Surveys reveal a continuing lack of pain content in health science curricula despite a worldwide need to improve pain management practices. Curricula need to change from focusing on pain as a diagnostic indicator of disease to pain as a multidimensional, complex entity in itself. Read this prospectus on why it is essential to ensure that our graduates have demonstrated proficiency in specific pain care competencies.
From 2010 to 2012, nine subgroups of the IASP Education Initiatives Working Group developed pain curriculum outlines based on the four components of the IASP Core Curriculum. A broad range of health-care professionals worldwide contributed to the process. As part of the Global Year initiative in 2017, similar groups reviewed and updated all nine curricula, and the IASP Council has approved the revisions. IASP encourages the use of these curricula for adoption in medical and health professional education as well as for research purposes.
Pain Management Domains and Core Competencies
An article in Pain Medicine, “Core Competencies for Pain Management: Results of an Interprofessional Consensus Summit,” by Scott M. Fishman and Heather M. Young, et al. (Pain Medicine 2013; 14: 971–981) describes a project aimed at developing core competencies in pain assessment and management for prelicensure health professional education. An interprofessional committee led a consensus-building process to develop such competencies.
The committee conducted an in-depth literature review and held a two-day summit in order to reach consensus. It then categorized the competencies within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for creating learning activities across health professions.
Pain Management Domains and Core Competencies
Domain 1: Multidimensional nature of pain: What is pain?
This domain focuses on the fundamental concepts of pain including the science, nomenclature, and experience of pain, and pain’s impact on the individual and society.
- Explain the complex, multidimensional, and individual-specific nature of pain.
- Present theories and science for understanding pain.
- Define terminology for describing pain and associated conditions.
- Describe the impact of pain on society.
- Explain how cultural, institutional, societal, and regulatory influences affect assessment and management of pain.
Domain 2: Pain assessment and measurement: How is pain recognized?
This domain relates to how pain is assessed, quantified, and communicated, in addition to how the individual, the health system, and society affect these activities.
- Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess related outcomes as appropriate for the clinical context and population.
- Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management.
- Assess patient preferences and values to determine pain-related goals and priorities.
- Demonstrate empathic and compassionate communication during pain assessment.
Domain 3: Management of pain: How is pain relieved?
This domain focuses on collaborative approaches to decision-making, diversity of treatment options, the importance of patient agency, risk management, flexibility in care, and treatment based on appropriate understanding of the clinical condition.
- Demonstrate the inclusion of patient and others, as appropriate, in the education and shared decision-making process for pain care.
- Identify pain treatment options that can be accessed in a comprehensive pain management plan.
- Explain how health promotion and self-management strategies are important to the management of pain.
- Develop a pain treatment plan based on benefits and risks of available treatments.
- Monitor effects of pain management approaches to adjust the plan of care as needed.
- Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence.
- Develop a treatment plan that takes into account the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at the end of life.
Domain 4: Clinical conditions: How does context influence pain management?
This domain focuses on the role of the clinician in the application of the competencies developed in domains 1–3 and in the context of varied patient populations, settings, and care teams.
- Describe the unique pain assessment and management needs of special populations.
- Explain how to assess and manage pain across settings and transitions of care.
- Describe the role, scope of practice, and contribution of the different professions within a pain-management care team.
- Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources.
- Describe the role of the clinician as an advocate in assisting patients to meet treatment goals.
The University of Minnesota offers a free online multidisciplinary course that uses evidence-based science and creative and experiential learning to help health-care professionals better understand chronic pain conditions and how to prevent them through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms.
7th Annual Pain Awareness Day
This educational conference focusing on the 2018 Global Year For Excellence in Pain Education is aimed at health-care professionals who see the issues associated with such pain first-hand in their interactions with patients. This conference will help those understand multidisciplinary approaches for the treatment of pain by sharing advances in research and innovative strategies for pain management within Alberta, Canada. A variety of topics will be covered: Cannabis Update, A Year in Review; Opioid Crisis Update; Barriers & Educational Solutions in Pain Management.
The Irish Pain Society announces an excellent multidisciplinary line up of speakers to compliment the 2018 Global Year for Excellence in Pain Education: Dr. Ipek Yalcin (Basic Science), Ms. Felicia Cox (Nursing), Prof. Hans-Georg Kress (Pain Medicine), Dr. Cormac Ryan (Physiotherapy) and Dr. Jeff Breckon (Psychology). The plenary talks will be followed by an afternoon of master classes, including ultrasound-guided nerve blocks and opioid prescribing, a poster competition and the 4th Annual Irish Pain Research Network Symposium.