BACKGROUND: Internal medicine residents care for a sizable number of patients with chronic pain. Programs need educational strategies to promote safe opioid prescribing. OBJECTIVE: To describe a safe opioid prescribing education program utilizing an objective structured clinical examination (OSCE) and report the resulting impact on residents' knowledge, confidence, and self-reported practices. METHODS: Using a quasi-experimental design, 39 internal medicine residents from an urban academic medical center were assigned to 1 of 4 groups: 1-hour lecture only, lecture followed by immediate OSCE, lecture followed by 4-month delayed OSCE, and control. Safe opioid prescribing knowledge, confidence, and self-reported practices were assessed at baseline and at 8 months. RESULTS: At 8 months, knowledge, confidence, and self-reported practices improved in the control and in all 3 intervention groups. The immediate OSCE group had the greatest improvements in combined confidence scores within group (0.74, P = .01) compared to controls (0.52, P = .05), using a 5-point scale. This group also had the greatest improvement in self-reported practice changes (1.04, P = .04), while other groups showed nonsignificant improvements-delayed OSCE (0.43, P = .44), lecture only (0.66, P = .24), and control (0.43, P = .19). CONCLUSIONS: Safe opioid prescribing education that includes a lecture immediately followed by an OSCE had an impact on residents' confidence and self-reported practices greater than those for delayed OSCE or lecture only groups. There was no difference in knowledge improvement among the groups. Lecture followed by an OSCE was highly regarded by residents, but required additional resources.
RCT Entities:
BACKGROUND: Internal medicine residents care for a sizable number of patients with chronic pain. Programs need educational strategies to promote safe opioid prescribing. OBJECTIVE: To describe a safe opioid prescribing education program utilizing an objective structured clinical examination (OSCE) and report the resulting impact on residents' knowledge, confidence, and self-reported practices. METHODS: Using a quasi-experimental design, 39 internal medicine residents from an urban academic medical center were assigned to 1 of 4 groups: 1-hour lecture only, lecture followed by immediate OSCE, lecture followed by 4-month delayed OSCE, and control. Safe opioid prescribing knowledge, confidence, and self-reported practices were assessed at baseline and at 8 months. RESULTS: At 8 months, knowledge, confidence, and self-reported practices improved in the control and in all 3 intervention groups. The immediate OSCE group had the greatest improvements in combined confidence scores within group (0.74, P = .01) compared to controls (0.52, P = .05), using a 5-point scale. This group also had the greatest improvement in self-reported practice changes (1.04, P = .04), while other groups showed nonsignificant improvements-delayed OSCE (0.43, P = .44), lecture only (0.66, P = .24), and control (0.43, P = .19). CONCLUSIONS: Safe opioid prescribing education that includes a lecture immediately followed by an OSCE had an impact on residents' confidence and self-reported practices greater than those for delayed OSCE or lecture only groups. There was no difference in knowledge improvement among the groups. Lecture followed by an OSCE was highly regarded by residents, but required additional resources.
Authors: Matthew Daubresse; Hsien-Yen Chang; Yuping Yu; Shilpa Viswanathan; Nilay D Shah; Randall S Stafford; Stefan P Kruszewski; G Caleb Alexander Journal: Med Care Date: 2013-10 Impact factor: 2.983
Authors: Teryl K Nuckols; Laura Anderson; Ioana Popescu; Allison L Diamant; Brian Doyle; Paul Di Capua; Roger Chou Journal: Ann Intern Med Date: 2014-01-07 Impact factor: 25.391
Authors: Sharon J Parish; Megha Ramaswamy; Melissa R Stein; Elizabeth K Kachur; Julia H Arnsten Journal: J Gen Intern Med Date: 2006-05 Impact factor: 5.128
Authors: Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski Journal: J Pain Date: 2009-02 Impact factor: 5.820
Authors: Christopher J Coyne; Cielito C Reyes-Gibby; Danielle D Durham; Beau Abar; David Adler; Aveh Bastani; Steven L Bernstein; Christopher W Baugh; Jason J Bischof; Corita R Grudzen; Daniel J Henning; Matthew F Hudson; Adam Klotz; Gary H Lyman; Troy E Madsen; Daniel J Pallin; Juan Felipe Rico; Richard J Ryan; Nathan I Shapiro; Robert Swor; Charles R Thomas; Arvind Venkat; Jason Wilson; Sai-Ching Jim Yeung; Jeffrey M Caterino Journal: Support Care Cancer Date: 2021-01-22 Impact factor: 3.603
Authors: Marissa S Heirich; Lanja S Sinjary; Maisa S Ziadni; Sandra Sacks; Alexandra S Buchanan; Sean C Mackey; Jordan L Newmark Journal: Pain Med Date: 2019-03-01 Impact factor: 3.750
Authors: Payel Roy; Angela H Jackson; Jeffrey Baxter; Belle Brett; Michael Winter; Ilana Hardesty; Daniel P Alford Journal: Pain Med Date: 2019-04-01 Impact factor: 3.750
Authors: Daniel P Alford; Brittany L Carney; Angela H Jackson; Belle Brett; Carly Bridden; Michael Winter; Jeffrey H Samet Journal: Subst Abus Date: 2018-04-05 Impact factor: 3.716
Authors: Roberto Cardarelli; William Elder; Sarah Weatherford; Karen L Roper; Dana King; Charlotte Workman; Kathryn Stewart; Chong Kim; William Betz Journal: J Interprof Care Date: 2018-03-30 Impact factor: 2.338