Durbhakula Shravani, Wang Tony Y, Segna Kara G, Limerick Gerard R, Broachwala Mustafa Y, Schatman Michael E, Zaidi Munfarid A, Siddarthan Ingharan James, Toy Serkan
Department of Anesthesiology, Division of Pain Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Pain Res. 2024 Mar 2;17:827-835. doi: 10.2147/JPR.S447671. eCollection 2024.
To examine the immediate effects of a comprehensive pain course on medical students' pre-existing perceptions and attitudes toward pain patients and opioid management.
First-year medical students at a major academic medical center enrolled in a required pre-clerkship pain course in June 2020 and completed pre- and post-course online surveys with Likert-scale questions about their attitudes toward pain management and opioid-related issues. Additionally, the surveys included a free-text question where the students listed the first five words that came to mind when hearing the word "opioids". These words were categorized as "professional" or "lay" words and further as having "positive", "negative", or "neutral" connotations. Data analyses included descriptive statistics, as well as non-parametric and parametric tests.
Fifty-four of the 119 students responded to pretest and posttest surveys and were included in paired analyses. There was a significant difference between the number of professional words used before (M=1.21, SD=0.97) and after the course (M=2.40 SD=1.33); t(52)=-6.39, <0.001. Students also used more lay-positive words after the course (M=0.81, SD=0.63) than they used pre-course (M=0.23, SD=0.43); t(51)=-5.98, <0.001. Students' post-course responses to several key Likert-scale questions showed significant shifts toward more positive attitudes about caring for patients with pain. For example, students acknowledged greater comfort in providing opioids for chronic pain (<0.001) where appropriate, and enhanced interest in handling complex pain cases (<0.001).
Results showed that a comprehensive, multi-disciplinary pain course could greatly enhance first-year medical students' attitudes toward pain management, chronic pain patients, and the complex issues surrounding opioids.
研究一门综合性疼痛课程对医学生对疼痛患者的既有认知以及对阿片类药物管理的态度的即时影响。
一所主要学术医疗中心的一年级医学生于2020年6月参加了一门必修的临床前疼痛课程,并完成了课程前后的在线调查,调查采用李克特量表问题,询问他们对疼痛管理和阿片类药物相关问题的态度。此外,调查还包括一个自由文本问题,要求学生列出听到“阿片类药物”这个词时首先想到的五个词。这些词被分类为“专业”或“外行”词汇,并进一步分为具有“积极”、“消极”或“中性”含义。数据分析包括描述性统计以及非参数和参数检验。
119名学生中有54名对课前和课后调查做出了回应,并被纳入配对分析。课程前使用的专业词汇数量(M=1.21,标准差=0.97)与课程后(M=2.40,标准差=1.33)存在显著差异;t(52)=-6.39,<0.001。课程后学生使用的外行积极词汇(M=0.81,标准差=0.63)也比课程前(M=0.23,标准差=0.43)更多;t(51)=-5.98,<0.001。学生在课程后的几个关键李克特量表问题上的回答显示,他们对照顾疼痛患者的态度明显转向更积极。例如,学生们承认在适当情况下为慢性疼痛患者提供阿片类药物时更自在(<0.001),并且对处理复杂疼痛病例的兴趣增强(<0.001)。
结果表明,一门综合性、多学科的疼痛课程可以极大地提升一年级医学生对疼痛管理、慢性疼痛患者以及围绕阿片类药物的复杂问题的态度。