Mardian Aram S, Villarroel Lisa, Quist Heidi E, Chang Lynn E, Mintert Jeffrey S, Su Tiffany N, Dhanjal-Reddy Amrita, Hanson Eric R
Chronic Pain Wellness Center, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.
Department of Family, Community and Preventive Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.
Front Pain Res (Lausanne). 2023 Jun 19;4:1197374. doi: 10.3389/fpain.2023.1197374. eCollection 2023.
Though long-sought, transformation of pain management practice and culture has yet to be realized. We propose both a likely cause-entrenchment in a biomedical model of care that is observed and then replicated by trainees-and a solution: deliberately leveraging the hidden curriculum to instead implement a sociopsychobiological (SPB) model of care. We make use of Implicit Bias Recognition and Management, a tool that helps teams to first recognize and "surface" whatever is implicit and to subsequently intervene to change whatever is found to be lacking. We describe how a practice might use iterations of recognition and intervention to move from a biomedical to a SPB model by providing examples from the Chronic Pain Wellness Center in the Phoenix Veterans Affairs Health Care System. As pain management practitioners and educators collectively leverage the hidden curriculum to provide care in the SPB model, we will not only positively transform our individual practices but also pain management as a whole.
尽管人们期待已久，但疼痛管理实践和文化的转变尚未实现。我们提出了一个可能的原因——在生物医学护理模式中根深蒂固，实习医生观察并效仿这种模式——以及一个解决方案：有意识地利用隐性课程，转而实施社会心理生物学（SPB）护理模式。我们使用“内隐偏见识别与管理”工具，该工具帮助团队首先识别并“揭示”任何隐性的东西，随后进行干预，改变发现存在不足的地方。我们通过凤凰城退伍军人事务医疗保健系统慢性疼痛健康中心的例子，描述一种实践如何通过识别和干预的迭代过程，从生物医学模式转变为SPB模式。随着疼痛管理从业者和教育工作者共同利用隐性课程以SPB模式提供护理，我们不仅将积极改变我们的个人实践，还将改变整个疼痛管理领域。
