An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Physical Therapy

Core competencies in pain management for prelicensure health professional education were recently established. These competencies represent the expectation of minimal capabilities for graduating health care students for pain management and include 4 domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain (Appendix 1). The purpose of this article is to advocate for and identify how core competencies for pain can be applied to the professional (entry-level) physical therapist curriculum. By ensuring that core competencies in pain management are embedded within the foundation of physical therapist education, physical therapists will have the core knowledge necessary for offering best care for patients, and the profession of physical therapy will continue to stand with all health professions engaged in comprehensive pain management

Core competencies for pain management: results of an interprofessional consensus summit.

ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

Interprofessional education: an overview of six initiatives across the schools of health at a single university

The benefits of interprofessional education (IPE) amongst health professionals are well documented, however, the implementation of interprofessional initiatives across the USA is inconsistent. This report describes the development and content of a number of IPE initiatives that are in the early stages of development and implementation at the University of California, Davis, USA. The article describes several important factors that were found to be necessary for the initial implementation of these IPE initiatives. Evaluation data from these initiatives, which is providing a range of positive outcomes, are also presented and discussed in relation to the wider IPE literature

Cancer Pain Treatment and Management: An Interprofessional Learning Module for Prelicensure Health Professional Students.

IntroductionThe imperative of medicine is to treat suffering and to cure when possible. This learning module has been designed to expand providers' knowledge of how to sustain life, restore health, relieve suffering, and provide comfort for people who are experiencing cancer-induced pain. The module uses cancer pain as the context through which students can learn interprofessional, team-based, and person-centered approaches to delivery of care.MethodsUsing the facilitator's guide, handouts, and other materials developed for this project, the module can be delivered as an in-person training session (approximately 120 minutes) for small groups of learners (teams of eight to 12 students drawn from multiple health care professions or schools). Prelearning materials and postsession activities are included that can enhance the experience.ResultsThis module was developed and tested with two pilot programs that were evaluated with focus groups, direct observation, and a postsession survey completed by learners. Data demonstrated high approval of and appreciation for the content and structure of the module by both learners and facilitators.DiscussionMany learners work with other health care professionals in their clinical experiences but have not had opportunities to effectively work in interprofessional collaborative practice. This interprofessional education activity allows students from disparate health professions to work together to identify patient-centered treatment options through interprofessional collaborative teamwork in a classroom setting

Implementation of a Statewide Web-Based Caregiver Resource Information System (CareNav): Mixed Methods Study

Background: With the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and referral. In 2019, the California Department of Health Care Services funded the 11 nonprofit California Caregiver Resource Centers (CRCs) to expand and improve family caregiver services and enhance CRC information technology services. Deployment of a statewide information system offered a unique opportunity to examine structures and processes facilitating implementation, providing feedback to the sites as well as lessons learned for similar projects in the future. Objective: The aim of this paper was to describe the statewide implementation of the comprehensive CareNav system using the Consolidated Framework for Implementation Research as an organizing structure for synthesizing the evaluation. Methods: This mixed methods study used two major approaches to evaluate the implementation process: a survey of all staff who completed training (n=82) and in-depth qualitative interviews with 11 CRC teams and 3 key informants (n=35). We initially analyzed interview transcripts using qualitative descriptive methods and then identified subthemes and relationships among ideas, mapping the findings to the Consolidated Framework for Implementation Research. Results: We present findings on the outer setting, inner setting, characteristics of the intervention, characteristics of the staff, and the implementation process. The critical elements for success were leadership, communication, harmonization of processes across sites, and motivation to serve clients in more accessible and convenient ways. Conclusions: These findings have implications for technology deployment in diverse community-based agencies that aspire to enhance web-based services

Interprofessional education: an overview of six initiatives across the schools of health at a single university

The benefits of interprofessional education (IPE) amongst health professionals are well documented, however, the implementation of interprofessional initiatives across the USA is inconsistent. This report describes the development and content of a number of IPE initiatives that are in the early stages of development and implementation at the University of California, Davis, USA. The article describes several important factors that were found to be necessary for the initial implementation of these IPE initiatives. Evaluation data from these initiatives, which is providing a range of positive outcomes, are also presented and discussed in relation to the wider IPE literature

Implementation of a Statewide Web-Based Caregiver Resource Information System (CareNav): Mixed Methods Study.

BackgroundWith the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and referral. In 2019, the California Department of Health Care Services funded the 11 nonprofit California Caregiver Resource Centers (CRCs) to expand and improve family caregiver services and enhance CRC information technology services. Deployment of a statewide information system offered a unique opportunity to examine structures and processes facilitating implementation, providing feedback to the sites as well as lessons learned for similar projects in the future.ObjectiveThe aim of this paper was to describe the statewide implementation of the comprehensive CareNav system using the Consolidated Framework for Implementation Research as an organizing structure for synthesizing the evaluation.MethodsThis mixed methods study used two major approaches to evaluate the implementation process: a survey of all staff who completed training (n=82) and in-depth qualitative interviews with 11 CRC teams and 3 key informants (n=35). We initially analyzed interview transcripts using qualitative descriptive methods and then identified subthemes and relationships among ideas, mapping the findings to the Consolidated Framework for Implementation Research.ResultsWe present findings on the outer setting, inner setting, characteristics of the intervention, characteristics of the staff, and the implementation process. The critical elements for success were leadership, communication, harmonization of processes across sites, and motivation to serve clients in more accessible and convenient ways.ConclusionsThese findings have implications for technology deployment in diverse community-based agencies that aspire to enhance web-based services

Scope and Nature of Pain- and Analgesia-Related Content of the United States Medical Licensing Examination (USMLE).

Background:"The ongoing opioid crisis lies at the intersection of two substantial public health challenges-reducing the burden of suffering from pain and containing the rising toll of the harms that can result from the use of opioid medications" [1]. Improved pain education for health care providers is an essential component of the multidimensional response to both still-unmet challenges [2,3]. Despite the importance of licensing examinations in assuring competency in health care providers, there has been no prior appraisal of pain and related content within the United States Medical Licensing Examination (USMLE). Methods:An expert panel developed a novel methodology for characterizing USMLE questions based on pain core competencies and topical and public health relevance. Results:Under secure conditions, raters used this methodology to score 1,506 questions, with 28.7% (432) identified as including the word "pain." Of these, 232 questions (15.4% of the 1,506 USMLE questions reviewed) were assessed as being fully or partially related to pain, rather than just mentioning pain but not testing knowledge of its mechanisms and their implications for treatment. The large majority of questions related to pain (88%) focused on assessment rather than safe and effective pain management, or the context of pain. Conclusions:This emphasis on assessment misses other important aspects of safe and effective pain management, including those specific to opioid safety. Our findings inform ways to improve the long-term education of our medical and other graduates, thereby improving the health care of the populations they serve