Evidence map›Paper›PMID 36890045›Full record

ArticleJournal of surgical education2023

Surgical Trainee Perspectives on the Opioid Crisis: The Influence of Explicit and Hidden Curricula.

Josh Bleicher, Jordan E Johnson, Brian T Cain, Robert D Shaw, Alexandra A Acher, Lauren Gleason, Richard J Barth, Daniel I Chu, Sarah Jung, David Melnick and 3 more

Open access · greenAbstract read
In one paragraph

Article in Journal of surgical education, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Josh BleicherDepartment of Surgery, University of Utah, Salt Lake City, Utah. Electronic address: Josh.bleicher@hsc.utah.edu.
Jordan E JohnsonDepartment of Surgery, University of Utah, Salt Lake City, Utah.
Brian T CainDepartment of Surgery, University of Utah, Salt Lake City, Utah.
Robert D ShawDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Alexandra A AcherDepartment of Surgery, University of Utah, Salt Lake City, Utah; Department of Surgery, University of Wisconsin, Madison, Wisconsin.
Lauren GleasonDepartment of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama.
Richard J BarthDepartment of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Daniel I ChuDepartment of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama.
Sarah JungDepartment of Surgery, University of Wisconsin, Madison, Wisconsin.
David MelnickDepartment of Surgery, University of Wisconsin, Madison, Wisconsin.
Kimberly A KaphingstDepartment of Communication, Unversity of Utah and Huntsman Cancer Institute, Salt Lake City, Utah.
Brigitte K SmithDepartment of Surgery, University of Utah, Salt Lake City, Utah.
Lyen C HuangDepartment of Surgery, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah.
University of Utah · USDartmouth–Hitchcock Medical Center · USUniversity of Alabama at Birmingham · USUniversity of Wisconsin–Madison · USHuntsman Cancer Institute · USUniversity of Wisconsin System · US

Funding

Vascular Health and Risk Factors in Children with Down SyndromeKL2TR002539 · NCATS · UNIVERSITY OF UTAH · PI MURTAUGH, MAUREEN A, NYGAARD, INGRID E · 2018 to 2022
$4.3M
NCATS NIH HHS KL2 TR002539
6 · The paper itself

Abstract

objectiveIn order to effectively create and implement an educational program to improve opioid prescribing practices, it is important to first consider the unique perspectives of residents on the frontlines of the opioid epidemic. We sought to better understand resident perspectives on opioid prescribing, current practices in pain management, and opioid education as a needs assessment for designing future educational interventions.

designThis is a qualitative study using focus groups of surgical residents at 4 different institutions.

settingWe conducted focus groups using a semistructured interview guide in person or over video conferencing. The residency programs selected for participation represent a broad geographic range and varying residency sizes.

participantsWe used purposeful sampling to recruit general surgery residents from the University of Utah, University of Wisconsin, Dartmouth-Hitchcock Medical Center, and the University of Alabama at Birmingham. All general surgery residents at these locations were eligible for inclusion. Participants were assigned to focus groups by residency site and their status as junior (PGY-2, PGY-3) or senior resident (PGY-4, PGY-5).

resultsWe completed 8 focus groups with a total of 35 residents included. We identified 4 main themes. First, residents relied on clinical and nonclinical factors when making decisions about opioid prescribing. However, hidden curricula based on unique institutional cultures and attending preferences heavily influenced residents' prescribing practices. Second, residents acknowledged that stigma and biases towards certain patient groups influenced opioid prescribing practices. Third, residents encountered barriers within their health systems to evidence-based opioid prescribing. Fourth, residents did not routinely receive formal education on pain management or opioid prescribing. Residents recommended several interventions to improve the current state of opioid prescribing, including standardized prescribing guidelines, improved patient education, and formal training during the first year of residency.

conclusionsOur study highlighted several areas of opioid prescribing that can be improved upon through educational interventions. These findings can be used to develop programs aimed at improving residents' opioid prescribing practices, both during and after training, and ultimately the safe care of surgical patients. ETHICS STATEMENT: This project was approved by the University of Utah Institutional Review Board, ID # 00118491. All participants provided written informed consent.

Indexed as

General SurgeryInternship and ResidencyAnalgesics, OpioidCurriculumDrug PrescriptionsHumansOpioid EpidemicPractice Patterns, Physicians'Surveys and QuestionnairesAnalgesics, Opioidgeneral surgeryopioid prescribingpain managementqualitative researchsurgical education

Identifiers

PMID36890045
PMCPMC10200738
OpenAlexW4323363411

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.