TOTB-01: AN INTERPROFESSIONAL PAIN MANAGEMENT CURRICULUM FOR SURGERY INTERNS ON THEIR NIGHT-FLOAT ROTATION
John R Martin, MD; Department of Surgery, Indiana University School of Medicine

What problem in education is addressed by this work?:
Residents—and in particular interns at our institution—are often responsible for overnight pain management of surgical inpatients, many of whom are receiving opioids. Yet according to one recent study, less than 10% of residents have received formal opioid training. We identified intern night-float as a target for educational intervention as it provides unique opportunities to deliberately practice inpatient pain management and receive continuous feedback over a month-long rotation.

Describe the intervention:
Interns on night-float attend didactics hosted by Department of Anesthesia faculty and accompany the Anesthesia Pain Service on bedside teaching rounds to learn appropriate use of regional anesthetics, epidurals, PCAs, and multi-modal pain management including opioid and non-opioid strategies. Rotation deliverables include (1) scripts to guide patient-centered discussion regarding the safe use, storage, and disposal of opioids, and (2) executable pain management plans for surgical inpatients with acute and chronic pain. Feedback is provided by both surgery and anesthesia faculty.

Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome:
At our Midwest institution we adapted the Massachusetts Department of Public Health’s "Core Competencies for Prevention & Management of Prescription Drug Misuse" as a framework for residents to develop and execute pain management plans on a night-float rotation, demonstrating feasibility for other institutions to adapt this same framework. Lack of a close working relationship between departments is one potential barrier to implementing this curriculum, but we have found that focusing attention on patients under the mutual care of surgery and anesthesia has encouraged cooperation and commitment. Because night-float is a difficult intern rotation, we are concerned the addition of this curriculum could place excessive demand on learners' cognitive load and plan to closely follow curriculum and rotation evaluations.