A New Program in Pain Medicine for Medical Students: Integrating Core Curriculum Knowledge with Emotional and Reflective Development

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2011 Feb 1

PMID 21276187

Citations 25

Authors

Beth B Murinson

Elizabeth Nenortas

Roberts Sam Mayer

Lina Mezei

Sharon Kozachik

Suzanne Nesbit

Jennifer A Haythornthwaite

James N Campbell

Affiliations

Soon will be listed here.

Abstract

Objective: Improvements in clinical pain care have not matched advances in scientific knowledge, and innovations in medical education are needed. Several streams of evidence indicate that pain education needs to address both the affective and cognitive dimensions of pain. Our aim was to design and deliver a new course in pain establishing foundation-level knowledge while comprehensively addressing the emotional development needs in this area.

Setting: One hundred eighteen first-year medical students at Johns Hopkins School of Medicine.

Outcome Measures: Performance was measured by multiple-choice tests of pain knowledge, attendance, reflective pain portfolios, and satisfaction measures.

Results: Domains of competence in pain knowledge included central and peripheral pain signalling, pharmacological management of pain with standard analgesic medications, neuromodulating agents, and opioids; cancer pain, musculoskeletal pain, nociceptive, inflammatory, neuropathic, geriatric, and pediatric pain. Socio-emotional development (portfolio) work focused on increasing awareness of pain affect in self and others, and on enhancing the commitment to excellence in pain care. Reflections included observations on a brief pain experience (cold pressor test), the multidimensionality of pain, the role of empathy and compassion in medical care, the positive characteristics of pain-care role models, the complex feelings engendered by pain and addiction including frustration and disappointment, and aspirations and commitments in clinical medicine. The students completing feedback expressed high levels of interest in pain medicine as a result of the course.

Discussion: We conclude that a 4-day pain course incorporating sessions with pain specialists, pain medicine knowledge, and design-built elements to strengthen emotional skills is an effective educational approach.

Summary: Innovations in medical education about pain are needed. Our aim was to design and deliver a new course for medical students addressing both the affective and cognitive dimensions of pain. Combining small-group sessions with pain specialists, active-learning approaches to pain knowledge, and design-built elements to strengthen emotional skills was highly effective.

Citing Articles

What are medical students taught about persistent physical symptoms? A scoping review of the literature.

Nagel C, Queenan C, Burton C BMC Med Educ. 2024; 24(1):618.

PMID: 38835003 PMC: 11151618. DOI: 10.1186/s12909-024-05610-z.

Shifts in Students' Attitudes Towards Pain Patients, Pain, and Opioid Management Following a Dedicated Medical School Pain Curriculum.

Durbhakula S, Wang T, Segna K, Limerick G, Broachwala M, Schatman M J Pain Res. 2024; 17:827-835.

PMID: 38449798 PMC: 10916513. DOI: 10.2147/JPR.S447671.

Interprofessional Active Learning for Chronic Pain: Transforming Student Learning From Recall to Application.

Helms J, Frankart L, Bradner M, Ebersole J, Regan B, Crouch T J Med Educ Curric Dev. 2023; 10:23821205231221950.

PMID: 38152832 PMC: 10752086. DOI: 10.1177/23821205231221950.

Outcomes of Pain Management Training for the Fourth- and Fifth-Year Medical Students.

Saeki A, Takao Y, Suzuki K, Hirose M Pain Res Manag. 2023; 2023:6080769.

PMID: 37664418 PMC: 10473891. DOI: 10.1155/2023/6080769.

Improving Access to Care for Patients Taking Opioids for Chronic Pain: Recommendations from a Modified Delphi Panel in Michigan.

Kehne A, Bernstein S, Thomas J, Bicket M, Bohnert A, Madden E J Pain Res. 2023; 16:2321-2330.

PMID: 37456356 PMC: 10348368. DOI: 10.2147/JPR.S406034.

References

Flowers L . The missing curriculum: experience with emotional competence education and training for premedical and medical students. J Natl Med Assoc. 2005; 97(9):1280-7. PMC: 2594773. View

Dobie S . Viewpoint: reflections on a well-traveled path: self-awareness, mindful practice, and relationship-centered care as foundations for medical education. Acad Med. 2007; 82(4):422-7. DOI: 10.1097/01.ACM.0000259374.52323.62. View

Monin J, Schulz R, Martire L, Jennings J, Hagerty Lingler J, Greenberg M . Spouses' cardiovascular reactivity to their partners' suffering. J Gerontol B Psychol Sci Soc Sci. 2010; 65B(2):195-201. PMC: 2821945. DOI: 10.1093/geronb/gbp133. View

Blasco P, Moreto G, Levites M . Teaching humanities through opera: leading medical students to reflective attitudes. Fam Med. 2004; 37(1):18-20. View

Murinson B, Agarwal A, Haythornthwaite J . Cognitive expertise, emotional development, and reflective capacity: clinical skills for improved pain care. J Pain. 2008; 9(11):975-83. PMC: 2596981. DOI: 10.1016/j.jpain.2008.07.010. View

Hunter J, Watt-Watson J, McGillion M, Raman-Wilms L, Cockburn L, Lax L . An interfaculty pain curriculum: lessons learned from six years experience. Pain. 2008; 140(1):74-86. DOI: 10.1016/j.pain.2008.07.010. View

Goldberg J . Humanism or professionalism? The White Coat Ceremony and medical education. Acad Med. 2008; 83(8):715-22. DOI: 10.1097/ACM.0b013e31817eba30. View

Epstein R, Hundert E . Defining and assessing professional competence. JAMA. 2002; 287(2):226-35. DOI: 10.1001/jama.287.2.226. View

Gibbins J, McCoubrie R, Maher J, Forbes K . Incorporating palliative care into undergraduate curricula: lessons for curriculum development. Med Educ. 2009; 43(8):776-83. DOI: 10.1111/j.1365-2923.2009.03400.x. View

10.

Sullivan M, Edlund M, Fan M, DeVries A, Brennan Braden J, Martin B . Trends in use of opioids for non-cancer pain conditions 2000-2005 in commercial and Medicaid insurance plans: the TROUP study. Pain. 2008; 138(2):440-449. PMC: 2668925. DOI: 10.1016/j.pain.2008.04.027. View

11.

Olthuis G, Dekkers W . Medical education, palliative care and moral attitude: some objectives and future perspectives. Med Educ. 2003; 37(10):928-33. DOI: 10.1046/j.1365-2923.2003.01635.x. View

12.

Wright S, Wong A, Newill C . The impact of role models on medical students. J Gen Intern Med. 1997; 12(1):53-6. PMC: 1497058. DOI: 10.1046/j.1525-1497.1997.12109.x. View

13.

Satterfield J, Hughes E . Emotion skills training for medical students: a systematic review. Med Educ. 2007; 41(10):935-41. DOI: 10.1111/j.1365-2923.2007.02835.x. View

14.

Pilowsky I . An outline curriculum on pain for medical schools. Pain. 1988; 33(1):1-2. DOI: 10.1016/0304-3959(88)90196-0. View

15.

Hundert E, BICKEL J . Context in medical education: the informal ethics curriculum. Med Educ. 1996; 30(5):353-64. DOI: 10.1111/j.1365-2923.1996.tb00847.x. View

16.

Wiener C, Thomas P, Goodspeed E, Valle D, Nichols D . "Genes to society"--the logic and process of the new curriculum for the Johns Hopkins University School of Medicine. Acad Med. 2010; 85(3):498-506. DOI: 10.1097/ACM.0b013e3181ccbebf. View

17.

Bergstrom L, Richards L, Morse J, Roberts J . How caregivers manage pain and distress in second-stage labor. J Midwifery Womens Health. 2010; 55(1):38-45. DOI: 10.1016/j.jmwh.2009.05.001. View

18.

Pitkala K, Mantyranta T . Feelings related to first patient experiences in medical school. A qualitative study on students' personal portfolios. Patient Educ Couns. 2004; 54(2):171-7. DOI: 10.1016/S0738-3991(03)00209-X. View

19.

Torppa M, Makkonen E, Martenson C, Pitkala K . A qualitative analysis of student Balint groups in medical education: contexts and triggers of case presentations and discussion themes. Patient Educ Couns. 2008; 72(1):5-11. DOI: 10.1016/j.pec.2008.01.012. View

20.

Bellini L, Shea J . Mood change and empathy decline persist during three years of internal medicine training. Acad Med. 2005; 80(2):164-7. DOI: 10.1097/00001888-200502000-00013. View