Perspective: Filling the Educational Void

Perspective: Filling the Educational Void In December of 2015, the Provost of my university (University of Southern California) asked me to be part of a small committee to review the online master degree programs in orofacial pain and oral medicine that were provided by the USC Ostrow School of Dentistry. This experience was an epiphany. I saw comprehensive, high-quality education on pain being provided to dentists from around the world. I thought of the Institute of Medicine 2011 report, Relieving Pain in America, which found that “Education is a central part of the necessary cultural transformation of the approach to pain.” The report went on to recommend that we increase the number of health professionals with advanced expertise in pain care. Educational programs for medical, dental, nursing, mental health, physical therapy, pharmacy, and other health professionals who will participate in the delivery of pain care should have increased capacity to train providers who can offer advanced pain care. [1] I realized that the online approach to pain education is a realistic and practical methodology for fulfilling the mandate of the Institute of Medicine. Dr. Glenn Clark, the Director of the dental school’s orofacial pain programs, agreed to partner with me, and now one and a half years later, we have a Master of Science in Pain Medicine program that has been approved by USC and accredited by the Western Association of Schools and Colleges (WASC). We have 20 faculty teaching 23 courses that cover assessment, diagnosis and classification, pharmacotherapeutics, psychology, complementary medicine, anatomy, neuroscience, epidemiology, sociology, history, public policy, and research methodology—courses aimed at addressing the areas of core competencies described by Scott Fishman and his colleagues in 2013 [2]. A full listing of our courses can be found under “Course List” at https://painmed.usc.edu/online-certificate-and-master-in-pain-medicine. The courses have been designed to appeal to all clinical specialists, especially to those who have some practice experience and have seen firsthand the difficulties and issues involved in the treatment of pain. It has been suggested that such education should be part of the prelicensure curricula of the various clinical professions [3]. As that has not yet been implemented, there is a need to offer “add-on” postlicensure pain education to interested clinicians. Our model is a blend of taped lectures and live, interactive online discussion groups. These interactive sessions will help the students to relate the lecture material to their actual practices. All of our students will gain a deeper understanding of the issues faced by patients suffering with chronic pain. The nonphysician students will learn about nondrug approaches to treating pain and will develop a basic appreciation for the use and the risk of various pain medications. Physicians and pharmacists will develop a deeper understanding of all the therapeutic options available. All of our students will be surveyed about the impact of the program on their careers, their clinical care, and their professional satisfaction. The efforts of our team were supported by the release of the National Pain Strategy in March of 2016, which identified a need for an educational mission. The mission includes grounding the pain-related education and training of physicians, nurses, advanced practice nurses, clinical pharmacists, dentists, podiatrists, clinical health psychologists, social workers, physician’s assistants, nurse practitioners, physical and occupational therapists, behavioral health specialists for mental health and substance use disorders, and other health, long-term services and supports, and social service professionals in core competencies, and making available easily accessible, evidence-based information for educators to work toward this goal. [4] Clearly the time is ripe. It is impossible to ignore the current opioid crisis with 91 Americans dying every day from an opioid overdose, and 55 of these deaths related to prescription opioids [5]. In spite of this apparent flood of opioids, 25.3 million American adults continue to suffer with daily pain [6]. Amazingly, this is occurring in an educational vacuum regarding pain—a 2010 survey revealed that of the 104 US medical schools, four reported having a required pain course [7]. The need for an educational mission is clear. Until now, there have been very few educational opportunities available to clinicians who want more advanced education about pain. Except for Dan Carr’s hybrid program at Tufts University for a Master of Science in Pain Research, Education and Policy [8], even interested physicians are limited to doing a full-time pain fellowship, a step that is out of reach for the vast majority of doctors; but this program is part-time and is feasible for the practicing clinician. The other clinical professions do not even have the option of doing a full-time fellowship. Furthermore, the problems with the treatment of pain are not just limited to the United States; rather, these are world-wide issues. By providing advanced education online, we believe that we can bring educational opportunities to countries where there are no other options for advanced education in pain medicine. We are hoping to develop funds to enable us to provide this education to international students with limited financial resources. We are also hoping our program and our future graduates will inspire more educational programs that aim to fulfill the mission described by the National Pain Strategy. Part of what makes our program feasible (and possibly replicable) is that we provide an academic certificate or degree, rather than a clinical credential. We believe that a strong educational background will enhance the practice of any clinician that deals with patients with pain. We hope to provide you with new partners and colleagues that support our common goal of safely alleviating pain. We can use your help. Visit us at https://painmed.usc.edu, and refer the clinicians in your institutions so that you can be surrounded by clinicians who support and understand the treatment of pain. Bit by bit, community by community, we can all work toward safer, more effective treatment for pain. References 1 Institute of Medicine Committee on Advancing Pain Research, Care, and Education. Relieving pain in America, a blueprint for transforming prevention, care, education, and research.  Washington, DC: National Academies Press; 2011; 4–3: 210. 2 Fishman SM, Young H, Arwood EL, et al.   Core competencies for pain management: Results of an interprofessional consensus summit. Pain Med  2013; 14 7: 971– 81. Google Scholar CrossRef Search ADS PubMed  3 Arwood E, Rowe JM, Singh NS, et al.   Implementing a paradigm shift: Incorporating pain management competencies into pre-licensure curricula. Pain Med  2015; 16 2: 291– 300. Google Scholar CrossRef Search ADS PubMed  4 National Pain Strategy. A comprehensive population health-level strategy for pain. 2016 . Available at: https://iprcc.nih.gov/docs/HHSNational_Pain_Strategy.pdf (accessed 14 Jun 2017). 5 American Society of Addiction Medicine. Opioid addiction: 2016 facts & figures. 2016. Available at: https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf (accessed 14 Jun 2017). 6 Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012. J Pain  2015; 16 8: 769– 80. Google Scholar CrossRef Search ADS PubMed  7 Mezei L, Murinson BB; The Johns Hopkins Pain Curriculum Development Team. Pain education in North American medical schools. J Pain  2011; 12 12: 1199– 208. Google Scholar CrossRef Search ADS PubMed  8 Tufts University School of Medicine, Pain Research, Education and Policy Program, 2016, http://publichealth.tufts.edu/Academics/MS-Pain-Research-Education-and-Policy. (accessed 14 Jun 2017). © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pain Medicine Oxford University Press

Perspective: Filling the Educational Void

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Oxford University Press
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© 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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1526-2375
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Abstract

In December of 2015, the Provost of my university (University of Southern California) asked me to be part of a small committee to review the online master degree programs in orofacial pain and oral medicine that were provided by the USC Ostrow School of Dentistry. This experience was an epiphany. I saw comprehensive, high-quality education on pain being provided to dentists from around the world. I thought of the Institute of Medicine 2011 report, Relieving Pain in America, which found that “Education is a central part of the necessary cultural transformation of the approach to pain.” The report went on to recommend that we increase the number of health professionals with advanced expertise in pain care. Educational programs for medical, dental, nursing, mental health, physical therapy, pharmacy, and other health professionals who will participate in the delivery of pain care should have increased capacity to train providers who can offer advanced pain care. [1] I realized that the online approach to pain education is a realistic and practical methodology for fulfilling the mandate of the Institute of Medicine. Dr. Glenn Clark, the Director of the dental school’s orofacial pain programs, agreed to partner with me, and now one and a half years later, we have a Master of Science in Pain Medicine program that has been approved by USC and accredited by the Western Association of Schools and Colleges (WASC). We have 20 faculty teaching 23 courses that cover assessment, diagnosis and classification, pharmacotherapeutics, psychology, complementary medicine, anatomy, neuroscience, epidemiology, sociology, history, public policy, and research methodology—courses aimed at addressing the areas of core competencies described by Scott Fishman and his colleagues in 2013 [2]. A full listing of our courses can be found under “Course List” at https://painmed.usc.edu/online-certificate-and-master-in-pain-medicine. The courses have been designed to appeal to all clinical specialists, especially to those who have some practice experience and have seen firsthand the difficulties and issues involved in the treatment of pain. It has been suggested that such education should be part of the prelicensure curricula of the various clinical professions [3]. As that has not yet been implemented, there is a need to offer “add-on” postlicensure pain education to interested clinicians. Our model is a blend of taped lectures and live, interactive online discussion groups. These interactive sessions will help the students to relate the lecture material to their actual practices. All of our students will gain a deeper understanding of the issues faced by patients suffering with chronic pain. The nonphysician students will learn about nondrug approaches to treating pain and will develop a basic appreciation for the use and the risk of various pain medications. Physicians and pharmacists will develop a deeper understanding of all the therapeutic options available. All of our students will be surveyed about the impact of the program on their careers, their clinical care, and their professional satisfaction. The efforts of our team were supported by the release of the National Pain Strategy in March of 2016, which identified a need for an educational mission. The mission includes grounding the pain-related education and training of physicians, nurses, advanced practice nurses, clinical pharmacists, dentists, podiatrists, clinical health psychologists, social workers, physician’s assistants, nurse practitioners, physical and occupational therapists, behavioral health specialists for mental health and substance use disorders, and other health, long-term services and supports, and social service professionals in core competencies, and making available easily accessible, evidence-based information for educators to work toward this goal. [4] Clearly the time is ripe. It is impossible to ignore the current opioid crisis with 91 Americans dying every day from an opioid overdose, and 55 of these deaths related to prescription opioids [5]. In spite of this apparent flood of opioids, 25.3 million American adults continue to suffer with daily pain [6]. Amazingly, this is occurring in an educational vacuum regarding pain—a 2010 survey revealed that of the 104 US medical schools, four reported having a required pain course [7]. The need for an educational mission is clear. Until now, there have been very few educational opportunities available to clinicians who want more advanced education about pain. Except for Dan Carr’s hybrid program at Tufts University for a Master of Science in Pain Research, Education and Policy [8], even interested physicians are limited to doing a full-time pain fellowship, a step that is out of reach for the vast majority of doctors; but this program is part-time and is feasible for the practicing clinician. The other clinical professions do not even have the option of doing a full-time fellowship. Furthermore, the problems with the treatment of pain are not just limited to the United States; rather, these are world-wide issues. By providing advanced education online, we believe that we can bring educational opportunities to countries where there are no other options for advanced education in pain medicine. We are hoping to develop funds to enable us to provide this education to international students with limited financial resources. We are also hoping our program and our future graduates will inspire more educational programs that aim to fulfill the mission described by the National Pain Strategy. Part of what makes our program feasible (and possibly replicable) is that we provide an academic certificate or degree, rather than a clinical credential. We believe that a strong educational background will enhance the practice of any clinician that deals with patients with pain. We hope to provide you with new partners and colleagues that support our common goal of safely alleviating pain. We can use your help. Visit us at https://painmed.usc.edu, and refer the clinicians in your institutions so that you can be surrounded by clinicians who support and understand the treatment of pain. Bit by bit, community by community, we can all work toward safer, more effective treatment for pain. References 1 Institute of Medicine Committee on Advancing Pain Research, Care, and Education. Relieving pain in America, a blueprint for transforming prevention, care, education, and research.  Washington, DC: National Academies Press; 2011; 4–3: 210. 2 Fishman SM, Young H, Arwood EL, et al.   Core competencies for pain management: Results of an interprofessional consensus summit. Pain Med  2013; 14 7: 971– 81. Google Scholar CrossRef Search ADS PubMed  3 Arwood E, Rowe JM, Singh NS, et al.   Implementing a paradigm shift: Incorporating pain management competencies into pre-licensure curricula. Pain Med  2015; 16 2: 291– 300. Google Scholar CrossRef Search ADS PubMed  4 National Pain Strategy. A comprehensive population health-level strategy for pain. 2016 . Available at: https://iprcc.nih.gov/docs/HHSNational_Pain_Strategy.pdf (accessed 14 Jun 2017). 5 American Society of Addiction Medicine. Opioid addiction: 2016 facts & figures. 2016. Available at: https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf (accessed 14 Jun 2017). 6 Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012. J Pain  2015; 16 8: 769– 80. Google Scholar CrossRef Search ADS PubMed  7 Mezei L, Murinson BB; The Johns Hopkins Pain Curriculum Development Team. Pain education in North American medical schools. J Pain  2011; 12 12: 1199– 208. Google Scholar CrossRef Search ADS PubMed  8 Tufts University School of Medicine, Pain Research, Education and Policy Program, 2016, http://publichealth.tufts.edu/Academics/MS-Pain-Research-Education-and-Policy. (accessed 14 Jun 2017). © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Journal

Pain MedicineOxford University Press

Published: Feb 1, 2018

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