Yealy Johnna K, Martinasek Mary, Doran Todd
Johnna K. Yealy, PhD, PA-C, is the program director and an associate professor in the Physician Assistant Medicine Program at the University of Tampa, Tampa, Florida. Mary Martinasek, PhD, is an assistant dean and associate professor in the Public Health Program at the University of Tampa, Tampa, Florida. Todd Doran, EdD, PA-C, is the director for PA admissions and professor in the Department of Physician Assistant Medicine Program at the University of Tampa, Tampa Florida.
J Physician Assist Educ. 2019 Mar;30(1):20-26. doi: 10.1097/JPA.0000000000000237.
Insufficient pain management and inappropriate use of pain medication are problems across the health care spectrum. Recent clinical practice guidelines and standardized core curricula have been developed to combat the deficiencies in pain education to ensure that health care professionals are proficient in assessing and managing pain; however, the extent to which physician assistant (PA) programs have implemented these in their training programs is unclear. The purpose of this study was to determine the magnitude of pain education in current PA programs in the United States, including how pain medicine instruction is incorporated into the curriculum, time spent teaching about pain management, the methods used, and barriers to providing pain medicine education.
Data from the 2016 Physician Assistant Education Association's Support to Advance Research grant, which allowed the inclusion of questions in the annual program survey, were analyzed. The response rate was 100%. Descriptive statistics were used to describe results. Nonparametric statistics used the Mann-Whitney U test and Kruskal-Wallis analysis to assess mean ranks and calculate effect sizes.
Of the 209 programs surveyed, 14% reported that pain management is not included in the curriculum, and 3% reported that it is a stand-alone module. The reason most often cited to explain lack of curriculum was insufficient time (39%), and 32% reported that it is not mandated by the program accreditors. Further analysis included assessment of differences in pain medicine curriculum by program housing, academic health science center status, and geography.
Eighty-six percent of programs include pain education in their curriculum, suggesting that PA programs recognize the importance of pain education. The methods of instruction and topics included across programs are inconsistent. As the first comprehensive benchmark of pain medicine education for PAs, this study shows that although most programs address pain curriculum, opportunities exist to improve pain training in PA programs in the United States.
疼痛管理不足和止痛药使用不当是整个医疗保健领域存在的问题。近期已制定了临床实践指南和标准化核心课程,以解决疼痛教育方面的不足,确保医疗保健专业人员精通疼痛评估和管理;然而,医师助理(PA)项目在其培训项目中实施这些指南和课程的程度尚不清楚。本研究的目的是确定美国当前PA项目中疼痛教育的程度,包括疼痛医学教学如何纳入课程、用于疼痛管理教学的时间、所采用的方法以及提供疼痛医学教育的障碍。
分析了2016年医师助理教育协会推进研究支持拨款的数据,该拨款允许在年度项目调查中纳入相关问题。回复率为100%。使用描述性统计来描述结果。非参数统计使用曼-惠特尼U检验和克鲁斯卡尔-沃利斯分析来评估平均秩并计算效应量。
在接受调查的209个项目中,14%报告称课程中不包括疼痛管理,3%报告称其为独立模块。最常被引用的解释课程缺失的原因是时间不足(39%),32%报告称项目认证机构未强制要求。进一步分析包括按项目所属机构、学术健康科学中心地位和地理位置评估疼痛医学课程的差异。
86%的项目在其课程中纳入了疼痛教育,这表明PA项目认识到疼痛教育的重要性。各项目所采用的教学方法和涵盖的主题不一致。作为PA疼痛医学教育的首个全面基准,本研究表明,尽管大多数项目涉及疼痛课程,但美国的PA项目仍有改进疼痛培训质量的空间。