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Nagel C, Queenan C, Burton C. What are medical students taught about persistent physical symptoms? A scoping review of the literature. BMC MEDICAL EDUCATION 2024; 24:618. [PMID: 38835003 DOI: 10.1186/s12909-024-05610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Persistent Physical Symptoms (PPS) include symptoms such as chronic pain, and syndromes such as chronic fatigue. They are common, but are often inadequately managed, causing distress and higher costs for health care systems. A lack of teaching about PPS has been recognised as a contributing factor to poor management. METHODS The authors conducted a scoping review of the literature, including all studies published before 31 March 2023. Systematic methods were used to determine what teaching on PPS was taking place for medical undergraduates. Studies were restricted to publications in English and needed to include undergraduate medical students. Teaching about cancer pain was excluded. After descriptive data was extracted, a narrative synthesis was undertaken to analyse qualitative findings. RESULTS A total of 1116 studies were found, after exclusion, from 3 databases. A further 28 studies were found by searching the grey literature and by citation analysis. After screening for relevance, a total of 57 studies were included in the review. The most commonly taught condition was chronic non-cancer pain, but overall, there was a widespread lack of teaching and learning on PPS. Several factors contributed to this lack including: educators and learners viewing the topic as awkward, learners feeling that there was no science behind the symptoms, and the topic being overlooked in the taught curriculum. The gap between the taught curriculum and learners' experiences in practice was addressed through informal sources and this risked stigmatising attitudes towards sufferers of PPS. CONCLUSION Faculties need to find ways to integrate more teaching on PPS and address the barriers outlined above. Teaching on chronic non-cancer pain, which is built on a science of symptoms, can be used as an exemplar for teaching on PPS more widely. Any future teaching interventions should be robustly evaluated to ensure improvements for learners and patients.
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Affiliation(s)
- Catie Nagel
- Primary Care Research Group, Division of Population Health, School of Medicine, University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, UK.
| | - Chloe Queenan
- Primary Care Research Group, Division of Population Health, School of Medicine, University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, UK
| | - Chris Burton
- Primary Care Research Group, Division of Population Health, School of Medicine, University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, UK
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McGhie-Fraser B, Lucassen P, Ballering A, Abma I, Brouwers E, van Dulmen S, Olde Hartman T. Persistent somatic symptom related stigmatisation by healthcare professionals: A systematic review of questionnaire measurement instruments. J Psychosom Res 2023; 166:111161. [PMID: 36753936 DOI: 10.1016/j.jpsychores.2023.111161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Patients with persistent somatic symptoms (PSS) experience stigmatising attitudes and behaviours by healthcare professionals. While previous research has focussed on individual manifestations of PSS related stigma, less is known about sound ways to measure stigmatisation by healthcare professionals towards patients with PSS. This review aims to assess the quality of questionnaire measurement instruments and make recommendations about their use. METHODS A systematic review using six databases (PubMed, Embase, CINAHL, PsycINFO, Open Grey and EThOS). The search strategy combined three search strings related to healthcare professionals, PSS and stigma. Additional publications were identified by searching bibliographies. Three authors independently extracted the data. Data analysis and synthesis followed COSMIN methodology for reviews of outcome measurement instruments. RESULTS We identified 90 publications that met the inclusion criteria using 62 questionnaire measurement instruments. Stereotypes were explored in 92% of instruments, prejudices in 52% of instruments, and discrimination in 19% of instruments. The development process of the instruments was not rated higher than doubtful. Construct validity, structural validity, internal consistency and reliability were the most commonly investigated measurement properties. Evidence around content validity was inconsistent or indeterminate. CONCLUSION No instrument provided acceptable evidence on all measurement properties. Many instruments were developed for use within a single publication, with little evidence of their development or establishment of content validity. This is problematic because stigma instruments should reflect the challenges that healthcare professionals face when working with patients with PSS. They should also reflect the experiences that patients with PSS have widely reported during clinical encounters.
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Affiliation(s)
- Brodie McGhie-Fraser
- Radboud University Medical Center, Radboud Institute for Health Services Research, Department of Primary and Community Care, Nijmegen, the Netherlands.
| | - Peter Lucassen
- Radboud University Medical Center, Radboud Institute for Health Services Research, Department of Primary and Community Care, Nijmegen, the Netherlands.
| | - Aranka Ballering
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands.
| | - Inger Abma
- Radboud University Medical Center, Radboud Institute of Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.
| | - Evelien Brouwers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands.
| | - Sandra van Dulmen
- Radboud University Medical Center, Radboud Institute for Health Services Research, Department of Primary and Community Care, Nijmegen, the Netherlands; Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden.
| | - Tim Olde Hartman
- Radboud University Medical Center, Radboud Institute for Health Services Research, Department of Primary and Community Care, Nijmegen, the Netherlands.
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Inman JGK, Ellard DR. What influences graduate medical students' beliefs of lower back pain? A mixed methods cross sectional study. BMC MEDICAL EDUCATION 2022; 22:633. [PMID: 35987611 PMCID: PMC9392230 DOI: 10.1186/s12909-022-03692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Low back pain (LBP) is a common condition with substantial associated disability and costs, best understood using a biopsychosocial approach. Research demonstrates that beliefs about LBP are important, with biomedical beliefs influencing practitioner's management and patient recovery. Beliefs about LBP can be inconsistent amongst healthcare and medical students. The aim of this study was to investigate graduate medical student's beliefs of LBP and what influences them. METHOD A cross sectional mixed methods study of Phase 1 (first year) and Phase 3 (third and fourth year) current graduate medical students at the University of Warwick (MBChB) was conducted. Participants were recruited via voluntary response sampling. A survey investigated LBP beliefs, utilising the Back Beliefs Questionnaire (BBQ) and Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). Qualitative data was collected on what influences beliefs about the causes and management of LBP, which was analysed descriptively using thematic analysis. RESULTS Fifty-seven students completed the questionnaire (61% female), with a mean age of 27.2 years. Eighty two percent of participants reported a history of LBP. Median BBQ scores were 31.5 for phase 1 and 31 for phase 3, with median HC-PAIRS scores of 57 and 60 for phase 1 and phase 3 students respectively. Three main themes emerged from the qualitative data: Sources of influence, influence of personal experience and influence of medical education. Participants discussed single or multiple sources influencing their beliefs about the causes and management of LBP. Another main theme was the influence of experiencing LBP personally or through discussions with family, friends and patients. The final main theme described the influence of medical education, including lectures, seminars and clinical placements. CONCLUSIONS The HC-PAIRS and BBQ scores suggest graduate medical students in this sample tended to have positive beliefs about the outcome of LBP and functional expectations of chronic LBP patients, consistent with other healthcare students. The findings from qualitative data suggest how medical students form beliefs about the causes and management of LBP is complex.
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Affiliation(s)
- John G. K. Inman
- Warwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7HL UK
| | - David R. Ellard
- Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7HL UK
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Mankelow J, Ryan CG, Taylor PC, Casey MB, Naisby J, Thompson K, McVeigh JG, Seenan C, Cooper K, Hendrick P, Brown D, Gibson W, Travers M, Kennedy N, O'Riordan C, Martin D. International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students. BMC MEDICAL EDUCATION 2022; 22:547. [PMID: 35840942 PMCID: PMC9284700 DOI: 10.1186/s12909-022-03488-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Persistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students' pain related knowledge and attitudes. The secondary aim was to explore what factors influence students' pain related knowledge and attitudes. METHODS In this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes]. RESULTS Physiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01) and attitudes (-17.2, -19.2 to 15.2, p = 0.01) between first and final year. Pain education teaching varied considerably from course to course (0 to 40 h), with greater levels of pain related knowledge and attitudes associated with higher volumes of pain specific teaching. CONCLUSIONS There was little difference in pain knowledge and attitudes between all first and final year NMAHP students other than physiotherapy. This suggests that for most NMAHP disciplines, undergraduate teaching has little or no impact on students' understanding of pain. There is an urgent need to enhance pain education provision at the undergraduate level in NMAHPs. TRIAL REGISTRATION The study protocol was prospectively registered at ClinicalTrials.Gov NCT03522857 .
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Affiliation(s)
- Jagjit Mankelow
- Teesside University, Middlesbrough, England.
- University of Limerick, Limerick, Ireland.
| | | | | | | | | | | | | | - Chris Seenan
- Glasgow Caledonian University, Glasgow, Scotland
| | - Kay Cooper
- Robert Gordon University, Aberdeen, Scotland
| | | | - Donna Brown
- University of Ulster, Belfast, Northern Ireland
| | - William Gibson
- The University of Notre Dame Australia, Fremantle, Australia
| | - Mervyn Travers
- The University of Notre Dame Australia, Fremantle, Australia
- Curtin University, Perth, Australia
| | | | | | - Denis Martin
- Teesside University, Middlesbrough, England
- Applied Research Collaboration for the North East and North Cumbria, National Institute for Health and Care Research, Newcastle Upon Tyne, England
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Factors associated with the low back pain-related attitudes and beliefs of physical therapists. Musculoskelet Sci Pract 2022; 58:102518. [PMID: 35131592 DOI: 10.1016/j.msksp.2022.102518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/05/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Clinicians who believe in a strong connection between pain and disability, and who have biomedically oriented beliefs recommend less physical activity, more time off work, and promote unhelpful beliefs in patients. Understanding how these beliefs develop may assist in identifying ways to reduce unhelpful beliefs in clinicians. OBJECTIVE To identify factors that are associated with the LBP-related attitudes and beliefs of US-based physical therapists. DESIGN Cross-sectional design METHOD: An electronic survey was sent to US-based physical therapists. Attitudes and beliefs were measured using the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), pain science knowledge was measured using the Neurophysiology of Pain Questionnaire (NPQ), and professional and demographic information were collected. RESULTS Completed surveys were obtained from 420 physical therapists. More helpful attitudes and beliefs were associated with board certification in orthopedics or sports, higher NPQ scores, and working in a hospital-based clinic. Less helpful attitudes and beliefs were associated with working in private practice and a personal history of LBP that had a minimum or significant impact on life. The factors included in this study explained 16.8% of the variability in HC-PAIRS scores (p < .001), 13% of the variability in PABS-BM scores (p < .001), and 8.3% of the variability in PABS-BPS scores (p < .001). CONCLUSION Several modifiable and non-modifiable factors are associated with the LBP-related attitudes and beliefs of US physical therapists.
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Mankelow J, Ryan CG, Morris H, Lauchlan D, Seenan C, Taylor P, Martin D. Charting physiotherapy students' attitudes toward people with chronic pain as they progress through their undergraduate programme: An observational study. Physiother Theory Pract 2021; 38:2658-2664. [PMID: 34496724 DOI: 10.1080/09593985.2021.1976890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Healthcare professionals' attitudes toward people with chronic pain influence their clinical practice. OBJECTIVES To investigate physiotherapy students' attitudes and beliefs toward people with chronic pain over the course of their Scottish undergraduate program. METHODS In this observational study, physiotherapy students from one university were recruited in the first year and followed up to their final year (year 1 n = 62/75, year 2 n = 68/72, year 3 n = 59/69, year 4 n = 74/74) for 4 years. The Health-Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS with scores ranging from 15 to 105) was completed annually. RESULTS A one-way ANOVA found that attitudes and beliefs improved significantly (p < .01) from the first to final year (9.2 ± 11.5 (mean±SD)). Participants showed a reduction in scores (signifying improved attitudes) annually with smaller reductions initially followed by a larger reduction in the final 2 years. CONCLUSIONS This is the first study to chart changes in the same cohort of physiotherapy students' attitudes and beliefs toward people with chronic pain over time. Future work should explore which aspects of degree courses, if any, impact upon attitudes and beliefs toward people with chronic pain so that courses can be enhanced accordingly.
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Affiliation(s)
- Jagjit Mankelow
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Cormac G Ryan
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Hayley Morris
- Institute of Cancer Sciences, University of Glasgow, Bearsden, Scotland
| | - Douglas Lauchlan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Christopher Seenan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Paul Taylor
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Denis Martin
- School of Health and Social Care, Centuria Building,Teesside University, UK
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Beetsma AJ, Reezigt RR, Reneman MF. Knowledge and attitudes toward musculoskeletal pain neuroscience of manual therapy postgraduate students in the Netherlands. Musculoskelet Sci Pract 2021; 52:102350. [PMID: 33640658 DOI: 10.1016/j.msksp.2021.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Health care practitioners' knowledge and attitudes influence patients' beliefs and health outcomes in musculoskeletal (MSK) pain. It is unclear to what extent physiotherapists undertaking a postgraduate master in manual therapy (MT students) possess the knowledge and attitudes toward pain neuroscience to be able to apply the biopsychosocial model in patients with MSK pain. OBJECTIVES The aim of this study was to assess the knowledge and attitudes toward pain neuroscience in MT students. DESIGN A cross-sectional study. METHOD Self-reported knowledge and attitudes were measured among students (n = 662) at baseline and in all years of the MT postgraduate programs in the Netherlands. The Knowledge and Attitudes of Pain questionnaire (KNAP) was used as a primary measure. Difference in KNAP-scores between baseline (0), year 1, year 2 and year 3 was tested using a one-way ANOVA (hypothesis: 0 < 1<2 < 3). A two factor ANOVA was used to determine the interaction effect of focused pain education and year in the curriculum with KNAP. RESULTS There was an overall significant difference of KNAP scores with a medium effect size (F(3, 218.18) = 13.56, p < .001, ω2 = 0.059). Differences between years ranged from small to medium. Interaction effect of knowledge and attitudes and focused pain education was significant with a small effect size (F(6) = 2.597, p = .017, ω2 = 0.012). Sensitivity analyses were consistent with the main results. CONCLUSIONS Positive differences in knowledge and attitudes toward pain neuroscience in MT students occur between the progressing years of the curriculum. Differences may be related to the provision of focused pain education.
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Affiliation(s)
- Anneke J Beetsma
- Department of Health Care Studies, School for Physiotherapy, Hanze University of Applied Sciences Groningen, P.O. Box 70030, 9714 CA, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, P.O. Box 30.002, 9750 RA, Haren, the Netherlands.
| | - Roland R Reezigt
- Department of Health Care Studies, School for Physiotherapy, Hanze University of Applied Sciences Groningen, P.O. Box 70030, 9714 CA, the Netherlands.
| | - Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, P.O. Box 30.002, 9750 RA, Haren, the Netherlands.
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Mankelow J, Ryan C, Taylor P, Martin D. The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial. Musculoskelet Sci Pract 2020; 50:102249. [PMID: 32920228 DOI: 10.1016/j.msksp.2020.102249] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/12/2020] [Accepted: 08/22/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE 1) To investigate the effects of a brief pain neuroscience education (PNE) lecture on multi-disciplinary healthcare students' knowledge, attitudes and behaviours towards people with pain post intervention and at 6-months follow-up, 2) To explore students' perceptions of PNE. DESIGN Mixed-methods randomized controlled trial. SETTING UK university. PARTICIPANTS Thirty-seven students (30♀, mean age 30 years) from six healthcare disciplines. INTERVENTION 70-min PNE lecture (intervention group) or a 70-min control education. MAIN OUTCOME MEASURES 1) Knowledge: The Revised Pain Neurophysiology Quiz (RPNQ); 2) Attitudes: Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS); 3) Behaviours: A case vignette to assess clinical recommendations; and 4) Thematic analysis of semi-structured interviews (n = 12). RESULTS The intervention group increased knowledge compared to the control, post-intervention [mean difference 3.7 (95% CI, 2.4, 5.0), P < 0.001] but not at 6-months (0.1 (-1.1, 1.3), P = 0.860). Greater improvements in attitudes for the intervention group were seen post-intervention [-10.4 (-16.3, -4.6), P < 0.001] and at 6-months [-5.8 (-11.5, -0.2), P < 0.044]. There was no difference in behaviours between groups. Thematic analysis identified increased patient empathy, partial and patchy reconceptualisation of pain and increased confidence in recommending an active management programme following PNE. CONCLUSION This study adds to existing knowledge by demonstrating that a 70-min PNE lecture can have a short-term effect on knowledge and positively shift attitudes towards people with pain in the short and medium-term. It also resulted in some students' reconceptualisation of pain, increased empathy, and confidence to recommend activity. The effect of PNE on clinical behaviours was unclear.
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Affiliation(s)
- Jagjit Mankelow
- School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, United Kingdom.
| | - Cormac Ryan
- School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, United Kingdom
| | - Paul Taylor
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BX, United Kingdom
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, United Kingdom
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Leysen M, Nijs J, Van Wilgen P, Demoulin C, Dankaerts W, Danneels L, Voogt L, Köke A, Pitance L, Roussel N. Attitudes and beliefs on low back pain in physical therapy education: A cross-sectional study. Braz J Phys Ther 2020; 25:319-328. [PMID: 32847758 DOI: 10.1016/j.bjpt.2020.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/28/2020] [Accepted: 08/04/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Prescription behavior in low back pain (LBP) differs between physical therapists with a biomedical versus a biopsychosocial belief, despite the presence of clinical guidelines. OBJECTIVE To examine (1) the beliefs of physical therapy students and their adherence to clinical LBP guidelines in Belgium and the Netherlands; (2) whether the beliefs and attitudes of physical therapy students change during education; (3) whether beliefs are related to guideline adherence; (4) whether beliefs and attitudes differ with or without a personal history of LBP. METHODS A cross-sectional design included students in the 2nd and 4th year of physical therapy education in 6 Belgian and 2 Dutch institutions. To quantify beliefs, the Pain Attitudes and Beliefs Scale, the Health Care Providers' Pain and Impairment Relationship Scale, and a clinical case vignette were used. RESULTS In total, 1624 students participated. (1) Only 47% of physical therapy students provide clinical guidelines' consistent recommendations for activity and 16% for work. (2) 2nd year students score higher on the biomedical subscales and lower on the psychosocial subscale. 4th year students make more guideline consistent recommendations about work and activity. (3) Students with a more biopsychosocial belief give more guideline adherent recommendations. (4) Personal experience with LBP is not associated with different beliefs or attitudes. CONCLUSIONS A positive shift occurs from a merely biomedical model towards a more biopsychosocial model from the 2nd to the 4th year of physical therapy education. However, guideline adherence concerning activity and work recommendations remains low.
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Affiliation(s)
- Marijke Leysen
- Department of Physical Therapy and Rehabilitation Sciences (REVAKI), Universiteit Antwerpen, Antwerp, Belgium; Pain in Motion International Research Group, www.paininmotion.be; Department of Physical Therapy, Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Jo Nijs
- Pain in Motion International Research Group, www.paininmotion.be; Department of Physical Therapy, Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Paul Van Wilgen
- Pain in Motion International Research Group, www.paininmotion.be; Department of Physical Therapy, Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christophe Demoulin
- Department of Sport and Rehabilitation Sciences, Université de Liège, Liege, Belgium
| | - Wim Dankaerts
- Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physical Therapy, Universiteit Gent, Ghent, Belgium
| | - Lennard Voogt
- Pain in Motion International Research Group, www.paininmotion.be; Department of Physical Therapy, University of Applied Sciences Rotterdam, Rotterdam, The Netherlands
| | - Albère Köke
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Laurent Pitance
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium; Stomatology and Maxillofacial Surgery Department, Brussels, Belgium
| | - Nathalie Roussel
- Department of Physical Therapy and Rehabilitation Sciences (REVAKI), Universiteit Antwerpen, Antwerp, Belgium
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Van Biesen T, Alvarez G. Beliefs about chronic low back pain amongst osteopaths registered in Spain: A cross-sectional survey. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Carroll SP, Augeard N, Tennant J, Seenan C. How do the attitudes, confidence, knowledge and understanding differ in pre-registration healthcare students towards treating people with chronic pain: an observational, cross-sectional study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1746830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sean Paul Carroll
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Nathan Augeard
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jacob Tennant
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Christopher Seenan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Lewis KL, Battaglia PJ. Knowledge of psychosocial factors associated with low back pain amongst health science students: a scoping review. Chiropr Man Therap 2019; 27:64. [PMID: 31807280 PMCID: PMC6857155 DOI: 10.1186/s12998-019-0284-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 10/01/2019] [Indexed: 01/07/2023] Open
Abstract
Background Low back pain is a burden worldwide and biological, psychological, and social mechanisms play a role in its development and persistence. Current guidelines support care using the biopsychosocial model. However, biomedical constructs dominate clinician training, and it is unknown the extent to which health science students understand the psychosocial determinates of a patient’s low back pain. Therefore, the aim of this scoping review is to report health science students’ current knowledge of psychosocial factors associated with low back pain. Methods A scoping review framework was used to search electronic databases for research examining health science students’ knowledge of psychosocial factors associated with low back pain. The nature and findings of the studies are highlighted using the data charting tool. Each study was analyzed to determine the type of outcome measurement used. Scores were compared to minimum accepted scores, between disciplines, as education advanced, and after educational modules. Results Fourteen studies published between 2004 and 2019 were identified. Seven healthcare disciplines were represented. In total, 12 different measurement tools were utilized. In 9 studies students demonstrated inadequate knowledge of psychosocial factors associated with low back pain. Three tools compared disciplines and nationalities. Three tools were associated with practice behavior. Eight studies showed improvement as students’ education advanced, and 3 studies demonstrated improvements in knowledge after implementation of pain education modules of varied lengths. Of those, two showed significant improvement. Conclusions Health science students in these studies had substandard understanding of psychosocial factors associated with low back pain. Dedicated pain education has the potential to improve low back pain understanding, resulting in more guideline appropriate care recommendation.
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Affiliation(s)
- Kelsey L Lewis
- Logan University Health Centers, Logan University, 1851 Schoettler Road, Chesterfield, MO 63017 USA
| | - Patrick J Battaglia
- Logan University Health Centers, Logan University, 1851 Schoettler Road, Chesterfield, MO 63017 USA
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Mukoka G, Olivier B, Ravat S. Level of knowledge, attitudes and beliefs towards patients with chronic low back pain among final year School of Therapeutic Sciences students at the University of the Witwatersrand - A cross-sectional study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:683. [PMID: 31535050 PMCID: PMC6739550 DOI: 10.4102/sajp.v75i1.683] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 04/23/2019] [Indexed: 01/29/2023] Open
Abstract
Background Knowledge of neurophysiology of pain influences healthcare providers' attitudes and beliefs about patients with chronic low back pain which affect management choices. Objectives The aim of this study was to determine the level of knowledge of pain and attitudes and beliefs towards patients with chronic low back pain among final year undergraduate students from the School of Therapeutic Sciences at the University of the Witwatersrand. Methods This cross-sectional study included two questionnaires - Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) for measuring attitudes and beliefs about pain and the Neurophysiology of Pain Questionnaire (NPQ) for knowledge of pain. These were distributed to 224 students. An analysis of variance and a two-sided t tests compared data with p ≤ 0.05. Results The study had a 65% response rate (n = 145), of which the majority were female students (n = 115, 79%). Overall, the mean correct NPQ score was 6.01 (± 1.98), with a significant difference among the programmes (p = 0.005). Mean NPQ scores for each programme were as follows: physiotherapy 6.97 (1.77), biokinetics 6.31 (2.43), exercise science 6.25 (2.5), pharmacy and pharmacology 5.69 (1.39), nursing 5.32 (1.39) and occupation therapy 5.21 (2.09). The mean correct scores for HC-PAIRS were 63.1 (8.9), with significantly higher scores in females than males (p = 0.04). Knowledge scores had a low inverse relationship with scores for attitudes and beliefs towards patients with chronic low back pain (r = -0.304; p = 0.0002). Conclusion There is a deficit in knowledge of pain among final year students in the School of Therapeutic Sciences, with a low correlation with attitudes and beliefs towards patients with chronic low back pain. Therefore, improving the knowledge of pain might result in a change in these attitudes and beliefs. Clinical implications The results have shown an association between knowledge of pain and attitudes and beliefs towards patients with chronic low back pain. Therefore, knowledge is one of the factors that could contribute in changing the attitudes.
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Affiliation(s)
- Grace Mukoka
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,South Africa.,Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Benita Olivier
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,South Africa
| | - Sadiya Ravat
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,South Africa
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The Effect of Pain Neuroscience Education on Sports Therapy and Rehabilitation Students’ Knowledge, Attitudes, and Clinical Recommendations Toward Athletes With Chronic Pain. J Sport Rehabil 2019; 28:438-443. [DOI: 10.1123/jsr.2017-0212] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Leahy A, O’Keeffe M, Robinson K, O’Sullivan K. The beliefs of healthcare students about the harmfulness of daily activities for their back: a cross-sectional study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1630854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Aoife Leahy
- Barking Havering and Redbridge University Trust, Romford, England
| | - Mary O’Keeffe
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, Australia
- Institute for Musculoskeletal Health, Sydney, Australia
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kieran O’Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
- Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Ankam NS, Bosques G, Sauter C, Stiens S, Therattil M, Williams FH, Atkins CC, Mayer RS. Competency-Based Curriculum Development to Meet the Needs of People With Disabilities: A Call to Action. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:781-788. [PMID: 30844926 DOI: 10.1097/acm.0000000000002686] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these gaps, the authors present practical examples of integrating concepts of disability into the curriculum with minimal additional time requirements. A comprehensive disability curriculum is suggested to include active classroom learning, clinical, and community-based experiences. At institutions that do not have a comprehensive curriculum, the authors recommend adding disability-related knowledge and skill acquisition to existing curricula through modifications to current case-based learning, simulated patients, and objective structured clinical examinations. To facilitate curriculum development, they recommend that the World Health Organization International Classification of Functioning, Disability, and Health be used as a tool to build disability concepts into active learning. The goal of these recommended curricular changes is to enhance student performance in the clinical management of people with disabilities and to better train all future physicians in the care of this population.
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Affiliation(s)
- Nethra S Ankam
- N.S. Ankam is associate professor and director of undergraduate medical education, Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. G. Bosques is associate professor of physical medicine and rehabilitation, University of Texas Health Science Center at Houston (UTHealth) Medical School, and medical staff, Shriners Hospital for Children, TIRR Memorial Hermann and Children's Memorial Hermann Hospital, Houston, Texas. C. Sauter is assistant professor and director of undergraduate medical education, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin. S. Stiens was associate professor, Department of Rehabilitation Medicine, University of Washington School of Medicine at the time this article was written, and is curator of education, Stiens' Designs: Personal Enablement, LLC, Seattle, Washington. M. Therattil is clinical assistant professor, Arthur S. Abramson Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, and director of medical education, Clinical Education Program, St. Lawrence Rehabilitation Center and Drexel University College of Medicine, Philadelphia, Pennsylvania. F.H. Williams is chief of physical medicine and rehabilitation, UMass Memorial Medical Center, and clinical professor of orthopedics and physical rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts. C.C. Atkins is adjunct professor of anatomy and physiology, Pomeroy College of Nursing at Crouse Hospital, Syracuse, New York, chief operations officer, MD Grand Rounds, Baltimore, Maryland, and chief executive officer, Cold Fusion Technologies LLC, Carthage, New York. R.S. Mayer is vice chair of education, Department of Physical Medicine and Rehabilitation, and associate professor of physical medicine and rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
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Rankin L, Fowler CJ, Stålnacke BM, Gallego G. What influences chronic pain management? A best-worst scaling experiment with final year medical students and general practitioners. Br J Pain 2019; 13:214-225. [PMID: 31656627 DOI: 10.1177/2049463719832331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Chronic pain education is an essential determinant for optimal chronic pain management. Given that attitudes and preferences are involved in making treatment decisions, identifying which factors are most influential to final year medical students' and general practitioners' (GPs) chronic pain management choices is of importance. This study investigates Swedish and Australian students' preferences with respect to a chronic pain condition, using a best-worst scaling (BWS) experiment, which is designed to rank alternatives. Methods BWS, a stated-preference method grounded in random utility theory, was used to explore the importance of factors influencing chronic pain management. Results All three cohorts considered the patients' pain description and previous treatment experience as the most important factors in making treatment decisions, whereas their demographics and voices or facial expressions while describing their pain were considered least important. Factors such as social support, patient preferences and treatment adherence were, however, disregarded by all cohorts in favour of pain assessment factors such as pain ratings, description and history. Swedish medical students and GPs show very high correlation in their choices, although the GPs consider their professional experience as more important compared to the students. Conclusion This study suggests that the relative importance of treatment factors is cemented early and thus underline the critical importance of improving pain curricula during undergraduate medical education.
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Affiliation(s)
- Linda Rankin
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | | | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
| | - Gisselle Gallego
- School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia
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Exploring assessment of medical students' competencies in pain medicine-A review. Pain Rep 2018; 4:e704. [PMID: 30801044 PMCID: PMC6370140 DOI: 10.1097/pr9.0000000000000704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/21/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. 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.
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The beliefs and attitudes of UK registered osteopaths towards chronic pain and the management of chronic pain sufferers - A cross-sectional questionnaire based survey. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Fitzgerald K, Fleischmann M, Vaughan B, de Waal K, Slater S, Harbis J. Changes in pain knowledge, attitudes and beliefs of osteopathy students after completing a clinically focused pain education module. Chiropr Man Therap 2018; 26:42. [PMID: 30364333 PMCID: PMC6194600 DOI: 10.1186/s12998-018-0212-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 08/21/2018] [Indexed: 11/29/2022] Open
Abstract
Background Chronic pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic pain. Knowledge of the neurophysiology and multidimensional aspects of pain is imperative to ensure health professionals apply a biopsychosocial approach to pain. Questionnaires may be used to assess learner changes in neurophysiology knowledge and beliefs and attitudes towards pain after education interventions. The aim of this study was to evaluate changes in pain neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS). Methods A pre-post design was utilised. Learners completed a demographic information survey pre-module, and completed the NPQ & HC-PAIRS prior to undertaking, and after completing, a twelve week clinically-focused pain module. Results Learners (n = 55) completed the NPQ & HC-PAIRS at both time points. The median NPQ score was significantly increased with a large effect size (p < 0.001, z = − 5.71, r = 0.78) following the completion of the module. In contrast, the HC-PAIRS total score was significantly increased after the completion of the module (p < 0.01, z = − 6.95, r = 0.91) suggesting an increase in negative pain attitudes and beliefs. Results indicate that a clinically-focused pain module can increase pain neurophysiology knowledge. However the HC-PAIRS results suggest an increase in negative pain attitudes and beliefs. The HC-PAIRS questionnaire was developed for use with chronic low back pain attitudes & beliefs in practitioners, rather than pre-clinical students. Students were provided with general principles of pain management, rather than condition specific pain management. This study is the first comparing pain neurophysiology knowledge and changes in attitudes and beliefs towards pain pre-post a clinically-focused pain module using the NPQ & HC-PAIRS. Conclusions There was a significant improvement in NPQ score after the 12 week clinically-focused pain module. The HC-PAIRS result was paradoxical and may reflect issues with the module design or the measurement tool. The module duration is longer than that reported in the literature and demonstrates effectiveness in increasing pain neurophysiology knowledge. Electronic supplementary material The online version of this article (10.1186/s12998-018-0212-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kylie Fitzgerald
- 1College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | | | - Brett Vaughan
- 2Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Kevin de Waal
- 1College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - Sarah Slater
- 1College of Health & Biomedicine, Victoria University, Melbourne, Australia
| | - John Harbis
- 1College of Health & Biomedicine, Victoria University, Melbourne, Australia
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Twenty-five years of pain education research—what have we learned? Findings from a comprehensive scoping review of research into pre-registration pain education for health professionals. Pain 2018; 159:2146-2158. [DOI: 10.1097/j.pain.0000000000001352] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Rankin L, Stålnacke BM, Fowler CJ, Gallego G. Differences in Swedish and Australian medical student attitudes and beliefs about chronic pain, its management, and the way it is taught. Scand J Pain 2018; 18:533-544. [PMID: 29794271 DOI: 10.1515/sjpain-2018-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 03/30/2018] [Indexed: 12/16/2022]
Abstract
Background and aims Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician's knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student's attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education. Methods An online survey was conducted with final year Australian and Swedish medical students from two different universities between December 2016 and February 2017. Attitudes and beliefs towards chronic pain patients were measured using the Health Care Providers' Pain and Impairment Scale (HC-PAIRS). A thematic analysis was conducted on open end questions regarding their views on their education and important skills for chronic pain management. Results A total of 57 Swedish and 26 Australian medical students completed the HC-PAIRS scale. The Swedish medical students showed statistically significantly lower total mean HC-PAIRS scores compared to Australian medical students (46 and 51, respectively). Australian students had statistically significantly higher scores than the Swedish students for two of four factors: functional expectations and need for cure, whereas no significant differences were seen for the factors social expectations or for projected cognition. From the open end questions it was evident that final year medical students are knowledgeable about key chronic pain items described in clinical guidelines. However, both cohorts described their chronic pain training as poor and in need of improvement in several areas such as more focus on the biopsychosocial model, working in multidisciplinary teams, seeing chronic pain patients and pharmacological training. Conclusions Attitudes and beliefs are formed during medical education, and our study exploring attitudes of medical students towards chronic pain and how it is taught have provided valuable information. Our survey provided detailed and cohesive suggestions for education improvement that also are in line with current clinical guidelines. This study indicates that the Swedish final year students have a more positive attitude towards chronic pain patients compared to their Australian counterparts. The majority of students in both cohorts perceived chronic pain management education in need of improvement. Implications This study highlights several areas of interest that warrant further investigation, for example, the impact of a changed medical curriculum in alignment with these clinical guidelines requested by students in this survey, and correspondingly if their attitudes towards chronic pain patients can be improved through education. Further, we conclude that it would be valuable to align the implementation of the HC-PAIRS instrument in order to achieve comparable results between future studies.
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Affiliation(s)
- Linda Rankin
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | | | - Christopher J Fowler
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
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Colleary G, O’Sullivan K, Griffin D, Ryan C, Martin D. Effect of pain neurophysiology education on physiotherapy students’ understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial. Physiotherapy 2017; 103:423-429. [DOI: 10.1016/j.physio.2017.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/10/2017] [Indexed: 10/19/2022]
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Cox T, Louw A, Puentedura EJ. An abbreviated therapeutic neuroscience education session improves pain knowledge in first-year physical therapy students but does not change attitudes or beliefs. J Man Manip Ther 2016; 25:11-21. [PMID: 28855788 DOI: 10.1080/10669817.2015.1122308] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To determine if a 3-hour therapeutic neuroscience education session alters physical therapy student's knowledge of pain and effects their attitudes and beliefs regarding treating chronic pain. METHODS Seventy-seven entry-level doctoral physical therapy students participated in the study. Following consent, demographic data were obtained and then the subjects completed the Neuroscience of Pain Questionnaire, the Health Care Provider's Pain and Impairment Relationship Scale and an additional questionnaire designed by the researchers. The subjects then received a 3-hour educational session developed by the researchers, focusing on the neurobiology and physiology of pain. The questionnaires were re-administered immediately after the educational session and at 6 months post-education. RESULTS Seventy-seven subjects (mean age = 24.7 years, 57.1% female and 81.8% white) completed the questionnaires pre- and post-educational session with 75 completing the questionnaires at 6 months. To assess the effect of the education on the scores of the questionnaires, a repeated measures ANOVA was conducted. Students demonstrated significantly higher scores on the neuroscience of pain questionnaire (p < 0.001) with no significant effect found on the attitudes and beliefs questionnaire at any of the time points. There were significant differences found on some of the individual questions that were part of the additional questionnaire. DISCUSSION An educational session on the neuroscience of pain is beneficial for educating entry-level doctoral physical therapy students immediately post-education and at 6 months. This educational session had no effect on the student's attitudes and beliefs regarding treating the chronic pain population. There were additional significant findings regarding individual questions posed to the subjects.
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Affiliation(s)
- Terry Cox
- Department of Physical Therapy, Southwest Baptist University, Bolivar, Missouri, USA
| | - Adriaan Louw
- International Spine and Pain Institute, Story City, Iowa, USA
| | - Emilio J Puentedura
- Department of Physical Therapy, School of Allied Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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Ihm JJ, Seo DG. Does Reflective Learning with Feedback Improve Dental Students’ Self-Perceived Competence in Clinical Preparedness? J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.2.tb06073.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jung-Joon Ihm
- Office of Dental Education; School of Dentistry; Seoul National University; Seoul Republic of Korea
| | - Deog-Gyu Seo
- Department of Conservative Dentistry and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Republic of Korea
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A comparison of the attitudes toward chronic low back pain in Saudi, Australian and Brazilian physical therapy students. J Taibah Univ Med Sci 2015. [DOI: 10.1016/j.jtumed.2014.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ung A, Salamonson Y, Hu W, Gallego G. Assessing knowledge, perceptions and attitudes to pain management among medical and nursing students: a review of the literature. Br J Pain 2015; 10:8-21. [PMID: 27551407 DOI: 10.1177/2049463715583142] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Chronic pain results in significant personal, societal and economic burden. Doctors and nurses have a pivotal role in patient pain management. In order to determine the effectiveness of current pain education on knowledge, attitudes and perceptions of medical and nursing students, there needs to be a valid measure to assess and quantify these domains. We reviewed the literature to identify approaches for assessing knowledge, perceptions and attitudes to pain management among nursing and medical students. METHODS Databases of peer-reviewed literature including CINAHL, EMBASE, ERIC, PsycInfo, Medline and PubMed were searched for articles published between 1993 and December 2014 using the following search terms: student, graduate, intern, junior, pain, pain management, analgesia, analgesic, pharmacology, pharmacological, knowledge, competence, attitude, preparedness, practice, nursing, medical, doctor, nurse. RESULTS The search revealed over 3500 articles, and on application of the inclusion criteria, 26 articles were included in the review. A total of 14 instruments were used in these studies with the Knowledge and Attitudes Survey Regarding Pain (KASRP) as the main instrument in 9 out of the 26 articles. The various instruments used different question formats such as multiple-choice questions (MCQs), true/false statements and Likert scales that went from 3 points to 7 points. Clinical skills examinations were also used in four studies to assess pain management. CONCLUSION There is no gold standard instrument currently used to assess knowledge, perceptions and attitudes to pain management. The results of this review showed, despite the diversity of standardised instruments that have been used to assess knowledge, perceptions and attitude to pain management, the literature has consistently reported that knowledge about pain management among nursing and medical students was generally poor among both groups.
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Affiliation(s)
- Andrew Ung
- School of Medicine, University of Western Sydney, Penrith, NSW, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, University of Western Sydney, Centre for Applied Nursing Research, Ingham Institute of Applied Medical Research, Penrith, NSW, Australia
| | - Wendy Hu
- School of Medicine, University of Western Sydney, Penrith, NSW, Australia
| | - Gisselle Gallego
- School of Medicine, University of Western Sydney, Penrith, NSW, Australia; Centre for Health Research, University of Western Sydney, Penrith, NSW, Australia; Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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Abadel FT, Hattab AS. How does the medical graduates' self-assessment of their clinical competency differ from experts' assessment? BMC MEDICAL EDUCATION 2013; 13:24. [PMID: 23402221 PMCID: PMC3576227 DOI: 10.1186/1472-6920-13-24] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 02/07/2013] [Indexed: 05/18/2023]
Abstract
BACKGROUND The assessment of the performance of medical school graduates during their first postgraduate years provides an early indicator of the quality of the undergraduate curriculum and educational process. The objective of this study was to assess the clinical competency of medical graduates, as perceived by the graduates themselves and by the experts. METHODS This is a hospital based cross-sectional study. It covered 105 medical graduates and 63 experts selected by convenient sampling method. A self-administered questionnaire covering the different areas of clinical competency constructed on a five-point Likert scale was used for data collection. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. The mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the graduates' and experts' assessments were influenced by the graduates' variables such as age, gender, experience, type of hospital, specialty and location of work at a (p ≤ 0.05) level of significance. RESULTS The overall mean scores for experts' and graduates' assessments were 3.40 and 3.63, respectively (p= 0.035). Almost 87% of the graduates perceived their competency as good and very good in comparison with only 67.7% by experts. Female and male graduates who rated themselves as very good were 33.8% and 25% respectively. More than 19% of the graduates in the age group > 30 years perceived their clinical competency as inadequate in contrast with only 6.2% of the graduates in the youngest age group. Experts rated 40% of the female graduates as inadequate versus 20% of males, (p= 0.04). More than 40% of the graduates in younger age group were rated by experts as inadequate, versus 9.7% of the higher age group >30 years (p = 0.03). CONCLUSION There was a wide discrepancy between the graduates' self-assessment and experts' assessment, particularly in the level of inadequate performance. Graduates in general, and those of younger age groups in particular, tend to overestimate their clinical skills and competency.
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Affiliation(s)
- Fatima Taleb Abadel
- Community Medicine and Public Health Department, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | - Abdulla Saeed Hattab
- Community Medicine and Public Health Department, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
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