Objectives Unrelieved pain is a substantial public health concern
necessitating improvements in medical education. The Advancing the Provision
of Pain Education and Learning (APPEAL) study aimed to determine current
levels and methods of undergraduate pain medicine education in Europe. Design
and methods Using a cross-sectional design, publicly available curriculum
information was sought from all medical schools in 15 representative European
countries in 2012–2013. Descriptive analyses were performed on: the provision
of pain teaching in dedicated pain modules, other modules or within the
broader curriculum; whether pain teaching was compulsory or elective; the
number of hours/credits spent teaching pain; pain topics; and teaching and
assessment methods. Results Curriculum elements were publicly available from
242 of 249 identified schools (97%). In 55% (133/242) of schools, pain was
taught only within compulsory non-pain-specific modules. The next most common
approaches were for pain teaching to be provided wholly or in part via a
dedicated pain module (74/242; 31%) or via a vertical or integrated approach
to teaching through the broader curriculum, rather than within any specific
module (17/242; 7%). The curricula of 17/242 schools (7%) showed no evidence
of any pain teaching. Dedicated pain modules were most common in France (27/31
schools; 87%). Excluding France, only 22% (47/211 schools) provided a
dedicated pain module and in only 9% (18/211) was this compulsory. Overall,
the median number of hours spent teaching pain was 12.0 (range 4–56.0 h; IQR:
12.0) for compulsory dedicated pain modules and 9.0 (range 1.0–60.0 h; IQR:
10.5) for other compulsory (non-pain specific) modules. Pain medicine was
principally taught in classrooms and assessed by conventional examinations.
There was substantial international variation throughout. Conclusions
Documented pain teaching in many European medical schools falls far short of
what might be expected given the prevalence and public health burden of pain