PPT5 From bottom to top: educating resident doctors with the aim of improving palliative opioid prescribing across the trust

<h3>Introduction</h3> In many foundation trusts, the majority of inpatient prescribing is carried out by foundation and resident doctors. Evidence shows that, at graduation, doctors are ill-prepared for their role in caring for dying patients. Locally, a number of opioid prescribing incidents had been identified. As foundation doctors interested in palliative care, we worked closely with the local specialist team to develop a learning resource to improve opioid prescribing at the end of life. <h3>Methods</h3> Lack of scope for face-to-face teaching sessions meant that we needed to think innovatively to come up with alternative methods of teaching. We developed a high-quality e-learning module that addressed key issues: 1) opioid initiation; 2) opioid prescription in renal disease; 3) commencement of CSCI; 4) converting transdermal and oral prescription to subcutaneous doses. Three clinical vignettes with associated multiple-choice questions and explanations were prepared. Confidence scale surveys for pre- and post- module delivery were provided. An initial pilot was conducted, with participants voluntarily undergoing the module and providing both numerical and free-hand feedback. Quantitative analysis was carried out after the module went live. <h3>Results</h3> Average confidence rating improved in all four domains assessed, with the most significant improvement seen regarding prescribing with transdermal opioids. Discrepancy between confidence scores reduced following completion of the eLearning module. Qualitative feedback was also positive; one participant commented that it provided a ‘boost of confidence’. <h3>Conclusions</h3> This e-learning module has proved highly successful: providing interactive learning that resident doctors are able to refer to at varying stages in their career. Given the positive feedback, the next intended step is to widen participation of the module to appropriate allied healthcare professionals. Future plans are to use this model to develop modules for other common palliative clinical presentations.