Table 1 Pre- and posttest ranks of medical student median scores for each question and overall using the Wilcoxon matched-pairs signed-rank test

How satisfied are you with the amount of OP training that you have received in your formal education thus far?

3 (2)

4 (1)

<  0.001

I understand the risks of opioids in chronic PM.

4 (0)

4 (1)

<  0.002

I understand the benefits of opioids in chronic PM.

4 (0)

4 (1)

<  0.001

I understand when it is appropriate to prescribe opioids for chronic PM.

3 (1)

4 (1)

<  0.001

I understand the risks of opioids in acute PM.

4 (0)

5 (1)

<  0.001

I understand the benefits of opioids in acute PM.

4 (0)

5 (1)

<  0.001

I understand when it is appropriate to prescribe opioids for acute PM.

3 (2)

4 (1)

<  0.001

I am familiar with the types of opioid medications used for PM.

4 (1)

4 (1)

<  0.001

I am familiar with the types of non-opioid medications used for PM.

4 (0)

5 (1)

<  0.001

I understand the role of prescription opioids in the opioid epidemic.

4 (1)

5 (1)

<  0.001

I am familiar with the Prescription Drug Monitoring Program and know when to use it.

4 (1)

5 (1)

<  0.001

I am familiar with OP guidelines (i.e. dosages and amounts to prescribe).

2 (1)

4 (0)

<  0.001

I understand the differences in OP for older adults (> 65) vs. adults (< 65).

2 (1)

4 (1)

<  0.001

I understand the complexities of pain assessment in patients with dementia.

3 (2)

4 (1)

<  0.001

I understand the differences between nociceptive, neuropathic and inflammatory pain.

4 (1)

5 (1)

<  0.001

I am familiar with the risks and benefits of commonly used pain medications for older adults (> 65).

3 (2)

5 (1)

<  0.001

I am familiar with safe PM strategies for older adults (> 65).

3 (2)

4 (1)

<  0.001

Case #2

I understand the differences in treating nociceptive, neuropathic and inflammatory pain.

3 (2)

5 (1)

<  0.001

I am familiar with first-line treatments and strategies for chronic PM.

3 (2)

5 (1)

<  0.001

I understand the concept of “opioid diversion.”

3 (2)

5 (1)

<  0.001

I am familiar with safe strategies for disposing of unused opioids.

2 (2)

5 (1)

<  0.001

I am familiar with the risk factors for patient opioid misuse.

4 (1)

5 (1)

<  0.001

I am familiar with safe management strategies for patients on long-term opioid treatment for chronic pain.

2 (1)

4 (1)

<  0.001

I understand the concept of opioid tapering.

4 (1)

4 (1)

<  0.001

I understand the concept of morphine milligram equivalents (MMEs).

4 (2)

5 (1)

<  0.001

I understand how to convert morphine milligram equivalents (MMEs).

2 (3)

5 (1)

<  0.001

I am familiar with the symptoms of an opioid overdose.

4 (1)

5 (1)

<  0.005

I understand the role of naloxone in opioid overdose.

5 (1)

5 (0)

<  0.002

I understand the importance of co-prescribing naloxone with opioids.

4 (1)

5 (0)

<  0.001

I understand the role of medication-assisted treatment (MAT) in patients with OUD.

4 (1)

5 (0)

<  0.001

I understand the differences between methadone, buprenorphine, and naltrexone.

4 (1)

5 (1)

<  0.001

I understand the concept of patient-controlled analgesia (PCA).

4 (0)

5 (1)

<  0.001

I am familiar with the differences in opioid dosing requirements for opioid-tolerant vs. opioid-naive patients.

3 (2)

4 (1)

<  0.001

I understand the danger of co-prescribing benzodiazepines and opioids.

4 (1)

5 (0)

<  0.001

I understand the role of multimodal analgesia in PM.

4 (0)

5 (1)

<  0.001

Case #6

I understand the differences in pain medication dosing for the pediatric vs. adult population.

2 (1)

4 (1)

<  0.001

I am familiar with the risks of prescribing opioids to adolescents for PM.

4 (2)

4 (1)

<  0.001

I am familiar with pain medications that are safe for pregnant patients.

2 (2)

4 (2)

<  0.001

I am familiar with safe opioid management strategies for pregnant patients.

2 (1)

4 (1)

<  0.001

I understand the postnatal effects of opioids on neonates.

4 (0)

5 (1)

<  0.001

I am familiar with the concept of pain syndromes in cancer survivors.

3 (2)

4 (1)

<  0.001

I understand the role of opioids in chronic cancer pain.

4 (1)

4 (1)

<  0.001

I am confident in my ability to manage opioids for patient pain.

2 (1)

4 (0)

<  0.001

I am capable of managing opioids for patient pain.

2 (1)

4 (0)

<  0.001

I am able to provide opioid management for patient pain.

2 (2)

4 (0)

<  0.001

I am able to meet the challenge of opioid management for patient pain.

3 (2)

4 (0)

<  0.001

Overall score

150 (24)

206 (25)

<  0.001