (59%) fellows participated. No significant difference was demonstrated between training level and comfort with dosing opioids in an opioid‐naive patient, though a smaller proportion of first‐year fellows (65%) reported comfort compared to more senior fellows (85.2% of second‐year fellows, 80.6% of third‐ and fourth‐year fellows). First‐year fellows correctly answered a mean of 5.05 ± 0.43 out of 10 objective knowledge questions; second‐year fellows answered 5.74 ± 0.35 correctly, and third‐ and fourth‐year fellows 5.58 ± 0.30. The majority of respondents chose an appropriate dose of intravenous morphine based on weight (92%), and identified a low‐dose naloxone drip as an appropriate intervention for opioid‐induced pruritis (91%). However, the remainder of the questions had a correct response rate of 15‐68%. Conclusion This study characterizes PHO fellows’ knowledge and comfort with prescribing opioids. Despite high levels of reported comfort, PHO fellows in all levels of training demonstrated knowledge gaps. PHO fellows may benefit from further education in pain management.

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Section: Survey Design (See Appendix S1)mentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

MacDonell-Yilmaz

Murillo

Panicker

et al. 2020

Pediatric Blood & Cancer

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“…Pilot testing among pediatrics residents at a single institution showed promise, with a statistically significant increase in objective knowledge and an increase in reported comfort immediately following exposure to the tool compared to pre‐exposure 21 . We subsequently modified PedOASIS to focus on PHO‐specific scenarios then completed validation and reliability testing, which guided further revisions 19 .…”

Section: Methodsmentioning

confidence: 99%

“…to the tool compared to pre-exposure. 21 We subsequently modified PedOASIS to focus on PHO-specific scenarios then completed validation and reliability testing, which guided further revisions. 19 The final product contained 10 case-based, single-best-answer multiplechoice questions.…”

Section: Interventionmentioning

confidence: 99%

A randomized controlled trial to examine the effect of the Pediatric Opioid Analgesia Self‐Instruction System (PedOASIS) tool on pediatric hematology/oncology trainee education

MacDonell-Yilmaz

Murillo

Welch

2023

Pediatric Blood & Cancer

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Background: Many children with hematologic and oncologic diagnoses require opioids for management of pain, yet knowledge gaps persist among pediatric hematology/oncology (PHO) fellows.Objective: Pediatric Opioid Analgesia Self-Instruction System (PedOASIS) is an interactive, case-based education tool designed for independent learning. The goal of this study was to evaluate its efficacy in increasing PHO fellows' knowledge and comfort with using opioids to manage pain.Design/method: PHO fellows were recruited from 74 American College of Graduate Medical Education-accredited US programs during the 2019-2020 academic year and randomized to receive access to PedOASIS (intervention) or usual PHO training (control). Surveys at baseline, immediately after accessing the tool, and 6 months later assessed knowledge and comfort related to prescribing opioids.Results: A total of 64 PHO fellows completed the study, with 32 in the intervention group and 32 controls. At baseline, mean scores on the 10-question knowledge assessment were similar between groups (intervention: 5, control: 6; p = .8). Following intervention, mean score was significantly higher in the intervention group (9) versus controls (5; p < .0001). Six months later, scores in both groups decreased but remained significantly higher in the intervention group (7) compared to controls (5, p < .0001) and compared to baseline (p = .0002). Fellows in the intervention group reported significant increases in comfort dosing opioids after exposure to the tool (p = .02). Conclusion:PHO fellows exposed to the tool had improved scores on validated knowledge questions and greater comfort using opioids for pain management compared to controls. We therefore suggest that PedOASIS warrants further evaluation as a potential tool for PHO fellows.

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Pediatric Pain Management: Tools for Resident Education

Cited by 2 publications

References 0 publications

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows

A randomized controlled trial to examine the effect of the Pediatric Opioid Analgesia Self‐Instruction System (PedOASIS) tool on pediatric hematology/oncology trainee education

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