The Perceptions and Attitudes of Medical Students toward Opioid Education: a Qualitative Research Study Restricted; Files Only
Luciano, Angelina (Spring 2023)
Abstract
Background: A major contributing factor of the opioid epidemic has been the inappropriate, over-prescribing of opioids, resulting in increased occurrences of opioid use, overdoses, and deaths. Some studies suggest that the quality and content of medical school education may affect future opioid prescribing behaviors, and there is a lack of standardization in opioid education instructed throughout medical schools. It is crucial to recognize and explore how aspects of opioid education during medical school may influence opioid prescribing behaviors as medical students graduate and become practicing medical providers.
Objective: The goal of this qualitative study was to explore the perceptions and attitudes of medical students regarding the opioid education they have received while in medical school.
Methods: Medical students were recruited using purposive and snowball sampling strategies to participate in focus groups to discuss their insights and experiences surrounding the opioid education they have received at their respective institution. Three focus groups, with four participants each, were conducted on themes surrounding perceptions and attitudes toward opioids, opioid education, and factors surrounding opioid prescribing. Thematic analysis was used to code and analyze the data in MAXQDA.
Results: Participants in the study emphasized the importance of approaching opioid use with both scientific and humanistic perspectives. Participants reported learning about the pharmacology and side effects of opioids during preclinical semesters and observing their use for pain management in patients during their clinical education . However, participants felt that the quality and quantity of opioid education was lacking in both preclinical and clinical education. Despite concerns about future opioid prescribing, participants expected to receive further education during their training in residency. Overall, the education they received allowed them to understand the various factors affecting opioid prescribing spanning across the socioecological model, from medical providers’ implicit biases to the infrastructure surrounding opioid prescribing in the U.S.
Conclusion: Variations in the quality and types of opioid education encountered during medical school were expressed throughout the focus groups. Increasing the quality of opioid education and standardizing it throughout U.S. medical schools may assist in optimizing opioid prescribing behaviors and reducing the risk of adverse patient outcomes from opioid prescribing.
Table of Contents
CHAPTER 1: INTRODUCTION 1
Introduction and Rationale 1
Problem Statement 2
Theoretical Framework 3
Purpose Statement 3
Research Question 4
Significance Statement 4
Definition of Terms 6
CHAPTER 2: LITERATURE REVIEW 7
Introduction 7
The Emergence of the Opioid Epidemic 7
Consequences of the Opioid Epidemic 10
Opioid Use Disorder and Opioid Overdose 12
Historic and Current Health Equity Trends 13
Health Equity Implications 15
Medical Provider Factors that Drive Opioid Prescribing Variation 18
Medical School Opioid Education during the Opioid Epidemic 22
Opioid Concerns of Medical Students 24
A Discussion of the Theoretical Framework 26
Summary of the Current Problem and Study Relevance 29
POSITIONALITY STATEMENT 31
CHAPTER 3: METHODOLOGY 32
Introduction 32
Population and Sample 32
Procedures 33
Sampling and Recruitment 33
Data Collection 36
Data Coding and Analysis Plan 36
Thematic Analysis 37
Ethics 38
CHAPTER 4: RESULTS 39
Introduction 39
Key Findings 39
Demographics 39
Code Frequency 40
Perceptions and Attitudes toward Opioids 44
I. Changes in Perceptions and Attitudes of Opioids Before versus During Medical School 44
II. The Opioid Prescribing and Pain Management Balancing Act 48
Insight on Opioid Education during Medical School 50
I. Knowledge and Experiences Developed during Preclinical Semesters 50
II. Knowledge and Experiences Developed during Clinical Semesters 53
III. Types and Quality of Support Systems 56
Future Opioid Prescribing 60
I. Current Perceived Preparedness for Future Prescribing 60
II. Anticipated Hesitations, Barriers, and Gaps in Knowledge for Future Practice 61
III. Perceived Factors that Influence Opioid Prescribing 66
IV. Future Hopes about the Opioid Epidemic 70
Summary of Findings 71
CHAPTER 5: DISCUSSION, IMPLICATIONS, AND RECOMMENDATIONS 72
Introduction 72
Summary of Study 72
Discussion of Key Results 72
Strengths and Limitations 74
Strengths 74
Limitations 74
Implications and Recommendations 75
Public Health Implications 75
Recommendations 76
I. Recommendations for Future Research 76
II. Standardization of Opioid Education in US Medical Schools 77
Conclusion 78
REFERENCES 79
APPENDIX A: IPRCE PROTOCOL 90
APPENDIX B: RECRUITMENT MATERIALS AND EMAIL TEMPLATES 105
APPENDIX C: FOCUS GROUP MODERATOR GUIDE 107
APPENDIX D: CODEBOOK 110
APPENDIX E: IRB EXEMPTION FORM 116
APPENDIX F: FOCUS GROUP #1 TRANSCRIPT 118
APPENDIX G: FOCUS GROUP #2 TRANSCRIPT 136
APPENDIX H: FOCUS GROUP #3 TRANSCRIPT 152
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File download under embargo until 18 May 2025 | 2023-04-21 13:30:55 -0400 | File download under embargo until 18 May 2025 |
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