Towards a more equitable future: development, implementation, and evaluation of a novel e-course on racial disparities in pain management for medical students

Background: Chronic pain is a major global public health concern, and racial minorities face significant challenges and inequity in receiving quality pain management. Implicit bias among healthcare providers contributes to these racial disparities. The purpose of this study was to develop, implement, and evaluate a brief online course, whereby the overall aim was to educate medical students about the reality of racial disparity in pain assessment and management, enhance empathy, and reduce implicit bias. Methods: This study evaluated a 90-min self-paced online e-course using a 20-item pre-post test design with a 5-point Likert scale, and six course-specific evaluative items. Data were analyzed using t-tests. Demographic differences in learning outcomes were also examined. Results: A total of N = 605 medical students (age 25.5 ± 3.6 years; 55.7% female) participated in this study. In within-subject analyses, 19 of the 20 test items pertaining to the existence of racial disparities and implicit bias in pain care demonstrated significant increase in agreement following course completion (Ps <.001). Male students were more likely than female students to endorse factually incorrect statements (Ps <.05), just as Doctor of Osteopathic Medicine (DO) students were more likely than Doctor of Medicine (MD) students to endorse factually incorrect statements (Ps <.001). Racially diverse students agreed more strongly than white students that more time should be devoted to pain in medical education (P = 0.011). Conclusions: Providing education to medical students about racial disparities and implicit bias in pain care is one approach to reducing disparities. This research underscores the need for more comprehensive and focused education on pain management and racial disparities within medical curricula to better prepare future physicians to deliver equitable care.