Resident Knowledge and Perception of Pain Management

Abstract

Chronic pain involves a complex mechanism that afflicts 50 million adults in the United States and incurs societal costs upwards of $560 billion annually. The consequences of this epidemic have resulted in an epidemic of its own, with the opioid crisis becoming a top priority in healthcare. Historically, the sub-optimal practices of overprescribing opioids and inadequate monitoring of iatrogenic addiction have contributed to this problem. If progress is to be made in this area, it is imperative that we examine how future physicians are being trained to manage pain. We examined internal medicine resident knowledge regarding pain as well as their satisfaction with medical school preparation in this regard using two surveys: The Knowledge and Attitudes Survey Regarding Pain (KASRP) and The Medical School Pain Curriculum Survey (MSPCS). Residents scored an overall 60.7% on the knowledge assessment survey, and less than 50% of respondents agreed that their medical school curriculum had prepared them sufficiently. This suggests that improvements can be made in medical school curricula regarding pain management education to better train physicians on how to manage pain, particularly in an era that demands expertise in this area.

A focus on the future of opioid prescribing: implementation of a virtual opioid and pain management module for medical students

“…According to the findings in our study, a case-based, interactive online educational module is an effective intervention for improving student knowledge, attitudes, and perceived competence regarding OPM concepts. Prior to our educational intervention, students reflected levels of uncertainty surrounding OP and PM concepts comparable to those observed in similar peer groups [ 11 , 12 ]. However, posttest results indicated overall student improvement in key knowledge areas such as opioid-sparing PM strategies (alternative medications, first-line treatments for specific pain types), opioid stewardship (PDMP utilization, proper opioid disposal), the opioid epidemic (prescriber contribution, opioid diversion, risk factors for opioid misuse), and appropriate opioid management and prescribing (recommended guidelines, opioid tapering, MME conversions, management of special populations).…”

“…Importantly, this inadequate preparation of medical students does not change at graduation, but rather traverses their transition into residency where knowledge deficits may have greater consequences. Garcia et al [ 11 ] administered a survey to assess opioid knowledge and medical school preparation to first-year internal medicine residents following orientation and found that residents scored an overall 60.7% on opioid knowledge concepts. Furthermore, less than 50% of these residents felt that their medical school curricula had sufficiently prepared them for managing patient pain, and 90% felt inadequately prepared to dose opioids for patients or understand state and federal OP requirements [ 11 ].…”

Perioperative Opioid Consumption and Clinical Outcomes in Surgical Patients With a Pre-existing Opioid-Based Intrathecal Drug Delivery System

“…This may reflect unfamiliarity of surgical, medical, and anesthesia care teams with effectively managing acute pain needs in chronic pain patients receiving intrathecal analgesics. 32,33 Nearly 40% of consultations were placed reflexively due to the presence of an IDDS. Remaining consults were placed for assistance in optimizing acute on chronic pain.…”

Impact of an Educational Intervention on the Opioid Knowledge and Prescribing Behaviors of Resident Physicians

“…Accordingly, residents across all medical disciplines are often underprepared to prescribe opioids for patient pain or respond to various opioid-related patient management scenarios [ 9 - 11 ]. The magnitude of this deficit is well-exemplified in a recent study surveying surgical residents at a large academic institution: 90% reported no formal training in best practices of pain management or opioid prescribing, despite reliance on opioids for postoperative pain management [ 11 ].…”