Difficult Conversations: Training Medical Students to Assess, Educate, and Treat the Patient with Chronic Pain

• Published in: Academic psychiatry 2019-10, Vol.43 (5), p.494-498
• Main Authors: Vargovich, Alison M., Schumann, Matthew E., Xiang, Jun, Ginsberg, Alexander D., Palmer, Brian A., Sperry, Jeannie A.
• Format: Article
• Language: English
• Subjects: Attitudes; Chronic pain; Chronic Pain - diagnosis; Chronic Pain - therapy; Class Size; Cohort Analysis; Collaboration; Communication; Communication Skills; Confidence; Curricula; Didacticism; Drug overdose; Drug Use; Education; Education, Medical, Undergraduate; Educational Measurement - statistics & numerical data; Empathy; Evidence; Feedback; Female; Health Knowledge, Attitudes, Practice; Humans; In Brief Report; Knowledge; Lecture Method; Likert scale; Likert Scales; Male; Medical Education; Medical schools; Medical students; Medicine; Medicine & Public Health; Models, Psychological; Narcotics; Outcomes of Treatment; Pain; Pain Management; Patient Simulation; Patients; Physicians; Problem-Based Learning; Psychiatry; Psychologists; Psychology; Rehabilitation Programs; Resistance (Psychology); Science Education; Science Instruction; Statistical Analysis; Student Evaluation; Student Satisfaction; Students, Medical - psychology; Surveys and Questionnaires; Teaching Methods; United States
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-019-01072-4

Objective Chronic pain, along with opioid abuse and misuse, continues to be a prevalent problem across the USA. Medical students have minimal training in biopsychosocial treatment of chronic pain and often lack the knowledge and skill necessary to address chronic pain with their patients. While there are a variety of treatment options available, research repeatedly has demonstrated that biopsychosocial treatment is the most effective option for chronic pain. Engaging patients in this type of treatment requires training and education. Methods The authors implemented a simulation workshop with standardized patients to educate medical students on the physical, psychological, and social aspects of chronic pain and also train students on the most effective ways to discuss chronic pain and educate their patients. Outcomes were measured by a pre- and post-test survey of knowledge, attitudes, and confidence in treating chronic pain, as well as satisfaction with the learning experience. Results Test and survey results indicated improvements in knowledge, attitudes, and confidence in treating chronic pain. Additionally, students were satisfied with the experience as evidenced by high post-workshop ratings. Conclusions Chronic pain training during medical school is associated with students feeling more prepared to provide non-opioid biopsychosocial pain treatment. Additionally, training with standardized patients allows students to learn how to effectively educate their patients, reduce negative confrontations, and maintain a positive physician-patient relationship.