More Americans are coping with chronic pain than ever before. Yet clinicians’ understanding of pain and their pain management skills vary widely because no such educational framework exists. Following an Institute of Medicine (IOM) recommendation, two UC Davis researchers led a team of experts to develop expectations for consistent, comprehensive pain management education for new health professionals, including nurses, physicians, pharmacists and physical therapists.
In an article scheduled for publication in the July issue of Pain Medicine, “Core Competencies for Pain Management: Results of an Interprofessional Consensus Summit” (available for free, public download at http://ucdmc.ucdavis.edu/paineducation/Happenings/PainMedicineArticle2013.pdf), UC Davis experts Scott Fishman and Heather M. Young, along with a team of international experts representing various health professions, identify the desired skills and knowledge new health professionals must possess to best care for people with pain. These educational outcomes, known as core competencies, serve as a foundation for the development of comprehensive pain management curricula for early learners in the health professions.
“The current state of educational content for pain management in schools of medicine and nursing, as well as other health professions, is often inadequate,” Fishman said. “The creation, distribution, and ultimately, the adoption of these basic expectations for pain management education is a critical step toward the preparation of more health-care professionals who understand and have basic skills to safely and effectively address pain."
The 2011 IOM report revealed the need for improved pain education for health professionals due to increasing numbers of Americans coping with chronic pain, as well as skyrocketing costs associated with chronic pain. According to the IOM, an estimated 100 million American adults—more than the total affected by heart diseases, cancer and diabetes combined—suffer from chronic pain. Pain costs the nation up to $600 billion annually in medical treatment and lost productivity.
“As pain remains a most common reason that patients seek healthcare, it is striking that so little time is spent in training healthcare professionals to understand and treat pain,” said Sean Mackey, professor and chief of the Division of Pain Medicine at Stanford University and member of the IOM Committee on Advancing Pain Research, Care and Education. “These core competencies represent a step that should have occurred a long time ago and hopefully will improve the effectiveness and safety of the care given to those in pain.”
The IOM study and other research indicate pain management education is often fragmented and inconsistently delivered across health professional education programs. The authors report that this identification of a foundation that supports consistent, early education of pain management throughout all the health professions will improve clinicians’ ability to address complex health issues and also improve collaboration and teamwork.
“Pain is an ideal topic to address from an interprofessional perspective,” said Young, associate vice chancellor for nursing and dean of the Betty Irene Moore School of Nursing. “Every health professional comes in contact with patients and their family members coping with pain. We all need to have a basic understanding of pain so we can provide appropriate care. By working together to develop these basic skills, we gain multiple perspectives on a very complex topic.”
Young and Fishman launched the Interprofessional Pain Management Competency Program with the goal to develop pain management core competencies and drive curriculum reform related to pain management.
The framework for pain management education and the resulting Pain Medicine article were the result of more than a year’s work that included a 29-member Expert Summit for Interprofessional Consensus on Pain Management in August 2012. The summit panel finalized draft materials and recommended a final set of core competencies that cover four key areas:
- Multidimensional nature of pain: What is pain?
- Assessment and measurement: How is pain recognized?
- Management of pain: How is pain relieved?
- Clinical conditions: How does context influence pain management?
The Interprofessional Pain Management Competency Program's initial phases were supported by The Mayday Fund, an organization dedicated to alleviating the incidence, degree and consequence of human physical pain.
Fishman, Young and the other experts plan to seek adoption in curricula throughout the health professions by presenting their findings in journals and association conferences. Fishman and Young also plan to incorporate pain management education into nursing and medical education at UC Davis.
“We hope to move quickly to incorporate these findings in learning activities for health professions at UC Davis in order to test them, refine them and help guide further curricular development,” Fishman said.
Details about the project, the core competencies and the summit participants are available on the project website at http://www.ucdmc.ucdavis.edu/paineducation/.