In hospital settings, approximately 20% of prescriptions are completed by interns. Analgesia – including opioids - forms one of the most prescribed drug categories. Inappropriate opioid prescribing carries potential for significant harm. Therefore, it is important to ensure medical students have reasonable confidence and knowledge while prescribing opioids as they begin the journey into clinical practice.

To determine if final year medical students at an Australian university feel confident in prescribing opioids, and whether they demonstrate adequate knowledge regarding opioids.

Methods: 

A questionnaire was designed to assess opioid confidence and knowledge. 92 final year medical students undergoing rotations in General Medicine or Palliative Care were asked to complete the questionnaire in a classroom setting. It assessed: 1) how confident students felt about opioids, and 2) their opioid knowledge. The pass mark for knowledge-based questions was set at 75%. The quiz was followed up with an education session regarding safe opioid prescribing, pharmacology, legislation, and modern resources to aid in opioid prescribing. Completion rate was 100% and data was collated and analyzed using Microsoft Excel. 

Only 30% of students felt confident in their opioid related knowledge. On formal testing, only 20/92 (21.7%) obtained a pass mark. Ex-pharmacists were the most confident and knowledgeable about opioids. Medical students showed growth across their final year – those tested in Term 1 and 2 had lower scores than those tested in Term 7 and 8. Questions about opioid harms were answered well (94% correct) but questions about pharmacology were variable (39-94% correct), and those assessing opioid use in clinical settings were poor (39-58%).

 

This is the first research to look at medical students’ confidence and knowledge about opioids, an essential drug in Palliative Medicine. It highlights specific areas of improvement within medical education to better train the future workforce.