Managing Acute Pain and Opioid Risks Following Wisdom Teeth Extraction: An Illustrative Case

Introduction The opioid epidemic has awakened educators to the insufficiency of training in the areas of pain management and substance use disorders within the curricula of health sciences schools. The University of Pittsburgh Center of Excellence in Pain Education created an online educational module focusing on factors contributing to the opioid epidemic and the role of robust interprofessional communication in avoiding common practitioner errors. Methods The 1-hour module created by an interprofessional team comprised a pretest, video presentation featuring case vignettes, posttest, and learner satisfaction survey. The content of the module focused on four core concepts: (1) managing acute perioperative pain, (2) maximizing opioid safety, and (3) identifying and (4) managing suspected opioid abuse and diversion. Results Data were obtained from 250 dental, pharmacy, and nursing students from the University of Pittsburgh who completed the module as part of their respective profession-specific curricula. Results collapsed across the three school-specific implementations indicated an average increase in knowledge test scores from pre- to posttest (Z = −8.82, p < .001). In addition, the learner satisfaction data revealed an overall positive response to the module, with students commenting that they enjoyed the module and felt it provided them with a valuable learning experience. Discussion Learner outcomes and feedback suggest that our interprofessional team was successful in creating an effective learning module applicable to several health care professions, namely, pharmacy, dentistry, and nursing. Future studies might address the application of the knowledge gained to actual patient care.

[1]  Laura M Frankart,et al.  A Laboratory Session to Prepare Pharmacy Students to Manage the Opioid Crisis Situation , 2019, American Journal of Pharmaceutical Education.

[2]  P. Ohtake,et al.  Improving Pharmacy Students’ Attitudes Toward Collaborative Practice Through a Large-scale Interprofessional Forum Targeting Opioid Dependence , 2019, American Journal of Pharmaceutical Education.

[3]  R. Chou,et al.  No Shortcuts to Safer Opioid Prescribing. , 2019, The New England journal of medicine.

[4]  Kimberly Dion Teaching Nursing Students How to Decrease the Stigma Against People Who Use Drugs. , 2019, Nurse educator.

[5]  R. Cervero,et al.  Untying the Interprofessional Gordian Knot: The National Collaborative for Improving the Clinical Learning Environment. , 2018, Academic medicine : journal of the Association of American Medical Colleges.

[6]  Laura Palombi,et al.  OPIOIDS: cultivating interprofessional collaboration to find solutions to public health problems , 2018, Journal of interprofessional care.

[7]  I. Kane,et al.  Creative Learning Through the Use of Simulation to Teach Nursing Students Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use in a Culturally Competent Manner , 2018, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[8]  D. Gordon,et al.  Interprofessional pain education—with, from, and about competent, collaborative practice teams to transform pain care , 2018, Pain reports.

[9]  A. Mitchell,et al.  Effect on Dental Hygiene Students of a Substance Use Simulation Conducted with Nursing Students. , 2018, Journal of dental education.

[10]  R. Cardarelli,et al.  An examination of the perceived impact of a continuing interprofessional education experience on opiate prescribing practices , 2018, Journal of interprofessional care.

[11]  B. Brandt Rethinking Health Professions Education through the Lens of Interprofessional Practice and Education. , 2018 .

[12]  Carol J. Hermansen-Kobulnicky,et al.  Teaching interprofessional teamwork skills to health professional students: A scoping review , 2018, Journal of interprofessional care.

[13]  Michael J. Englesbe,et al.  Persistent Opioid Use Among Pediatric Patients After Surgery , 2018, Pediatrics.

[14]  M. Sudders Confronting the Opioid Epidemic: How Dental Schools Can Lead. , 2017, Journal of dental education.

[15]  R. Donoff,et al.  Massachusetts Dental Schools Respond to the Prescription Opioid Crisis: A Statewide Collaboration. , 2017, Journal of dental education.

[16]  M. E. El Hajj,et al.  A comprehensive systematic review of pharmacy perspectives on interprofessional education and collaborative practice , 2017, Research in social & administrative pharmacy : RSAP.

[17]  Natalie L. Murdoch,et al.  Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review , 2017, Journal of interprofessional care.

[18]  Dawnelle Schatte,et al.  A Difficult Patient Encounter: Using a Standardized Patient Scenario to Teach Medical Students to Treat Medication-Seeking Patients , 2017, MedEdPORTAL : the journal of teaching and learning resources.

[19]  J. A. Johnson,et al.  Integrating Substance Use Content in an "Overcrowded" Nursing Curriculum. , 2017, Nurse educator.

[20]  Z. Smothers,et al.  Substance Use Education in Schools of Nursing: A Systematic Review of the Literature , 2017, Nurse educator.

[21]  Elizabeth A Andrews The Future of Interprofessional Education and Practice for Dentists and Dental Education. , 2017, Journal of dental education.

[22]  P. George,et al.  Substance Use Disorder Training Workshop for Future Interprofessional Health Care Providers , 2017, MedEdPORTAL : the journal of teaching and learning resources.

[23]  B. Martin,et al.  Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015 , 2017, MMWR. Morbidity and mortality weekly report.

[24]  P. George,et al.  An interprofessional education workshop to develop health professional student opioid misuse knowledge, attitudes, and skills. , 2017, Journal of the American Pharmacists Association : JAPhA.

[25]  R. Donoff,et al.  Problems and Solutions for Interprofessional Education in North American Dental Schools. , 2016, Dental clinics of North America.

[26]  F. Cerra,et al.  Reflections From the Intersection of Health Professions Education and Clinical Practice: The State of the Science of Interprofessional Education and Collaborative Practice , 2016, Academic medicine : journal of the Association of American Medical Colleges.

[27]  R. Chou,et al.  CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. , 2016, JAMA.

[28]  Brigitte L. Sicat,et al.  Interprofessional Team-Based Learning Module: Chronic Non-Cancer Pain , 2015 .

[29]  Katherine Wright,et al.  Using SPs to Teach About Patients at Risk For Drug Abuse , 2014 .

[30]  Michael J. Schneider,et al.  E‐Learning Module on Chronic Low Back Pain in Older Adults: Evidence of Effect on Medical Student Objective Structured Clinical Examination Performance , 2014, Journal of the American Geriatrics Society.

[31]  Jason G. Williams Are online learning modules an effective way to deliver hand trauma management continuing medical education to emergency physicians? , 2014, Plastic surgery.

[32]  T. Shaw,et al.  Impact of a novel online learning module on specialist palliative care nurses’ pain assessment competencies and patients’ reports of pain: Results from a quasi-experimental pilot study , 2014, Palliative medicine.

[33]  D. Weiner,et al.  Pain as the fifth vital sign: exposing the vital need for pain education. , 2013, Clinical therapeutics.

[34]  J. Wilkins,et al.  Training the next generation of providers in addiction medicine. , 2012, The Psychiatric clinics of North America.

[35]  A. Greenwald,et al.  The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. , 2012, American journal of public health.

[36]  L. Mezei,et al.  Pain education in North American medical schools. , 2011, The journal of pain : official journal of the American Pain Society.

[37]  H. Fineberg,et al.  Health professionals for a new century: transforming education to strengthen health systems in an interdependent world , 2010, The Lancet.

[38]  Bonnie Spring,et al.  Interdisciplinary evidence-based practice: moving from silos to synergy. , 2010, Nursing outlook.

[39]  Jessica Schneiderman,et al.  2008 NACNS National Conference: March 5-8, 2008, Atlanta, Georgia , 2008 .

[40]  C. Phillips,et al.  Assessment of online continuing dental education in North Carolina , 2000, The Journal of continuing education in the health professions.

[41]  L. Lioce,et al.  State of Interprofessional Education in Nursing: A Systematic Review , 2018, Nurse educator.

[42]  A. Nanda,et al.  Interprofessional Education: A Reform Plan for Collaborative , 2017, Contemporary clinical dentistry.

[43]  Leonard J. Paulozzi,et al.  Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. , 2011, MMWR. Morbidity and mortality weekly report.

[44]  H. Fineberg,et al.  Health professionals for a new century : transforming education to strengthen health systems in an interdependent world , 2010 .