The prevalence and burden of pain has long been reported as problematic. Comprehensive pain education in undergraduate programmes is essential for developing knowledgeable, skilled and effective healthcare professionals. This cross-sectional survey describes the nature, content and learning strategies for pain curricula in undergraduate healthcare programmes in major universities in the United Kingdom (UK). Document analysis also highlighted gaps in pain-related standards from professional regulators and a higher education quality assurance body. The sample consisted of 19 higher education institutions delivering 108 programmes across dentistry, medicine, midwifery, nursing, occupational therapy, pharmacy, physiotherapy and veterinary science. Seventy-four (68.5%) questionnaires were returned averaging 12.0 h of pain content with physiotherapy and veterinary science students receiving the highest input. Pain education accounted for less than 1% of programme hours for some disciplines. Traditional teaching methods dominated (e.g. lectures 87.8%) and only two programmes had fully implemented the International Association for the Study of Pain's (IASP) curricula. Minimal pain-related standards were found from professional regulators and the quality assurance documents. Pain education is variable across and within disciplines and interprofessional learning is minimal. Published curricula for pain education have been available for over 20 years but are rarely employed and pain is not a core part of regulatory and quality assurance standards for health professions. The hours of pain education is woefully inadequate given the prevalence and burden of pain. Recommendations include the introduction of pain-related educational standards across all professions, greater integration of pain content in undergraduate programmes and interprofessional approaches to the topic.
The Mental Health Services have been accused of providing a ‘soft option’ to offenders and this charge is highlighted in cases where the mentally disordered offender absconds (hereafter called the absconder) from the hospital. Society just about manages to accept the disposal of disturbed offenders to hospital, which it sees as providing at least some limited incarceration, but in the event of an offender absconding the whole dilemma of offenders considered to be in need of treatment is thrown into question. The Responsible Medical Officer (RMO) is concerned with issues of treatment, public safety and his/her responsibility to the Courts and society; and thus finds himself/herself in the conflicting roles of a doctor and an agent of social control. This paper attempts to address some of the issues surrounding the areas of the rights of the patient, the dilemma faced by the clinicians and the rightful use of the powers of the doctor and of the State in relation to Hospital Order and the absconder.
If you believe what the politicians say you might be forgiven for thinking that the only thing that matters these days is demonstrating that value for money has been provided, clinical needs have been met and targets reached. Therapists, to mention just one group of practitioners, are in danger of becoming obsessed with measurement and outcomes, often combining the two as outcome measures (Chartered Society of Physiotherapy, 2002).
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