加州大学戴维斯分校培训师初级保健疼痛管理奖学金：解决疼痛管理教育差距。

UC Davis Train-the-Trainer Primary Care Pain Management Fellowship: Addressing the Pain Management Education Gap.

机构信息

S.M. Fishman is Fullerton Endowed Chair in Pain Medicine and professor, Department of Anesthesiology and Pain Medicine, School of Medicine, University of California, Davis, and director, Center for Advancing Pain Relief, Betty Irene Moore School of Nursing and School of Medicine, University of California, Davis, Davis, California; ORCID: https://orcid.org/0000-0001-8717-8300 .

D. Copenhaver is associate professor and chief, Department of Anesthesiology and Pain Medicine, Division of Pain Medicine, School of Medicine, University of California, Davis, and associate director, Center for Advancing Pain Relief, Betty Irene Moore School of Nursing and School of Medicine, University of California, Davis, Davis, California.

出版信息

Acad Med. 2021 Feb 1;96(2):236-240. doi: 10.1097/ACM.0000000000003554.

DOI:10.1097/ACM.0000000000003554

PMID:32590468

Abstract

PROBLEM

Primary care providers are responsible for the majority of pain care and opioid prescribing, but they are often inadequately trained. Training current providers to address the crisis of excessive opioid prescribing and inadequate pain management is a substantial workforce problem that requires urgent action. This educational need is vast and requires a staged solution to amplify its effect.

APPROACH

The University of California, Davis Train-the-Trainer (T3) Primary Care Pain Management Fellowship targets the most pressing topics related to pain management, including prescription drug abuse, responsible opioid prescribing, and substance abuse, as well as broad coverage of comprehensive pain management. It offers an innovative, scalable solution to address the education gap in pain management that, in part, fuels the opioid epidemic in the United States. The T3 Fellowship incorporates a competency-based curriculum and a hybrid educational model of in-person and distance-based learning and direct faculty-fellow mentoring to comprehensively train primary care providers in pain care and prepare them to train others. Since it was established in 2017, 2 cohorts (of 17 and 26 fellows) have completed the 10-month fellowship and a third cohort of 38 fellows started the program in September 2019.

OUTCOMES

Pre- and postprogram surveys for the first 2 cohorts, and a 6-month postprogram survey for the first cohort, demonstrated fellows' improvement and sustained performance in pain competencies as well as increased recognition and understanding of pain and related topics.

NEXT STEPS

If adopted by other institutions and expanded across the country, the T3 Fellowship holds potential for developing an ever-growing legion of trained professionals who will locally fill the need for effective pain management, including appropriate opioid prescribing. Advancing this model will require further economic and feasibility studies to assess costs, resources, and other variables, as well as a robust comprehensive outcomes program.

摘要

问题

初级保健提供者负责大部分的疼痛护理和阿片类药物处方，但他们通常培训不足。培训现有提供者解决阿片类药物处方过多和疼痛管理不足的危机是一项重大的劳动力问题，需要立即采取行动。这种教育需求是巨大的，需要分阶段解决，以扩大其效果。

方法

加州大学戴维斯分校培训培训师（T3）初级保健疼痛管理奖学金针对与疼痛管理相关的最紧迫的问题，包括处方药物滥用、负责任的阿片类药物处方和药物滥用，以及广泛涵盖全面疼痛管理。它提供了一种创新的、可扩展的解决方案，以解决疼痛管理方面的教育差距，部分原因是这种差距助长了美国的阿片类药物泛滥。T3 奖学金采用基于能力的课程和混合式教育模式，包括面对面和基于远程的学习以及直接的教师-学员指导，全面培训初级保健提供者的疼痛护理，并为他们培训其他人做好准备。自 2017 年成立以来，已有 2 个队列（17 人和 26 人）完成了为期 10 个月的奖学金，第三个队列的 38 人于 2019 年 9 月开始了该项目。