Implications of IASP Core Curriculum for Pre-Registration Physiotherapy Education

Toward consensus on pain-related content in the pre-registration, undergraduate physical therapy curriculum: a Delphi-study

BACKGROUND

Access to pain education for healthcare professionals is an International Association for the Study of Pain's key recommendation to improve pain care. The content of preregistration and undergraduate physical therapy pain curricula, however, is highly variable.

OBJECTIVE

This study aimed to develop a list, by consensus, of essential pain-related topics for the undergraduate physical therapy curriculum.

METHODS

A modified Delphi study was conducted in four rounds, including a Delphi Panel (N = 22) consisting of in pain experienced lecturers of preregistration undergraduate physical therapy of Universities of Applied Sciences in the Netherlands, and five Validation Panels. Round 1: topics were provided by the Delphi Panel, postgraduate pain educators, and a literature search. Rounds 2-4: the Delphi Panel rated the topics and commented. All topics were analyzed in terms of importance and degree of consensus. Validation Panels rated the outcome of Round 2.

RESULTS

The Delphi Panel rated 257, 146, and 90 topics in Rounds 2, 3, and 4, respectively. This resulted in 71 topics judged as "not important," 97 as "important," and 89 as "highly important." In total, 63 topics were rated as "highly important" by the Delphi Panel and Validation Panels.

CONCLUSION

A list was developed and can serve as a foundation for the development of comprehensive physical therapy pain curricula.

What do Finnish physiotherapists and physiotherapy students know about the neurophysiology of pain? The Finnish version of the revised Neurophysiology of Pain Questionnaire

BACKGROUND

Understanding the concept of pain and its underlying biological mechanisms is an essential part of physiotherapists' professional knowledge.

OBJECTIVES

The first aim of the study was to translate and cross-culturally adapt the revised Neurophysiology of Pain Questionnaire into Finnish (RNPQ-FI) and to evaluate its reliability (internal consistency and test-retest reliability) in a sample of Finnish physiotherapists and physiotherapy students. The second aim was to compare the knowledge of pain neurophysiology between these two groups.

METHODS

Translation and cross-cultural adaptation followed the COSMIN Study Design checklist. Participants (202 physiotherapists and 97 physiotherapy students) completed an online survey containing RNPQ-FI. Internal consistency was assessed with Cronbach's alpha and test-retest reliability using Intraclass correlation coefficient (ICC3,1).

RESULTS

Cronbach's alpha was 0.44 and ICC was 0.70 (p < .001). The mean percentage of correct responses was 61.4% for physiotherapists and 62.1% for students. Forty-seven percent of the physiotherapists and 35.1% of the students reported difficulties in understanding the items. A higher amount of pain education was associated with higher RNPQ-FI scores.

CONCLUSIONS

The RNPQ-FI showed low internal consistency and moderate test-retest reliability among Finnish physiotherapists and physiotherapy students. Physiotherapists and students had equal amount of pain neurophysiology knowledge. Pain education is encouraged.

The current state of pain education within Canadian physiotherapy programs: a national survey of pain educators

Purpose: To determine the current state of pain education across physiotherapy programs in Canada.Materials and methods: Educators that were responsible for teaching pain-related content at each of the 14 Canadian physiotherapy programs were invited to complete a cross-sectional survey. The online survey evaluated total time spent on pain education and the integration of content from international guidelines on pain education curricula.Results and conclusions: Complete data were obtained from all Canadian physiotherapy programs. The total median time spent on pain education was 18 h, ranging from 8 to 65 h. Across all programs, only 38.6% of the recommended pain curriculum themes were fully integrated within physiotherapy programs. Most of the curriculum themes were partially addressed (median: 52.6%) and a small minority were not addressed (median: 10.5%). There was an overall trend in which greater time spent on pain education corresponded to a higher proportion of pain curriculum themes that were fully integrated. This is the first national survey of pain education that has included all physiotherapy programs across Canada. These data provide a foundation for understanding the current resources and content dedicated to pain education and are an essential step in benchmarking and potentially improving pain education for physiotherapists.Implications for rehabilitationIntegrating pain education within entry-level physiotherapy programs is a foundational step in translating pain research into effective physiotherapy pain management.This survey of all entry-level physiotherapy programs across Canada shows considerable variability in the time and scope of pain education and that, on average, less than 40% of recommended pain education curriculum content is adequately addressed.This work highlights the need for national reference standards in pain education to help improve consistency across training programs.

Physiotherapy pain curricula in Finland: a faculty survey

Background and aims

Despite the recognition of pain as a global health problem and advancements achieved in what is known about effective pain management, pain education for undergraduate health care professionals remains insufficient. This study investigated the content of pain curricula and the time allocated to pain education on physiotherapy programs at bachelor’s level at Universities of Applied Sciences (UASs) in Finland.

Methods

A web-based survey questionnaire was sent to the directors of the physiotherapy programs at all the Finnish UASs (n=15) where physiotherapy is taught at bachelor’s level. The questionnaire consisted of 14 questions covering basic concepts and the science of pain, pain assessment, pain management, and the adequacy of pain curricula. Each UAS completed one questionnaire i.e. returned one official opinion.

Results

The response rate was 80% (n=12). The mean for the total number of contact hours of pain education was 74 (standard deviation 34.2). All UASs had integrated pain education. In addition to this 42% (n=5) of the UASs had a separate pain course. The UASs offering such a course over and above the integrated pain education had twice the amount of pain content education compared to those UASs that only had integrated pain education (mean 103 h vs. 53 h, p=0.0043). Most of the education was devoted to conditions where pain is commonly a feature, manual therapy, and electrical agents for pain control. The biopsychosocial model of pain, cognitive behavioral methods of pain management, physician management, and multidisciplinary management were the least covered topics. Five UASs (42%) payed attention to the International Association for the Study of Pain curriculum outline and only 33% (n=4) considered their pain education to be sufficient.

Conclusions

Our results indicate that more contact hours are devoted to pain education on the Finnish UASs’ physiotherapy programs at bachelor’s level, than has previously been reported in faculty surveys. A separate pain course is one way to ensure a sufficient amount of pain education. Overall, despite a sufficient time devoted to pain education, some essential pain contents were inadequately covered.

Implications

The study contributes information on how pain education can be organized on physiotherapy programs at undergraduate level. Besides a sufficient amount of pain education, which can be ensured by a separate pain course, attention should be paid to pain education content being up-to-date. This could help in estimating the different proportions of pain content needed in educational settings. Efforts should also be made at keeping integrated pain education well-coordinated and purposeful. There is a need for further research estimating the effectiveness of pain education according to the different ways in which it is organized. There is also a need to investigate whether more hours allocated to pain education results in better understanding and professional skills.