Attitudes and Beliefs Regarding Pain in Interprofessional Education: A Multifaceted Dilemma (original) (raw)
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Physiotherapy, 2019
To investigate: (1) the differences in attitudes and beliefs towards persistent pain management between first-and final-year undergraduate healthcare students and (2) the magnitude of change across disciplines. Methods: Online cross-sectional questionnaires of first-and final-year adult, child and mental health nursing, occupational therapy, physiotherapy and podiatry students at Glasgow Caledonian University. Scores from the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Back Beliefs Questionnaire (BBQ) were analysed with independent ttests and a two-way analysis of variance. Results: Completed questionnaires were analysed (HC-PAIRS n=177; BBQ n=173). Mean HC-PAIRS scores in final-year mental health nursing (65.08) and physiotherapy students (55.64) indicated significantly more evidence-based beliefs than first-year students (72.17, p=.029 and 65.75, p<.001 respectively). Similarly, final-year physiotherapy students mean score on the BBQ was greater than their first-year peers (34.06 versus 27.96, p<.001). HC-PAIRS scores were found to be significantly different between the courses, (F(5,165)=3.69 p=.003 η p 2 =.101) and years (F(1,165)=6.71 p=.010 η p 2 =.039). This main effect of Course, (F(5,161)=2.72 p=.022 η p 2 =.078) and Year, (F(1,161)=5.20 p=.024 η p 2 =.031) was also observed for the BBQ. However, the Course x Year interaction only reached statistical significance for the BBQ (F(5,161)=2.44 p=.036 η p 2 =.071). No differences were observed in questionnaire scores for the other students included in the study. Conclusion: Final-year healthcare students appear to have more positive attitudes and beliefs towards persistent pain management than first-year students, suggesting that undergraduate education may have a positive influence on pain-related attitudes and beliefs. Specific disciplines or courses seem to be associated with greater improvements than others. The curriculum employed in these courses could be investigated as a way to enhance pain-related education. However, further research is required to explore the best way to improve pain-related attitudes and beliefs in undergraduate healthcare students.
BMC Medical Education
Background Persistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students’ pain related knowledge and attitudes. The secondary aim was to explore what factors influence students’ pain related knowledge and attitudes. Methods In this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes]. Results Physiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01...
British Journal of Pain, 2015
Introduction: Chronic pain results in significant personal, societal and economic burden. Doctors and nurses have a pivotal role in patient pain management. In order to determine the effectiveness of current pain education on knowledge, attitudes and perceptions of medical and nursing students, there needs to be a valid measure to assess and quantify these domains. We reviewed the literature to identify approaches for assessing knowledge, perceptions and attitudes to pain management among nursing and medical students. Methods: Databases of peer-reviewed literature including CINAHL, EMBASE, ERIC, PsycInfo, Medline and PubMed were searched for articles published between 1993 and December 2014 using the following search terms: Results: The search revealed over 3500 articles, and on application of the inclusion criteria, 26 articles were included in the review. A total of 14 instruments were used in these studies with the Knowledge and Attitudes Survey Regarding Pain (KASRP) as the main instrument in 9 out of the 26 articles. The various instruments used different question formats such as multiple-choice questions (MCQs), true/false statements and Likert scales that went from 3 points to 7 points. Clinical skills examinations were also used in four studies to assess pain management. Conclusion: There is no gold standard instrument currently used to assess knowledge, perceptions and attitudes to pain management. The results of this review showed, despite the diversity of standardised instruments that have been used to assess knowledge, perceptions and attitude to pain management, the literature has consistently reported that knowledge about pain management among nursing and medical students was generally poor among both groups.
Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
Pain is one of the most common reasons for individuals to seek medical advice, yet it remains poorly managed. One of the main reasons that poor pain management persists is the lack of adequate knowledge and skills of practicing clinicians, which stems from a perceived lack of pain education during the training of undergraduate medical students. To identify gaps in knowledge with respect to pain management as perceived by students, patients and educators. A qualitative descriptive study was conducted. Data were generated through six focus groups with second- and fourth-year medical students, four focus groups with patients and individual semistructured interviews with nine educators. All interviews were audiotaped and an inductive thematic analysis was performed. A total of 70 individuals participated in the present study. Five main themes were identified: assessment of physical and psychosocial aspects of pain; clinical management of pain with pharmacology and alternative therapies;...
Medical students' perspectives of their clinical comfort and curriculum for acute pain management
Journal of pain research, 2018
Acute pain is a common presenting complaint in health care. Yet, undertreatment of pain remains a prevailing issue that often results in poor short- and long-term patient outcomes. To address this problem, initiatives to improve teaching on pain management need to begin in medical school. In this study, we aimed to describe medical students' perspectives of their curriculum, comfort levels, and most effective pain teaching modalities. A cross-sectional, online survey was distributed to medical students at the University of Alberta (Edmonton, Canada) from late May to early July 2015. Data were collected from pre-clerkship (year 1 and 2) and clerkship (year 3 and 4) medical students for demographic characteristics, knowledge, comfort, and attitudes regarding acute pain management. A total of 124/670 (19.6%) surveys were returned. Students recalled a median of 2 (interquartile range [IQR]=4), 5 (IQR=3.75), 4 (IQR=8), and 3 (IQR=3.75) hours of formal pain education from first to for...
Asian Pacific Journal of Cancer Prevention, 2015
Background: Medical practitioners' attitudes have a significant impact on quality of care for cancer pain patients. This study was conducted to determine if being given a lecture concerning cancer pain and its management could improve the attitudes of medical students. Materials and Methods: A comparative study was conducted in 126 fifth-year medical students. Each student completed a pretest consisting of 3 questions about attitudes toward the optimal use of analgesics and 5 questions about attitudes toward prescribing opioids. Then they were given a 1.5-hour lecture, immediately following which they completed a post-test with the same questions. Results: Analysis with either comparison between groups or by matching, the post-test showed significantly more positive attitudes (p<0.05) of the medical students in all 3 questions about optimal use of analgesics and 4 out of 5 questions about prescription of opioids. The post-test results showed significantly more negative attitudes concerning the most appropriate stage for patients with severe pain to receive maximal doses of analgesics. Conclusions: Conservative attitudes, especially concerns about addiction, have been associated with a reluctance in many physicians to prescribe opioids. This study found that cancer pain education can help to improve medical student attitudes. However, fear of addiction and tolerance was still evident so emphasis of this particular issue during a lecture is essential. Providing appropriate information by means of a lecture can improve the attitudes of medical students regarding cancer pain management. However, more information should be given to lessen fear of addiction and tolerance.
Journal of Palliative Medicine, 2002
Although effective means for pain management have long been available, cancer pain remains widely undertreated. Surveys of medical personnel have revealed knowledge deficits and attitudinal barriers to pain management, but have not determined why such attitudes persist and how they may be addressed in medical and nursing curricula. This paper presents findings from a qualitative study of the beliefs and attitudes toward pain and cancer pain management held by medical and nursing students and faculty who participated in the Cancer Education Module for the Management of Pain (CEMMP) project. Analysis centered on informants' prioritization and knowledge of pain and cancer pain management and on the meanings informants assigned to pain in a clinical context. Themes in prioritization included the importance of learning about pain versus cancer pain and the responsibility of primary care providers versus specialists for pain and cancer pain management. Themes in informants' knowledge of pain included knowledge deficits about medications and adjunct therapies and the presence of pain management in the curriculum, and the role of knowledgeable faculty members and mentors in the dissemination of information about pain management. Themes in the meanings informants' assigned to pain included opioidphobia, and the (inter-)subjectivity of pain. The discussion focuses in particular on tensions within the prioritization, knowledge and meanings of pain that must be resolved before students can be appropriately educated for optimal pain management.
Pain Education at the University of Washington School of Medicine
The Journal of Pain, 2013
Contemporary medical education is inadequate to prepare medical students to competently assess and design care plans for patients with acute and chronic pain. The time devoted to pain education in most medical school curricula is brief and not integrated into case-based clinical experiences, and it is frequently nonexistent during clinical clerkships. Medical student pain curricula have been proposed for over 30 years and are commonly agreed upon, though rarely implemented. As a consequence of poor undergraduate pain education, postgraduate trainees and practicing physicians struggle with both competency and practice satisfaction; their patients are similarly dissatisfied. At the University of Washington School of Medicine, a committee of multidisciplinary pain experts has, between 2009 and 2011, successfully introduced a 4-year integrated pain curriculum that increases required pain education teaching time from 6 to 25 hours, and clinical elective pain courses from 177 to 318 hours. It is expected that increased didactic and case-based multidisciplinary clinical training will increase knowledge and competency in biopsychosocial measurement-based pain narrative and risk assessment, improve understanding of persistent pain as a chronic complex condition, and expand the role of patient-centered interprofessional treatment for medical students, residents, and fellows, leading to better prepared practicing physicians.
Attitudes of anesthesiology residents and faculty members towards pain management
Middle East journal of anaesthesiology, 2012
There is a large armamentarium of pain-reducing interventions and analgesic choices available to anesthesiologists, but oligoanalgesia continues to be a large problem. We studied the attitudes of residents and faculty members of anesthesiology towards different domains of pain medicine. anonymous questionnaires were mailed to 68 professionals containing demographic and personal data plus 40 items in 10 domains: control, emotion, disability, solicitude, cure, opioids, harm, practice settings, training, and barriers. Internal consistency was 0.70 and the test-retest reliability was 0.80. With 81% response rate, we observed desirable beliefs towards all domains except moderately undesirable beliefs towards the domain solicitude. Scores of residents and faculties were not significantly different. Continuing education programs on both the international guidelines, routine professional education, are needed to improve attitudes towards pain control.