Abstract
Purpose: In response to the opioid epidemic and efforts to expand substance use education in medical school, the authors introduced opioid overdose prevention training (OOPT) with naloxone for all first-year medical students (MS1s) as an adjunct to required basic life support training (BLST). The authors previously demonstrated improved knowledge and preparedness following in-person OOPT with BLST; however, it remains unclear whether online-administered OOPT would produce comparable results. In this study, the authors perform a retrospective comparison of online-administered OOPT with in-person-administered OOPT. Objectives: To compare the educational outcomes: knowledge, preparedness, and attitudes, for online versus in-person OOPT. Methods: In-person OOPT was administered in 2014 and 2015 during BLST, whereas online OOPT was administered in 2016 during BLST pre-work. MS1s completed pre- and post-training tests covering 3 measures: knowledge (11-point scale), attitudes (66-point scale), and preparedness (60-point scale) to respond to an opioid overdose. Online scores from 2016 and in-person scores from 2015 were compared across all 3 measures using analysis of covariance (ANCOVA) methods. Results: After controlling for pre-test scores, there were statistical, but no meaningful, differences across all measures for in-person- and online-administered training. The estimated differences were knowledge: −0.05 (0.5%) points (95% confidence interval [CI]: −0.47, 0.36); attitudes: 0.65 (1.0%) points (95% CI: −0.22, 1.51); and preparedness: 2.16 (3.6%) points (95% CI: 1.04, 3.28). Conclusions: The educational outcomes of online-administered OOPT compared with in-person-administered OOPT were not meaningfully different. These results support the use of online-administered OOPT. As our study was retrospective, based on data collected over multiple years, further investigation is needed in a randomized controlled setting, to better understand the educational differences of in-person and online training. Further expanding OOPT to populations beyond medical students would further improve generalizability.
Acknowledgments
The authors wish to thank Dova Marder, MD, Andrew Hallett, Keith Goldfeld, DrPH, Robert Rosenwald, and Ben Suwing.
Additional information
Funding
Notes on contributors
Noah Berland
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
Daniel Lugassy
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
Aaron Fox
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
Keith Goldfeld
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
So-Young Oh
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
Babak Tofighi
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.
Kathleen Hanley
All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. N.B. initially conceived of the project under the mentorship of B.T. and advising from A.F., later with additional advising from D.L. and S.O. N.B. designed the training, instruments, and obtained IRB approval with consultation principally with B.T., and additional support from A.F. and K.H. N.B. performed the training and got support principally from K.G. for data analysis. The manuscript was prepared by N.B. with help from B.T., A.F., S.O., K.G., and K.H. All authors participated in editing the manuscript.