Interprofessional Education for the Dentist in Managing Acute and Chronic Pain

Effectiveness and Dissemination of the Interprofessional Pediatric Pain PRN Curriculum

INTRODUCTION

Cultural transformation is needed for health care to be sensitive to children's pain. The Pediatric Pain Practice Registered Nurses (PRN) Curriculum is the first free, open access, downloadable, interprofessional pain continuing education (IPPCE) curriculum developed to empower health care professionals to translate evidence-based pain care into clinical practice. To evaluate the curriculum and its experiential flipped-learning strategies, we used a mixed methods approach.

METHODS

Interprofessional pediatric teams from eight health care systems evaluated the curriculum after attending Pediatric Pain PRN Courses in the Fall of 2017 (N = 90). Qualitative methods were used to evaluate the acceptability, feasibility, and utility of the curriculum and IPPCE strategies. Pain knowledge and attitudes were measured pre-IPPCE/post-IPPCE with the Pediatric Healthcare Provider's Knowledge & Attitude Survey Regarding Pain (PHPKAS). Web analytics were used to describe dissemination for the first year after the curriculum's webpage launch.

RESULTS

Learners rated their achievement of course objectives as moderate-great. PHPKAS scores significantly increased (P < .0005); but significant differences in physician and nurse PHPKAS question responses pre-IPPCE/post-IPPCE were found. Within 2 years of the IPPCE, three health care systems were certified as Childkind Hospitals, five Pediatric Pain PRN Programs were established, and various practice changes and improved patient outcomes, such as decreased hospital lengths of stay and emergency department returns for pain, were realized. Curriculum dissemination was global.

DISCUSSION

Results support the acceptability, effectiveness, feasibility, utility, and global dissemination of the curriculum and IPPCE strategies. More rigorous patient outcome data are needed; however, this study demonstrated the benefit of a free, open-access, downloadable, interprofessional health care provider continuing education curriculum.

Policy Development Fosters Collaborative Practice: The Example of the Minamata Convention on Mercury

This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholders; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.

The Barber Pole Might Have Been an Early Sign for Patient-Centered Care: What Do Interprofessional Education and Interprofessional Collaborative Practice Look Like Now?

In 2009, the Interprofessional Education Collaborative (IPEC) was initiated. Its release of interprofessional collaborative practice (ICP) core competencies in 2011 was pivotal for the engagement of health care professionals, including dentistry; in patient-centered, collaborative efforts for interprofessional education (IPE); and ICP. Thereby, IPEC is helping to put into application, in North America, the 2010 World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice. This article introduces IPE/ICP in 5 phases of evolution, emphasizing dental influence and inclusion, from historical perspectives through current applications that are expanded on in the accompanying articles elsewhere in this issue.

Massachusetts Dental Schools Respond to the Prescription Opioid Crisis: A Statewide Collaboration

The prescription opioid crisis has involved all sectors of U.S. society, affecting every community, socioeconomic group, and age group. While federal and state agencies are actively working to deal with the epidemic, medical and dental providers have been tasked to increase their awareness of the issues and consider ways to safely prescribe opioids and, at the same time, effectively treat their patients' pain. The Commonwealth of Massachusetts, under the leadership of Governor Charles D. Baker and his administration, challenged the state's four medical schools and three dental schools to improve their curricula to prepare the next generation of clinicians to deal with this crisis in an evidence-based, effective, and sympathetic way. This Perspectives article outlines the national prescription opioid crisis, details its effects in Massachusetts, and describes the interdisciplinary collaboration among the Commonwealth, the three dental schools, the Massachusetts Dental Society, and a concerned student group. The article also describes the efforts each dental school is undertaking as well as an assessment of the challenges and limitations in implementing the initiative. The authors hope that the Massachusetts model will be a useful resource for dental schools in other states.