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REP 20 - How the CPA Pain Science Division Approaches Professional Development

Geoff Bostick
 

Most physical therapists consider themselves life long learners.  Since CPA Divisions are in the business of supporting professional development, there is quite a lot of interest in supporting life long learning.
 

I routinely find myself thirsty for new knowledge and skills. As soon as I set out to satisfy this thirst, it becomes clear that the amount of information is overwhelming. Should I take a course or go to a conference? Should I read a blog or an article? Do I need a mentor? The accessibility of information has grown to a point that it has become difficult to navigate.
 

While sitting around a conference room table at Congress in Victoria, the Pain Science Division (PSD) executive grappled with a framework for supporting professional development in the field of Pain Science. Do we follow in the highly successful footsteps of the Orthopedic and Sport Divisions? These successful programs have an established step-by-step learning path. We struggled with envisioning how this could work for pain since the practice areas in pain are so diverse that a course-based system seemed untenable. There was also quite a bit of professional development opportunities out there, perhaps we should focus on compiling this information, rather than creating something new.
 

After much debate, we decided to develop a professional development tool that organized the vast amount of information available into something more user- friendly and could be 100% individualized.
 

Sounds good, right? We quickly realized this would be a monumental task!
 

We were fortunate to take advantage of a lot of great work being done in the field of pain education. The International Association for the Study of Pain developed a set of learning objectives for physical therapists who help sufferers of pain to better manage their pain. This gave us a blueprint to develop a ‘professional development curriculum in pain’. The blueprint was vetted by PSD executive and gaps filled with additional learning objectives.
 

Armed with a set of learning objectives, we needed to start compiling resources and organizing them according to each learning objective. We identified key articles, reputable blogs, online and face-to-face courses, certificate programs and other resources. Of course, this list is not fully comprehensive, but it is a great start!
 

Now that we had learning objectives, linked to learning resources, we created a website that facilitated self-reflection: Physical therapists could review each learning objective and decide if they felt they needed to learn more about the topic. If a learning gap was identified, the tool would then direct the learner to a number of resources. These resources range from easily accessible and free to intensive online certificate programs to a mentorship program. (Hat tip to Veronica Wong who lead this process.)

 

Here is an example:

The self-reflection/evaluation tool will display several learning objectives:

  I can describe, assess and/or measure the biological, psychological, and social factors that contribute to pain, physical dysfunction and disability using valid and reliable measurement tools
 

If this is something one needs to improve upon, the tool will direct you to resources such as:

  •   Articles for Eggheads: Lee H, Hübscher M, Moseley GL, Kamper SJ, Traeger AC, Mansell G, et al. How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain. Pain. 2015 Jun;156(6):988–97
     
  • Online courses, videos or webinars: Comprehensive Pain Assessment for Clinicians – free youtube videos (part 1-1 to part 6-2) by Dave Walton
     
  • (Many other resources are suggested)
     

The next time my thirst for new pain knowledge and skills needs quenching, I know to go to the PSD professional development reflection tool and follow these 2 steps: (1) determine my learning needs; and (2) look through the recommended learning opportunities compiled by the PSD.
 

The PSD is really proud of the hard work that went into developing the tool and we hope you find it useful.
 

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Comments

If the profession is going to embrace the biopsychosocial model of pain management, then perhaps the name for the interest group should reflect that tripartite approach by indicating in its name that this is so, rather than refer to it as "Pain Science".  Naming the division "Pain Management", or "Pain Education", versus "Pain Science" would go a long way in embracing the psychological and sociological contributions to the pain experience.  The experience of pain is not limited to the biological elements, yet despite research indicating how complex the phenomenon of pain is, adopting these non-biological elements into an integrated, entry-level curriculum limits the effective management of pain by graduates. 

Pain education must be included in the curriculum rather than limited to continuing education.  Given the current opioid addiction epidemic and overdose death statistics that are not going away, it is difficult to justify regulation without a robust education in current models of care.  Pain education should be at the core of what physiotherapists base their approach on as a client-centred profession.  

I agree with the author in how important pain education is in the profession.  I hope that advocacy efforts now at the national level will be sufficient for program leaders to accept the task at hand--to begin to reform the curriculum and pedagogy of physiotherapy programs across the country, and base this on current research and approaches that show most promise for improving effectiveness of interventions. 

Hello,

Thank you for your insightful comment. We, as a Division, have considered a name change for some of the reasons you've mentioned. However, we have not moved forward for a number of reasons. One is that you can view the term science broadly - for example, the social sciences include anthropology where the field have pain has had a number of important contributions to narrative medicine (see for example Arthur Kleinman Illness Narratives). So 'science' is not just limited to biology. Your point is well taken though - science for many would equate to biology. Hopefully you've been able to work through our professional development tool and will see there are quite a few learning outcomes related to the psychological, ethical and social aspects of pain. Another reason we have not moved on a name change is that the term science also has strong linkages to best evidence. Finally, in the few discussions we've had, we have not arrived at a 'better' name that adequately captures the breadth of pain (for example, Pain Management or Education Division are likely too narrow).

You will likely be pleased to know we wholeheartedly agree that pain education needs to optimized in PT Entry-Level Training. There is a group of academics and clinicians working on this right now! Here are two articles that we have published on the topic: https://www.ncbi.nlm.nih.gov/pubmed/30620223 and https://www.ncbi.nlm.nih.gov/pubmed/29434415. The PSD actively supported this initiative. This work is ongoing.

Thank youfor your interest!

Geoff

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