Self-Reported Comfort and Competencies for Pain Among Undergraduate Medical Students at Memorial University
Keywords:pain, pain education, undergraduate medical education, quality assurance
AbstractBackground: Pain is a unique, multifaceted and poorly understood topic. Research has found prevalent gaps in knowledge regarding pain management in medicine, partially stemming from inadequate coverage in undergraduate medical education. Pain in Memorial University’s curriculum has not been systematically explored and our study sought to examine medical students’ perceptions of pain-related curriculum. Methods: A previously created survey questionnaire for examining Canadian undergraduate medical student perspectives on pain was adapted for use at Memorial University. A web-based survey was administered between April – June 2020 to pre-clerkship and clerkship student cohorts using the Dillman Tailored Design Method. The questionnaire comprised a total of 25 items using Likert scale and visual analog scale (VAS) measures. Results: Forty-seven students (N=47) completed the survey. Respondents reported a median 4 (Interquartile range (IQR) = 6.5) total hours of pain instruction. Median perceived importance of pain management was 85 (IQR = 25.75) and 80 (IQR = 20.25) for pre-clerks and clerks respectively. Prioritization of pain in medical education, was a median 23.5 (IQR = 15) and 27.5 (IQR = 26) by clerk status, consistent with University of Alberta findings suggesting minimal recalled prioritization. Clerks indicated greater comfort with assessing pain (p=0.02), and managing adult pain (p=0.049), while all respondents lacked comfort managing children’s pain (VAS<50mm). Discussion: Undergraduate medical students at Memorial University view pain management as a significant, yet obscured topic in their medical education. While clerks indicated a greater comfort level, a consensus noted a lack of designated hours towards pain.
Association of Faculties of Medicine of Canada (AFMC). (2020). Academic Medicine Responds to the Opioid Crisis. Association of Faculties of Medicine of Canada. Retrieved from https://www.afmc.ca/en/priorities/opioids
Briggs, E. V., Battelli, D., Gordon, D., Kopf, A., Ribeiro, S., Puig, M. M., & Kress, H. G. (2015). Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study. BMJ Open, 5(8). doi: 10.1136/bmjopen-2014-006984
Campbell F, Hudspith M, Anderson M, Choiniere M, El-Gabalawy H, Laliberte J, Swidrovich J, Wilhelm L.. Canadian pain task force report: June 2019. Government of Canada; 2019. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2019.html
Corner, L. (2017). Content analysis of chronic pain content at three undergraduate medical schools in Ontario. Canadian Journal of Pain, 1(1), 75–83. doi: 10.1080/24740527.2017.1337467
Dillman, D. A. (2007). Mail and Internet Surveys: The Tailored Design Method (2nd ed.). Hoboken, NJ: John Wiley & Sons.
Fong, S., & Morley-Forster, P. (2018). Pain management training in undergraduate medical
education. University of Western Ontario Medical Journal, 87(1). doi: 10.5206/uwomj.v87i1.1790
Gordon, D. B., Watt-Watson, J., & Hogans, B. B. (2018). Interprofessional pain education—with, from, and about competent, collaborative practice teams to transform pain care. Pain Reports, 3(3), e663. doi: 10.1097/pr9.0000000000000663
Hogan, M.-E., Taddio, A., Katz, J., Shah, V., & Krahn, M. (2016). Incremental health care costs for chronic pain in Ontario, Canada. Pain, 157(8), 1626–1633. doi: 10.1097/j.pain.0000000000000561
Hurley-Wallace, A., Wood, C., Franck, L. S., Howard, R. F., & Liossi, C. (2019). Paediatric pain education for health care professionals. Pain Reports, 4(1), e701. doi: 10.1097/PR9.0000000000000701
International Association for the Study of Pain (IASP). (2021). Curricula. International Association for the Study of Pain (IASP). Retrieved from https://www.iasp-pain.org/Education/CurriculaList.aspx?navItemNumber=647
King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 152(12), 2729–2738. https://doi.org/10.1016/j.pain.2011.07.016
Mezei, L., & Murinson, B. B., & John Hopkins Pain Curriculum Development Team (2011). Pain Education in North American Medical Schools. The Journal of Pain, 12(12), 1199–1208. doi: 10.1016/j.jpain.2011.06.006
Prefontaine, K., & Rochette, A. (2013). A Literature Review on Chronic Pain: The Daily Overcoming of a Complex Problem. British Journal of Occupational Therapy, 76(6), 280–286. doi: 10.4276/030802213X13706169932905
Royal College of Physicians and Surgeons of Canada (RCPSC). (2018). Objectives of training in the subspecialty of pain medicine. (Version 2.0). Royal College of Physicians and Surgeons of Canada.
Schopflocher, D., Taenzer, P., & Jovey, R. (2011). The prevalence of chronic pain in Canada. Pain research & management, 16(6), 445–450. doi:10.1155/2011/876306
Shipton, E. E., Bate, F., Garrick, R., Steketee, C., & Visser, E. J. (2018). Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand. BMC Medical Education, 18(110). doi: 10.1186/s12909-018-1204-4
Shipton, E. E., Steketee, R., Bate, F., & Visser, E. J. (2019). Exploring assessment of medical students’ competencies in pain medicine—A review. Pain Reports, 4(1), e704. doi: 10.1097/PR9.0000000000000704
Tellier, P. P., Bélanger, E., Rodríguez, C., Ware, M. A., & Posel, N. (2013). Improving undergraduate medical education about pain assessment and management: a qualitative descriptive study of stakeholders' perceptions. Pain research & management, 18(5), 259–265. doi:10.1155/2013/920961
Tran, U. E., Kircher, J., Jaggi, P., Lai, H., Hillier, T., & Ali, S. (2018). Medical students’ perspectives of their clinical comfort and curriculum for acute pain management. Journal of Pain Research, Volume 11, 1479–1488. doi: 10.2147/jpr.s159422
Watt-Watson, J., Mcgillion, M., Hunter, J., Choiniere, M., Clark, A., Dewar, A., … Webber, K.
(2009). A Survey of Prelicensure Pain Curricula in Health Science Faculties in Canadian Universities. Pain Research and Management, 14(6), 439–444. doi: 10.1155/2009/307932
World Health Organization (WHO). ICD-11 Implementation or Transition Guide. Geneva, 2019. License: CC BY-NC-SA 3.0 IGO.
Wideman, T. H., Miller, J., Bostick, G., Thomas, A., Bussières, A., & Wickens, R. H. (2019). The current state of pain education within Canadian physiotherapy programs: A national survey of pain educators. Disability and Rehabilitation, 42(9), 1332–1338. https://doi.org/10.1080/09638288.2018.1519044
Wilson, M. G., Lavis, J. N., & Ellen, M. E. (2015). Supporting Chronic Pain Management across Provincial and Territorial Health Systems in Canada: Findings from Two Stakeholder Dialogues. Pain Research and Management, 20(5), 269–279. doi: 10.1155/2015/918976
How to Cite
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work