Abstract
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.
Perspective
Strategies for improving multidisciplinary pain education at the University of Washington
School of Medicine are described and the preliminary results demonstrated.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of PainAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diseases of the curriculum.J Med Educ. 1978; 53: 951-957
- Academic health center management of chronic diseases through knowledge networks: Project ECHO.Acad Med. 2007; 82: 154-160
- Partnering urban academic medical centers and rural primary care clinicians to provide complex chronic disease care.Health Aff (Millwood). 2011; 30: 1176-1184
- Learning from our learners: implications for pain management education in medical schools.Pain Med. 2011; 12: 1139-1141
- Medical education: a barrier to pain therapy and palliative care.J Pain Symptom Manage. 2001; 21: 360-362
- The role of the anaesthetist in the management of intractable pain.Proc R Soc Med. 1954; 47: 1029-1032
- Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom.Eur J Pain. 2011; 15: 789-795
- Undergraduate medical education in pain medicine, end-of-life care, and palliative care.Pain Med. 2000; 1: 224
- Charlton J.E. Core curriculum for professional education in pain. 3rd ed. IASP Press, Seattle, WA2005
- What can we learn from 7 first-year medical students' perceptions of pain in the primary care setting?.Pain Med. 2011; 12: 1216-1222
- Veterans affairs primary care clinicians' attitudes toward chronic pain and correlates of opioid prescribing rates.Pain Med. 2008; 9: 564-571
- Listening to Pain: A Physician's Guide to Improving Pain Management Through Better Communication.Oxford University Press, New York2012
- Primary care and pain medicine. A community solution to the public health problem of chronic pain.Med Clin North Am. 1999; 83 (v): 555-583
- Analysis of the physician variable in pain management.Pain Med. 2001; 2: 317-327
- The hidden curriculum, ethics teaching, and the structure of medical education.Acad Med. 1994; 69: 861-871
- Fitting it all in: integration of 12 cross-cutting themes into a School of Medicine curriculum.Med Teach. 2007; 29: 489-494
- Training medical students to manage a chronic pain patient: both knowledge and communication skills are needed.Eur J Pain. 2006; 10: 167-170
- The First National Pain Medicine Summit–final summary report.Pain Med. 2010; 11: 1447-1468
- Chronic Pain: A Primary Care Guide to Practical Management.Humana Press, New York, NY2010
- The patient-provider relationship in chronic pain care: providers' perspectives.Pain Med. 2010; 11: 1688-1697
- Pain education in North American medical schools.J Pain. 2011; 12: 1199-1208
- A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development.Pain Med. 2011; 12: 186-195
- Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research.The National Academies Press, Washington, DC2011
- A flood of opioids, a rising tide of deaths.N Engl J Med. 2010; 363: 1981-1985
- An outline curriculum on pain for medical schools.Pain. 1988; 33: 1-2
- Pain related undergraduate teaching in medical faculties in Finland.Pain. 1999; 79: 121-125
- Lecture halls without lectures–a proposal for medical education.N Engl J Med. 2012; 366: 1657-1659
Righton B, Kohler N: Need to see a specialist fast? Too bad you're not a dog. Toronto, ONT, Macleans, 2008
- Medical students retain pain assessment and management skills long after an experiential curriculum: a controlled study.Pain. 2009; 145: 319-324
University of Washington: Curriculum Renewal and Development. Seattle, WA, Available at http://www.uwmedicine.org/Education/MD-Program/curriculum-renewal/Pages/default.aspx
University of Washington: UW Pain Medicine Patient Care: Project ECHO, Extension for Community Health Outcomes. Seattle, WA: Available at: http://depts.washington.edu/anesth/care/pain/echo/overview.shtml
- Primary care provider concerns about management of chronic pain in community clinic populations.J Gen Intern Med. 2006; 21: 652-655
- An integrated undergraduate pain curriculum, based on IASP curricula, for six health science faculties.Pain. 2004; 110: 140-148
- A survey of prelicensure pain curricula in health science faculties in Canadian universities.Pain Res Manag. 2009; 14: 439-444
- Medical students' attitudes toward pain and the use of opioid analgesics: implications for changing medical school curriculum.South Med J. 2000; 93: 472-478
- Development of a comprehensive e-learning resource in pain management.Pain Med. 2009; 462: 95-105
Article info
Publication history
Published online: March 25, 2013
Footnotes
This work was supported in part by the NIH Pain Consortium, John D. Loeser Center of Excellence in Pain Education, National Institute of Nursing Research Grant # R01NR012450 and the National Cancer Institute grant #R42 CA141875.
The authors report no conflicts of interest and have no disclosures to report.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
