Scheidecker Anne, Green Amanda, Syed Muzammil H, Ling Celine S, Fiala Clare, Pakkal Oya, Monteiro Sandra, Schandelmaier Stefan, Korz Linda
MacPherson Institute, McMaster University, Hamilton, ON Canada.
Department of Anesthesia, Sankt Elisabethenkrankenhaus, Lörrach, Germany.
Med Sci Educ. 2021 Jun 7;31(4):1463-1469. doi: 10.1007/s40670-021-01335-6. eCollection 2021 Aug.
Managing patients with chronic pain can be complex and requires specialized clinical knowledge and advanced communication skills. Simulation-based learning has been shown to improve learning outcomes for complex competencies and could be a valuable resource for trainees in chronic pain medicine.
We assessed the need for a simulation-based course for trainees in chronic pain medicine at McMaster University in Canada. The needs assessment consisted of three steps: (1) literature review to identify preexisting needs assessments, (2) targeted interviews with six healthcare professionals in chronic pain management, and (3) an analysis of 366 routinely collected patient experience surveys.
The systematic review identified a small body of related literature and no previous needs assessment. We identified the following key competencies and skills that trainees in pain medicine need to develop: (1) communicating with distressed patients using skills such as de-escalation, active listening, and motivational interviewing, (2) managing patients in difficult emotional situations such as poorly controlled pain or showing signs of opioid misuse, and (3) recognizing and managing mental health issues related to chronic pain using appropriate instruments.
Suggestions for scenarios included the following: (1) consulting a patient with poor pain control and running out of treatment options, (2) managing a patient with suspected inappropriate opioid use, and (3) diagnosing depression in a patient suffering from chronic pain and developing an appropriate treatment plan.
We propose the development of suggested scenarios into simulation-based courses, and test and refine them together with trainees and experts in pain medicine.
The online version contains supplementary material available at 10.1007/s40670-021-01335-6.
管理慢性疼痛患者可能很复杂，需要专业的临床知识和先进的沟通技巧。基于模拟的学习已被证明可以提高复杂能力的学习效果，对于慢性疼痛医学的实习生来说可能是一种宝贵的资源。
我们评估了加拿大麦克马斯特大学慢性疼痛医学实习生对基于模拟的课程的需求。需求评估包括三个步骤：（1）文献综述以确定先前存在的需求评估；（2）对六名慢性疼痛管理领域的医疗保健专业人员进行有针对性的访谈；（3）对366份常规收集的患者体验调查进行分析。
系统综述发现了一小部分相关文献，且之前没有需求评估。我们确定了疼痛医学实习生需要培养的以下关键能力和技能：（1）使用诸如缓和情绪、积极倾听和动机性访谈等技巧与痛苦的患者沟通；（2）在困难的情绪状况下管理患者，如疼痛控制不佳或出现阿片类药物滥用迹象；（3）使用适当的工具识别和管理与慢性疼痛相关的心理健康问题。
情景建议如下：（1）为疼痛控制不佳且治疗选择用尽的患者提供咨询；（2）管理疑似阿片类药物使用不当的患者；（3）诊断患有慢性疼痛的患者的抑郁症并制定适当的治疗计划。
我们建议将建议的情景开发成基于模拟的课程，并与疼痛医学的实习生和专家一起进行测试和完善。
在线版本包含可在10.1007/s40670-021-01335-6获取的补充材料。
