Cornwall Jon, Shipton Elspeth, Cowie Matthew, Kaw Anu, Landers Amanda, Lennox Thompson Bronwyn, Darlow Ben
University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
Christchurch Pain Management Services, 60 Hawthornden Road, Avonhead, Christchurch 8042, New Zealand.
J Pain. 2024 Oct 11:104696. doi: 10.1016/j.jpain.2024.104696.
Pain is the most common reason to seek healthcare, however pain teaching is often not prominent in medical school curricula. This project reviewed an existing medical curriculum to develop a comprehensive pain curriculum that consolidated pain learning across a medical degree delivered on geographically-distinct campuses, looking to provide contemporary pain learning that was culturally appropriate in a local context. A cross-campus, interdisciplinary pain working group (PWG) was established to work across the two program stages (pre-clinical, clinical) and three clinical campuses. The PWG undertook a three-phase project to i) develop a range of potential target competencies based on expert input and international pain curricula, ii) identify and review existing pain competencies, and iii) undertake iterative review of information, consult with stakeholders, and propose revised competencies. Eight pain competencies were identified within the extant curriculum. Recommendations included two existing competencies remained unchanged, four be modified, two merged, and 26 new competencies adopted including some specific to local Indigenous Māori and Pacific Island communities. The 33 pain target competencies were structured across different teaching domains: science, research, and scholarship (n = 5); population health and epidemiology (n = 3); clinical skills (n = 5); and diagnostics and therapeutics (n = 20). Contemporary pain learning, including around Indigenous health, was not adequately represented. New target competencies were adopted to ensure pain learning is appropriate for medical practice in Aotearoa New Zealand, containing competencies specific to Māori and Pacific Island communities. Curricula review needs to consider local cultural requirements while integrating international best practice to ensure pain learning is appropriate. PERSPECTIVE: A comprehensive pain curriculum was developed across a multi-campus medical school setting. Through a three-phase project, existing pain competencies were reviewed and new target competencies developed, including those specific to local Indigenous communities. Findings highlight the importance of ensuring contemporary curricula include pain learning that is culturally focused and relevant.
疼痛是寻求医疗保健的最常见原因，然而疼痛教学在医学院课程中往往并不突出。本项目回顾了现有的医学课程，以制定一个全面的疼痛课程，该课程整合了在地理位置不同的校区提供的医学学位课程中的疼痛学习内容，旨在提供在当地背景下符合文化习惯的当代疼痛学习内容。一个跨校区、跨学科的疼痛工作组（PWG）成立，以在两个课程阶段（临床前、临床）和三个临床校区开展工作。PWG开展了一个三阶段项目，以：i）根据专家意见和国际疼痛课程制定一系列潜在的目标能力；ii）识别和审查现有的疼痛能力；iii）对信息进行反复审查，与利益相关者协商，并提出修订后的能力。在现有课程中确定了八项疼痛能力。建议包括两项现有能力保持不变，四项进行修改，两项合并，以及采用26项新能力，其中包括一些针对当地毛利人和太平洋岛民社区的特定能力。33项疼痛目标能力分布在不同的教学领域：科学、研究和学术（n = 5）；人群健康与流行病学（n = 3）；临床技能（n = 5）；诊断与治疗（n = 20）。包括围绕原住民健康的当代疼痛学习没有得到充分体现。采用了新的目标能力，以确保疼痛学习适合新西兰奥塔哥的医疗实践，其中包含针对毛利人和太平洋岛民社区的特定能力。课程审查需要在整合国际最佳实践的同时考虑当地文化要求，以确保疼痛学习是合适的。观点：在一个多校区医学院环境中制定了一个全面的疼痛课程。通过一个三阶段项目，对现有的疼痛能力进行了审查，并制定了新的目标能力，包括针对当地原住民社区的能力。研究结果突出了确保当代课程包括具有文化针对性和相关性的疼痛学习的重要性。
