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Pain Management Practices by Internal Medicine Residents—A Comparison Before and After Educational and Institutional Interventions

Albert Einstein Medical Center, emma.c.scott{at}gmail.com

Uma Borate, MD

Albert Einstein Medical Center

Stephen Heitner, MD

Albert Einstein Medical Center

Mark Chaitowitz, MD

Thomas Jefferson University Hospital Philadelphia, Pennsylvania

William Tester, MD, FACP

Albert Einstein Medical Center

Glenn Eiger, MD, FACP

Albert Einstein Medical Center

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.

Key Words: pain management • resident education • hospital standards • opioid conversion • opiophobia

This version was published on January 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 6, 431-439 (2009)
DOI: 10.1177/1049909108320884


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