Contemporary pain science education and physician assistant students: a longitudinal educational intervention study
Description
Background: Chronic pain is a common reason people seek health care and is frequently encountered in clinical settings where physician associate medicine (PAM) graduates are likely to practice. Contemporary pain science education emphasizes pain as a biopsychosocial construct and the value of understanding pain neuroscience; however, pain education remains limited and inconsistently integrated across health professions curricula. The purpose of this study was to examine the longitudinal impact of a single multimodal biopsychosocial contemporary pain science education session on PAM students’ pain neuroscience knowledge and pain-related attitudes and beliefs. Methods: A prospective longitudinal repeated-measures educational intervention study was conducted with one cohort of master’s-level PAM students at a single university. The educational session occurred early during the second semester of a 27-month program and included four hours of lecture with small-group active learning, discussion, case-based application, and a 30-minute laboratory component. Pain neuroscience knowledge was assessed using the Revised Neurophysiology of Pain Questionnaire (rNPQ), and pain-related attitudes and beliefs were assessed using the Health Care Provider’s Pain and Impairment Relationship Scale (HC-PAIRS). Repeated-measures ANOVA with post hoc Holm-adjusted pairwise comparisons was used to evaluate changes over time. Results: Thirty-five participants had complete data across all five time points. HC-PAIRS scores changed significantly over time (p = 0.002, η²p = 0.114), with pre-session scores significantly higher than scores at all subsequent time points. Mean HC-PAIRS scores decreased from 64.21 before the session to 57.87 immediately before graduation. rNPQ scores also changed significantly over time (p = 0.010, η²p = 0.118), but demonstrated a more variable pattern. Scores increased immediately after the session, declined by the end of the second semester, recovered by the end of didactic training, and returned toward baseline before graduation. Conclusions: A single multimodal biopsychosocial contemporary pain science education session was associated with sustained improvement in PAM students’ pain-related attitudes and beliefs, while pain neuroscience knowledge gains were more variable over time. These findings support incorporating contemporary pain science education into PAM curricula and suggest that repeated curricular reinforcement may be needed to support durable knowledge retention.
Files
Steps to reproduce
All students in a single cohort of master's degree physician assistant medicine (PAM) students from a single university in the southeastern United States consented to participate in the study. The in-person, 27-month PAM curriculum included 12 months of didactic training, 14 months of clinical training, and a one-month summative phase on campus. Data were collected at five time points across the duration of the PAM educational program. The first time point (T1) occurred immediately before the educational session during the fourth month of the program, followed by the second (T2) immediately after the session. The third time point (T3) was at the end of the second semester, approximately four months after the session. The fourth (T4) occurred at the end of didactic training, 11 months after the session, and the final time point (T5) was immediately before graduation, following clinical rotations, approximately 23 months after the initial training. At the initial time point (T1), participants provided basic demographic information, rated their current pain using the Numeric Pain Rating Scale (NPRS), and reported whether they had a personal or familial history of persistent pain. Participants also indicated any prior exposure to pain-related education. In addition, at all time points, participants completed two standardized instruments: the 12-item Revised Neurophysiology of Pain Questionnaire (rNPQ) and the Health Care Provider’s Pain and Impairment Relationship Scale (HC-PAIRS). The rNPQ was used to assess participants’ knowledge about contemporary pain neuroscience. The rNPQ has demonstrated acceptable psychometric properties, including acceptable internal consistency Person Separation Index = 0.84 and strong test-retest reliability (ICC = 0.97 and 0.99), and has been widely used among patients, healthcare students, and practitioners.(21,23–28) Higher rNPQ scores indicate greater pain neurophysiology knowledge. The HC-PAIRS was used to assess participant pain-related attitudes and beliefs. The HC-PAIRS has been widely used and has demonstrated acceptable construct validity, good internal consistency (Cronbach’s α = 0.84), and modest test-retest reliability.(29–31) Higher HC-PAIRS scores reflect stronger beliefs that pain is directly linked to impairment and activity limitation.
Institutions
- Belmont UniversityTennessee, Nashville