Methadone for Palliative Care Providers: A Case-Based Flipped Classroom Module for Faculty and Fellows

Introduction: Methadone is an effective medication for treating pain and has unique characteristics that require specialized knowledge to prescribe safely. Palliative care providers use methadone for analgesia in patients with a wide range of prognoses, goals of care, and comorbid conditions. New consensus guidelines for methadone use released in 2019 by the American Academy of Hospice and Palliative Medicine provide guidance for safe use in patients who have potentially life-limiting illnesses. A needs assessment of palliative care fellows and faculty at our institution highlighted lack of knowledge and confidence with regard to prescribing methadone. Methods: We created a virtual, flipped classroom, interactive learning module intended for palliative care fellows and practicing clinicians that emphasized updated practice recommendations. Participants took a pretest, reviewed an article and lecture, and completed practice cases prior to an interactive session conducted via videoconference. Following the session, participants completed a posttest to assess knowledge and confidence regarding the learning objectives. Results: A total of 28 clinicians at the fellow and faculty/staff levels completed the intervention during two sessions in 2020. Self-reported confidence in all educational objectives improved following the intervention. Participants demonstrated improved skill in calculating methadone doses, converting between modes of drug administration, and identifying safety guidelines during and after the intervention. Discussion: Following the intervention, participants reported improved confidence and demonstrated improved skills in prescribing methadone for pain. Additional benefits of this training model include ease of implementation, engaging format, and time and resource efficiency given its virtual format.