title: Pain management practices by internal medicine residents--a comparison before and after educational and institutional interventions.
abstract: We aimed to improve internal medicine residents' deficiencies in pain management and evaluate the effectiveness of our intervention, which included an interactive conference series, e-mail vignettes, and didactic sessions. An anonymous survey was administered at the beginning and at the end of an academic year, before and after the intervention, respectively. We analyzed 65 preintervention and 63 postintervention surveys. Self-perception of competency in pain management increased from 40% to 60% (P = .02). Perception of adequacy of training increased from 38.5% to 55.6% (P = .05). Opioid conversion skills improved by 25% (P = .02). Overall, knowledge did not change significantly, except in the subgroup of residents who had completed the oncology rotation from 0.60 to 0.72 (P = .003). "Opiophobia'' improved by 20% (P = .05). Documentation of pain improved (rank correlation = 21; P = .02). We concluded that educational and institutional interventions administered over an academic year improved pain management skills and documentation and reduced "opiophobia'' among residents.
authors.affiliation: Department of Medicine, Albert Einstein Medical Center, 5501 Old York Rd., Philadelphia, PA 19147, USA. emma.c.scott@gmail.com
authors.forename: Emma
authors.initials: E
authors.lastname: Scott
authors.forename: Uma
authors.initials: U
authors.lastname: Borate
authors.forename: Stephen
authors.initials: S
authors.lastname: Heitner
authors.forename: Mark
authors.initials: M
authors.lastname: Chaitowitz
authors.forename: William
authors.initials: W
authors.lastname: Tester
authors.forename: Glenn
authors.initials: G
authors.lastname: Eiger
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D004282:Documentation / Q000592:standards; D004521:Educational Measurement; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology; D010146:Pain / Q000175:diagnosis; D059408:Pain Management; D010147:Pain Measurement; D018579:Patient Selection; D015143:Philadelphia; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D015397:Program Evaluation; D020377:Self Efficacy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid