Stensland Meredith, Maples Natalie, Sanford Elizabeth, Martinez Melissa
Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas Health Science Center of San Antonio, 5788 Eckhert Rd, San Antonio, TX, 78240, USA.
BMC Med Educ. 2025 May 22;25(1):752. doi: 10.1186/s12909-025-07196-6.
Chronic pain is a major global public health concern, and racial minorities face significant challenges and inequity in receiving quality pain management. Implicit bias among healthcare providers contributes to these racial disparities. The purpose of this study was to develop, implement, and evaluate a brief online course, whereby the overall aim was to educate medical students about the reality of racial disparity in pain assessment and management, enhance empathy, and reduce implicit bias.
This study evaluated a 90-min self-paced online e-course using a 20-item pre-post test design with a 5-point Likert scale, and six course-specific evaluative items. Data were analyzed using t-tests. Demographic differences in learning outcomes were also examined.
A total of N = 605 medical students (age 25.5 ± 3.6 years; 55.7% female) participated in this study. In within-subject analyses, 19 of the 20 test items pertaining to the existence of racial disparities and implicit bias in pain care demonstrated significant increase in agreement following course completion (Ps < .001). Male students were more likely than female students to endorse factually incorrect statements (Ps < .05), just as Doctor of Osteopathic Medicine (DO) students were more likely than Doctor of Medicine (MD) students to endorse factually incorrect statements (Ps < .001). Racially diverse students agreed more strongly than white students that more time should be devoted to pain in medical education (P = 0.011).
Providing education to medical students about racial disparities and implicit bias in pain care is one approach to reducing disparities. This research underscores the need for more comprehensive and focused education on pain management and racial disparities within medical curricula to better prepare future physicians to deliver equitable care.
慢性疼痛是一个重大的全球公共卫生问题，少数族裔在获得高质量疼痛管理方面面临重大挑战和不平等。医疗服务提供者的隐性偏见导致了这些种族差异。本研究的目的是开发、实施和评估一门简短的在线课程，其总体目标是让医学生了解疼痛评估和管理中种族差异的现实情况，增强同理心，并减少隐性偏见。
本研究使用一个包含20个项目的前后测试设计，采用5点李克特量表以及六个课程特定的评估项目，对一门90分钟的自主学习在线电子课程进行评估。数据使用t检验进行分析。还检查了学习成果方面的人口统计学差异。
共有N = 605名医学生（年龄25.5±3.6岁；55.7%为女性）参与了本研究。在受试者内分析中，与疼痛护理中种族差异和隐性偏见存在相关的20个测试项目中的19个，在课程完成后，同意程度显著增加（P值<0.001）。男学生比女学生更有可能认可事实上错误的陈述（P值<0.05），同样，骨科医学博士（DO）学生比医学博士（MD）学生更有可能认可事实上错误的陈述（P值<0.001）。与白人学生相比，种族多样化的学生更强烈地认同在医学教育中应该为疼痛投入更多时间（P = 0.011）。
向医学生提供关于疼痛护理中种族差异和隐性偏见的教育是减少差异的一种方法。这项研究强调了在医学课程中需要对疼痛管理和种族差异进行更全面、更有针对性的教育，以便更好地让未来的医生做好提供公平护理的准备。
