First Year Medical Student Opioid Overdose Reversal Training, an Adjunct to Basic Life Support, a non-inferiority analysis of in-person vs online training

June 6, 2017 8:00 AM – 9:15 AM

Noah Berland, New York University School of Medicine
Daniel Lugassy, New York University School of Medicine
Aaron Fox, Albert Einstein College of Medicine
Jacqueline Gutman, New York University School of Medicine
So-young Oh, New York University School of Medicine
Babak Tofighi , New York University School of Medicine
Kathleen Hanley, New York University School of Medicine

Background: Drug overdose deaths are the leading cause of accidental deaths ages 25-64. More than 38% of drug overdose deaths are attributed to prescription opioids.Healthcare professionals are unprepared to respond to this epidemic. Integrating an in-person opioid overdose reversal training (OORT) component to basic life support (BLS) for first year medical students (MS1s) has been shown to increase knowledge and self-reported preparedness.

Objectives: To demonstrate non-inferiority of online OORT with in person OORT as a part of BLS training for MS1s.

Methods: An online module was developed to mirror the prior administered in person OORT as a part of BLS training for MS1s. The online module used pre- and post-test surveys identical to our second year analysis to assess knowledge (11 items), attitudes (11 items, 6 point scale) and preparedness (12 items, 5 point scale).  Changes in pre-test and post-test results were assessed with paired t-tests and non-inferiority was established using a .01% one sided confidence interval with a δ of 0.7 odds ratio as a lower bound for non-inferiority.

Results:

Arm                N     N Included (%)  Pre-Mean(sd)   Post-Mean(sd)   P (Cohen’s D)

In-Person

(Knowledge)   127    112(88.2)           3.6(1.6)           9.4(1.5)           

(Preparedness)                                 30.1(6.5)         44.3(5.2)          

(Attitudes)                                        47.4(6.8)         47.8(7.2)            >0.1(0.1)

Online

(Knowledge)   132    23(93.2)             4.7(2.0)          9.5(1.7)           

(Preparedness)                                 27.5.1(6.5)     45.1(5.7)          

(Attitudes)                                       47.3(5.4)       48.3(5.9)            

 

Measure     .01% Lower Bound Odds Ratio (Bold is non-inferior >0.7)

Knowledge                 0.72

Preparedness             1.11

Attitudes                   0.95

 

Conclusions

Utilizing an online-module for OORT for MS1s is non-inferior to in-person OORT for MS1s. Online-module for OORT is a good alternative.