Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study

Abstract

ObjectivesUnrelieved pain is a substantial public health concern necessitating improvements in medical education. The Advancing the Provision of Pain Education and Learning (APPEAL) study aimed to determine current levels and methods of undergraduate pain medicine education in Europe.Design and methodsUsing a cross-sectional design, publicly available curriculum information was sought from all medical schools in 15 representative European countries in 2012–2013. Descriptive analyses were performed on: the provision of pain teaching in dedicated pain modules, other modules or within the broader curriculum; whether pain teaching was compulsory or elective; the number of hours/credits spent teaching pain; pain topics; and teaching and assessment methods.ResultsCurriculum elements were publicly available from 242 of 249 identified schools (97%). In 55% (133/242) of schools, pain was taught only within compulsory non-pain-specific modules. The next most common approaches were for pain teaching to be provided wholly or in part via a dedicated pain module (74/242; 31%) or via a vertical or integrated approach to teaching through the broader curriculum, rather than within any specific module (17/242; 7%). The curricula of 17/242 schools (7%) showed no evidence of any pain teaching. Dedicated pain modules were most common in France (27/31 schools; 87%). Excluding France, only 22% (47/211 schools) provided a dedicated pain module and in only 9% (18/211) was this compulsory. Overall, the median number of hours spent teaching pain was 12.0 (range 4–56.0 h; IQR: 12.0) for compulsory dedicated pain modules and 9.0 (range 1.0–60.0 h; IQR: 10.5) for other compulsory (non-pain specific) modules. Pain medicine was principally taught in classrooms and assessed by conventional examinations. There was substantial international variation throughout.ConclusionsDocumented pain teaching in many European medical schools falls far short of what might be expected given the prevalence and public health burden of pain.

Pain management in low- and middle-income countries

“…Education, when provided, occurred within other subjects and tended to not use practical teaching methods. 16 In a survey of doctors in 49 LMICs, 90% considered their undergraduate training in pain management to be inadequate, and 80% did not receive formal training. The survey also found that postgraduate training was very variable.…”

Anaesthesia and the undergraduate medical curriculum

“…21 In terms of pain management, a recent European survey concluded that pain teaching in many European medical schools fell short of what might be expected given the prominence and public health burden of pain. 22 In addition, there is continuing evidence that pain is still not optimally managed in hospital. 23 Enhancing undergraduate education in this clinical field can only be beneficial.…”

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