An examination of pain education of medical students in Australia and New Zealand

Background: Unrelieved pain is a significant public health challenge in Australia and New Zealand. Medical practitioners play an essential role in the management of acute, cancer and chronic non-cancer pain. Aim: This thesis aimed to examine the delivery of pain education at medical schools in Australia and New Zealand, and to determine how effectively it equips medical students with pain medicine competencies required for internship. Methods: An explanatory sequential mixed methods approach was used. Quantitative studies focused on gathering information regarding the pain-related content of medical curricula of all medical schools; and on testing pain medicine competencies of final-year medical students and interns across different universities and hospitals. Qualitative methods were used to appraise perceptions of healthcare practitioners and students working alongside interns regarding the extent to which the existing medical student education programme prepared interns to manage patients with pain. Results: Nineteen out of 23 medical schools completed the curriculum audit and innovative Medical School Pain Curriculum Questionnaire. Medical schools do not have well-documented or comprehensive pain curricula. Pain medicine education is not delivered and assessed using pedagogically sound approaches considering the complexity of the topic, and the prevalence and public health burden of pain. Important barriers and enablers influencing the delivery of successful pain medicine education were identified. The Medical Students Pain Attitudes and Knowledge Questionnaire, designed to assess pain medicine knowledge and attitudes, was completed by 351 students from 10 universities and 36 interns from two geographical areas. Twenty-one medical students participated in a pain-focused objective structured clinical examination. Gaps in students’ and interns’ pain medicine competencies were evident in basic concepts of pain processing, multidimensional aspects of pain, pain assessment and management, multiprofessional approach to pain management and pain medicine ethics. Fifteen healthcare practitioners and students participated in the qualitative interview study. The three major themes emerged: 1) gaps in the current medical curriculum regarding pain medicine education; 2) interns’ competencies not matching their pain medicine responsibilities; and 3) gaps in interns’ pain medicine competencies affecting the patient and wider community, the intern themselves and the hospital system. Conclusion: This research has highlighted the necessity for major changes to the current medical curriculum in Australia and New Zealand so that medical students are adequately prepared to address the pain management needs of the communities they will serve in the future. The Pain Medicine Curriculum Framework for improving pain medicine education for medical students is proposed to assist in the ongoing process of ensuring that medical graduates meet the professional and ethical challenges that arise in caring for those in pain

Systematic review of pain medicine content, teaching, and assessment in medical school curricula internationally

Introduction: Pain management is a major health care challenge in terms of the significant prevalence of pain and the negative consequences of poor management. Consequently, there have been international calls to improve pain medicine education for medical students. This systematic review examines the literature on pain medicine education at medical schools internationally, with a particular interest in studies that make reference to: a defined pain medicine curriculum, specific pain medicine learning objectives, dedicated pain education modules, core pain topics, medical specialties that teach pain medicine, elective study opportunities, hours allocated to teaching pain medicine during the curriculum, the status of pain medicine in the curriculum (compulsory or optional), as well as teaching, learning, and assessment methods. Methods: A systematic review was undertaken of relevant studies on pain medicine education for medical students published between January 1987 and May 2018 using PubMed, Medline, Excerpta Medica database (EMBASE), Education Resources Information Center (ERIC), and Google Scholar, and Best Evidence Medical Education (BEME) data bases. Results: Fourteen studies met the inclusion criteria. Evaluation of pain medicine curricula has been undertaken at 383 medical schools in Australia, New Zealand, the United States of America (USA), Canada, the United Kingdom (UK), and Europe. Pain medicine was mostly incorporated into medical courses such as anaesthesia or pharmacology, rather than presented as a dedicated pain medicine module. Ninety-six percent of medical schools in the UK and USA, and nearly 80% of medical schools in Europe had no compulsory dedicated teaching in pain medicine. On average, the median number of hours of pain content in the entire curriculum was 20 in Canada (2009), 20 in Australia and New Zealand (2018), 13 in the UK (2011), 12 in Europe (2012/2013), and 11 in the USA (2009). Neurophysiology and pharmacology pain topics were given priority by medical schools in all countries. Lectures, seminars, and case-based instruction were the teaching methods most commonly employed. When it was undertaken, medical schools mostly assessed student competency in pain medicine using written examinations rather than clinical assessments. Conclusions: This systematic review has revealed that pain medicine education at medical schools internationally does not adequately respond to societal needs in terms of the prevalence and public health impact of inadequately managed pain

Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand

Background: The objective of pain medicine education is to provide medical students with opportunities to develop their knowledge, skills and professional attitudes that will lead to their becoming safe, capable, and compassionate medical practitioners who are able to meet the healthcare needs of persons in pain. This study was undertaken to identify and describe the delivery of pain medicine education at medical schools in Australia and New Zealand. Method: All 23 medical schools in Australia and New Zealand in 2016 were included in this study. A structured curriculum audit tool was used to obtain information on pain medicine curricula including content, delivery, teaching and assessment methods. Results: Nineteen medical schools (83%) completed the curriculum audit. Neurophysiology, clinical assessment, analgesia use and multidimensional aspects of pain medicine were covered by most medical schools. Specific learning objectives for pain medicine were not identified by 42% of medical schools. One medical school offered a dedicated pain medicine module delivered over 1 week. Pain medicine teaching was delivered at all schools by a number of different departments throughout the curriculum. Interprofessional learning (IPL) in the context of pain medicine education was not specified by any of the medical schools. The mean time allocated for pain medicine teaching over the entire medical course was just under 20 h. The objective structured clinical examination (OSCE) was used by 32% of schools to assess knowledge and skills in pain medicine. 16% of schools were unsure of whether any assessment of pain medicine education took place. Conclusion: This descriptive study provides important baseline information for pain medicine education at medical schools in Australia and New Zealand. Medical schools do not have well-documented or comprehensive pain curricula that are delivered and assessed using pedagogically-sound approaches considering the complexity of the topic, the prevalence and public health burden of pain

A Review of the Opioid Epidemic – What Do We Do About It?

<p><strong>Article full text</strong><br> <br> The article associated with this content has been accepted for online publication and is in the final stages of production. The link to the full text will be made available on this page in the next few days. <br> <br> <strong>Provide enhanced digital features for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced digital features for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slides</p

The Pain Medicine Curriculum Framework-structured integration of pain medicine education into the medical curriculum

Medical practitioners play an essential role in preventing pain, conducting comprehensive pain assessments, as well as promoting evidence-based practices. There is a need for the development of innovative, interprofessional and integrated pain medicine curricula for medical students. The Pain Medicine Curriculum Framework (PMCF) was developed to conceptualise a purposeful approach to the complex process of curriculum change and to prioritise the actions needed to address the gaps in pain medicine education. The PMCF comprises four dimensions: (1) future healthcare practice needs; (2) competencies and capabilities required of graduates; (3) teaching, learning and assessment methods; and (4) institutional parameters. Curricula need to meet the requirements of registration and accreditation bodies, but also equip graduates to serve in their particular local health system while maintaining the fundamental standards and values of these institutions. The curriculum needs to connect knowledge with experience and practice to be responsive to the changing needs of the increasingly complex health system yet adaptable to patients with pain in the local context. Appropriate learning, teaching and assessment strategies are necessary to ensure that medical practitioners of the future develop the required knowledge, skills and attitudes to treat the diverse needs of patients\u27 experiencing pain. The historical, political, social and organisational values of the educational institution will have a significant impact on curriculum design. A more formalised approach to the development and delivery of a comprehensive pain medicine curriculum is necessary to ensure that medical students are adequately prepared for their future workplace responsibilities

Deaths from Opioid Overdosing: Implications of Coroners’ Inquest Reports 2008–2012 and Annual Rise in Opioid Prescription Rates: A Population-Based Cohort Study

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>.</b></p><p><a href="https://link.springer.com/article/10.1007/s40122-017-0080-7">https://link.springer.com/article/10.1007/s40122-017-0080-7</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p> </p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Exploring assessment of medical students' competencies in pain medicine—A review

Abstract. Introduction:. Considering the continuing high prevalence and public health burden of pain, it is critical that medical students are equipped with competencies in the field of pain medicine. Robust assessment of student expertise is integral for effective implementation of competency-based medical education. Objective:. The aim of this review was to describe the literature regarding methods for assessing pain medicine competencies in medical students. Method:. PubMed, Medline, EMBASE, ERIC, and Google Scholar, and BEME data bases were searched for empirical studies primarily focusing on assessment of any domain of pain medicine competencies in medical students published between January 1997 and December 2016. Results:. A total of 41 studies met the inclusion criteria. Most assessments were performed for low-stakes summative purposes and did not reflect contemporary theories of assessment. Assessments were predominantly undertaken using written tests or clinical simulation methods. The most common pain medicine education topics assessed were pain pharmacology and the management of cancer and low-back pain. Most studies focussed on assessment of cognitive levels of learning as opposed to more challenging domains of demonstrating skills and attitudes or developing and implementing pain management plans. Conclusion:. This review highlights the need for more robust assessment tools that effectively measure the abilities of medical students to integrate pain-related competencies into clinical practice. A Pain Medicine Assessment Framework has been developed to encourage systematic planning of pain medicine assessment at medical schools internationally and to promote continuous multidimensional assessments in a variety of clinical contexts based on well-defined pain medicine competencies

Additional file 1: of Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand

Medical School Pain Curriculum Audit Scoring Tool, This audit scoring tool was used to gather information on the pain curricula at medical schools. Details of this audit tool are presented. (DOCX 14 kb