Abstract ID 20961

Poster Board 599

Introduction: Despite national directives to improve pain, opioid, and analgesic pharmacology healthcare education to manage pain without promoting addiction, deficiencies persist in healthcare curricula in integrating educational activities with diverse patients. Given biases and misconceptions related to pain and analgesia hamper effective pain management and harm outcomes, improvements in medical education at all levels are essential. The purpose of this abstract is to present data from our undergraduate medical curriculum evaluating medical student misconceptions, biases, and perceptions on the effectiveness of integration of diversity topics into their opioid/analgesic education. Our goal in analyzing outcomes is to inform curriculum improvement in pharmacology/therapeutics education at our institution and others.

Methods: A Likert survey (anchored where 5=strongly agree to 1=strongly disagree) was developed with themes of Biases/misconceptions on pain/analgesia (B-M) and Educational activities in diverse populations (Ed-Dp). Three medical student cohorts were invited to participate: E-M2: N=34 emerging second-year (M2); E-M3: N=27 emerging clerkship; E-M4: N=26 emerging fourth-year. Anti-inflammatory analgesics were covered in medical school year one (M1) while opioids, antidepressants, anticonvulsants, drugs of abuse, substance use disorder, and pain diagnosis/management were all covered toward the end of M2 and integrated throughout M3. E-M2 served as a baseline (novice cohort) for comparison given their limited exposure to structured analgesic content.

Results: Mean Likert scores were used in statistical comparisons; % were reported for descriptive purposes. For B-M, 94%(E-M2), 89%(E-M3), 85%(E-M4) recognized poor pain management increases suicide risk; E-M2 (94%) were more likely to identify biases in minority pain treatment then E-M3 (70%) or E-M4 (81%); Gender biases were evident: 29%(E-M2), 46%(E-M3), 42%(E-M4) misbelieved that females exaggerate pain more than males; Age-related misconceptions/biases were evident in all cohorts for geriatric patients. E-M2 scored lower than E-M3 and E-M4 in non-opioid analgesic pharmacology knowledge (E-M2 vs E-M3 or e-M4, p< 0.01 by Student’s t-test of mean Likert scores). For (Ed-Dp), E-M3 (69%) and E-M4 (61%) rated general opioids/analgesia diversity significantly higher (p<0.001) than E-M2 (4%). All cohorts perceived education in geriatric pain and prescribing biases were insufficient.

Conclusions: Students perceived M2/M3 curricula were successful in general analgesic/opioid pharmacology education and better in comparison with M1 but about 40% of E-M3 and E-M4 felt it was insufficient in addressing diversity and biases. Most cohorts understood the need for effective pain management and identified concerns with poor pain management and opioid prescribing in underrepresented minorities. However, large percentages in all cohorts demonstrated gender biases and age biases which negatively impact pain management in these groups. Most perceived that more education in diverse patients was essential and many noted insufficient experiences with geriatric cases. Thus, our data support our previous data showing insufficient diversity in substance use disorders education and confirm national findings that much improvement is needed in integrating biases and diverse patient experiences into opioid/analgesia pharmacology, and pain management curricula.