The IASP Curricula Outlines provide recommended curricula for pharmacy, psychology, physical therapy, occupational therapy, nursing, medicine, dentistry, social work, and interprofessional education. The outlines are helpful for establishing teaching courses on acute, chronic, and cancer pain at both the undergraduate and graduate levels. The curricula outlines were all updated in 2017 for the Global Year on Excellence in Pain Education.
The European Pain Federation Core Curriculum for the European Diploma in Pain Medicine (2016) articulates the learning outcomes for trainees to achieve through self-directed learning, clinical experience in the workplace, and other educational experiences delivered during their training and helped by the EFIC® Pain Schools and educational initiatives.
The North American Core Pain Competencies by Fishman et al (2013) address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care-team models. A set of values and guiding principles are embedded within each domain. These competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain.
How to integrate
- Map the content outlines and competencies with existing curricula to help identify gaps or areas for improvement.
- Encourage curriculum developers across the health sciences to evaluate their current educational content and adopt and test the content outlines and competencies.
- Incorporate into learning opportunities and activities throughout the formative stages of health-care education and training for students and for future professional development.
- Urge local and national licensure, accreditation, certification, education, and policy governing bodies to consider incorporating pain competencies when establishing standards.
| Teaching Methods | Related Pain Education Example Reference |
| Case-Based Learning
Use of real or simulated stories that include patient problems/symptoms. Students analyze these and may work individually or in small groups to arrive at a solution using course concepts and clinical literature. |
Schwartz LR, Fernandez R, Kouyoumjian SR, Jones KA, Compton S. A randomized comparison trial of case-based learning versus human patient simulation in medical student education. Acad Emerg Med 2007;14(2):130-7 |
| Didactic
A slide presentation or lecture that may include brief question-and-answer sessions. |
McFadden P, Crim A. Comparison of the effectiveness of interactive didactic lecture versus online simulation-based CME programs directed at improving the diagnostic capabilities of primary care practitioners. J Contin Educ Health Prof 2016;36(1):32-7. |
| Problem-Based Learning
Focused experiential learning that is organized around the investigation of clinical problems. Learner groups are presented with a case and set their own learning objectives, often dividing the work, teaching each other, guided discussions, etc. |
Telehealth
Shelley BM, Katzman JG, Comerci GD Jr, Duhigg DJ, Olivas C, Kalishman S, Monette R, Britt M, Flatow-Trujllo L, Arora S. ECHO pain curriculum: balancing mandated continuing education with the needs of rural health care practitioners. J Contin Educ Health Prof 2017; Aug 16. doi: 10.1097/CEH.0000000000000165. [Epub ahead of print] |
| Simulation-Based Learning
Simulations (low tech–e.g., role playing–or high tech) duplicate clinical scenarios and allow learners to engage in activities that approximate realistic situations. |
Hecimovich M, Volet S. Simulated learning in musculoskeletal assessment and rehabilitation education: comparing the effect of a simulation-based learning activity with a peer-based learning activity. BMC Med Educ 2014;14:253 http://www.biomedcentral.com/1472-6920/14/253
McGillion M, Dubrowski A, Stremler R, Watt-Watson J, CAmpbellF, McCartney C, Victor C, Wiseman J, Snell J, Robb A, Nelson S, Stinson J, Hunter J, Dao T, Promislow S, McNaughton N, White S, Shobbrook C, Jeffs L, Mauch K, Leegaard M, Beattie W, Schreiber M, Silver I. The Postoperative Pain Assessment Skills pilot trial. Pain Res Manag 2011;16(6):433-9. |
| Team-Based Learning (“flipped classroom”)
Teacher-directed method for incorporating small-group active participation in large-group educational setting. Learners must actively participate in and out of class (preparation and discussion). Shift away from facts to application. |
Della Ratta CB. Flipping the classroom with team-based learning in undergraduate nursing education. Nurse Educ 2015;40(2):71-4.
Martinelli SM, Chen F, DiLorenzo AN, Mayer DC, Fairbanks S, Moran K, Ku C, Mitchell JD, Bowe EA, Royal KD, Hendrickse A, VanDyke K, Trawicki MC, Rankin D, Guldan GJ, Hand W, Gallagher C, Jacob Z, Zvara DA, McEvoy MD, Schell RM. Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents. J Grad Med Educ. 2017; 9(4):485-490. |
| Interprofessional Learning Activities
Combinations of aforementioned learning activities can be incorporated into interprofessional group problem solving and learning. |
Carr E, Watt-Watson J. Interprofessional pain education: definitions, exemplars and future directions. Br J Pain 2012;6(20:59-65. |
| Clinical Experiences
Observation of and practice in inpatient and/or outpatient health-care settings. |
Goldberg GR, Filatto P, Karani R. Effect of 1-week clinical rotation in palliative medicine on medical school graduates’ knowledge of and preparedness in caring for seriously ill patients. J Am Geriatr Soc 2011;59(9):1724-9. |
| Other:
Literature Review Critical review of evidence-based literature to inform best practices in pain management. Video Education Video-based training modules for learning clinical information and/or skills. Online Modules Learning modules including mixed learning methods (videos, case-based material, slide presentations, evidence-based discussions, etc.) Participating in Pain Group Therapy: Participating in already-established therapeutic groups to hear patients’ and staff experiences and then discuss specific topics with staff. |
Literature Review
Guerriero F, Bolier R, Van Cleave JH, Reid MC. Pharmacological approaches for the management of persistent pain in older adults: what nurses need to know. J Gerontol Nurs 2016;42(12):49-57. Video Education Bjorn A, Pudas-Tahka SM, Salantera S, Axelin A. Video education for critical care nurses to assess pain with a behavioral pain assessment tool: a descriptive comparative study. Intensive Crit Care Nurs 2017; Apr 18. pii: S0964-3397(17)30070-8. doi: 10.1016/j.iccn.2017.02.010. [Epub ahead of print] Online Training Richmond H, Hall AM, Hansen Z, Williamson E, Davies D, Lamb SE. Using mixed methods evaluation to assess the feasibility of online clinical training in evidence based interventions: a case study of cognitive behavioral treatment for low back pain. BMC Med Educ 2016;16(163): DOI 10.1186/s12909-016-0683-4 Weiner DK, Morone NE, Spallek H, Karp JF, Schneider M, Washburn C, Dziabiak MP, Hennon JG, Elnicki DM. E-learning module on chronic low back pain in older adults: evidence of effect on medical student objective structured clinical examination performance. J Am Geriatr Soc. 2014; 62(6):1161-7. Huestis SE, Kao G, Dunn A, Hilliard AT, Yoon IA, Golianu B, Bhandari RP. Multi-Family Pediatric Pain Group Therapy: Capturing Acceptance and Cultivating Change. Children (Basel). 2017; 7;4(12): E106 |
Resources
IASP Curricula Outlines
European Federation of International Chapters (EFIC) Curriculum for Pain Medicine
U.S. National Institute of Health (NIH) Centers of Excellence in Pain Education Case-Based Modules
REFERENCES
- Arwood E, Rowe JM, Singh NS, Carr DB, Herr KA, Chou R. Implementing a paradigm shift: incorporating pain management competencies into pre-licensure curricula. Pain Med 2015;16(2):291-300.
- Briggs EV, Carr EC. Whittaker MS. Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom. Eur J Pain 2011;15(8):789-95.
- Doorenbos AZ, Gordon DB, Tauben D, Palisoc J, Drangsholt M, Lindhorst T, Sanielson J, Spector J, Ballweg R, Vorvick L, Loeser JD. A blueprint of pain curriculum across prelicensure health sciences programs: one NIH Pain Consortium Center of Excellence in Pain Education (CoEPE) experience. J Pain 2013;14(12):1533-8.
- Eachempatil P, Kiran Kumar KS, Sumanth KN. Blended learning for reinforcing dental pharmacology in the clinical years: A qualitative analysis. Indian J Pharmacol 2016;48(Suppl 1):S25-S28.
- Fishman SM, Young HM, Arwood E, Chou R, Herr K, Murinson BB, Watt-Watson J, Carr DB, Gordon DB, Stevens BJ, Bakerjian D, Ballantyne JC, Courtenay M, Djukic M, Koebner IJ, Mongoven JM, Paice JA, Prasad R, Singh N, Sluka KA, St Marie B, Strassels SA. Pain Med 2013;14(7):971-81.
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- Hoeger Bement MK, St Marie BJ, Nordstrom TM, Christensen N, Mongoven JM, Koebner IJ, Fishman SM, Sluka KA. An interprofessional consensus of core competencies for prelicensure education in pain management: curriculum application for physical therapy. Phys Ther 2014;94(4):451-65.
- Hunter J, Watt-Watson J, McGillion M, Raman-Wilms L, Cockburn L, Lax L, Stinson J, Cameron A, Dao T, Pennefather P, Schreiber M, Librach L, Kavanagh T, Gordon a, Cullen N, Mock D, Salter M. An interfaculty pain curriculum: lessons learned from six years’ experience. Pain 2008;15(140):74-86.
- Martinelli SM, Chen F, DiLorenzo AN, Mayer DC, Fairbanks S, Moran K, Ku C, Mitchell JD, Bowe EA, Royal KD, Hendrickse A, VanDyke K, Trawicki MC, Rankin D, Guldan GJ, Hand W, Gallagher C, Jacob Z, Zvara DA, McEvoy MD, Schell RM. Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents. J Grad Med Educ. 2017; 9(4):485-490.
- Murinson BB, Nenorta E, Sam Mayer R, Mezei L, Kozachik S, Nesbit S, Haythornthwaite JA, Campbell JN. A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development. Pain Medicine 2011;12(2):186-95.
- Smith CD. A curriculum to address family medicine residents’ skills in treating patients with chronic pain. Int J Psychiatry Med 2014;47(4):327-36.
- Watt-Watson J, McGillion M, Hunter J, Choiniere M, Clark AJ, Dewar A, Johnston C, Lynch M, Morely-Forster P, Moulin D, Thie N, von Baeyer CL, Webber K. A survey of prelicensure pain curricula in health science faculties in Canadian universities. Pain Res Manag 2009;14(6):439-44.
- Watt-Watson J, Lax L, Davies R, Langlois S, Oskarsson J, Raman-Wilms L. The pain interprofessional curriculum design model. Pain Med 2017;18(6):1040-1048.
- Weiner DK, Morone NE, Spallek H, Karp JF, Schneider M, Washburn C, Dziabiak MP, Hennon JG, Elnicki DM. E-learning module on chronic low back pain in older adults: evidence of effect on medical student objective structured clinical examination performance. J Am Geriatr Soc. 2014; 62(6):1161-7.
AUTHORS
Deb Gordon, RN, DNP, FAAN
Anesthesiology & Pain Medicine
Co-Director Harborview Integrated Pain Care Program
University of Washington
Seattle, Wash., USA
Antje M. Barreveld, MD
Assistant Professor of Anesthesiology
Tufts University School of Medicine
Co-Principal Investigator, HSDM-BWH NIH Pain Consortium Center of Excellence in Pain Education
Medical Director, Pain Management Center
Director, Substance Use Services (SUS)
Anesthesiologist, Commonwealth Anesthesia Associates (CAA)
Newton-Wellesley Hospital
Newton, Mass., USA
REVIEWERS
Abrahão Fontes Baptista, PT, PhD
Center for Mathematics, Computation and Cognition, UFABC
Universidade Federal da Bahia
São Paulo, Brazil
Cynthia Goh, MBBS, PhD, FAChPM, FRCP
Associate Professor, Lien Center for Palliative Care
Duke-NUS Graduate Medical School Singapore
Senior Consultant & Head, Department of Palliative Medicine
National Cancer Center Singapore
Clinical Associate Professor, National University of Singapore
Singapore