Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada

Abstract

Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being “very satisfied” with the process. Conclusions This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis

“…Current efforts to improve the management of chronic pain conditions might be more successful if we broaden professional understanding of the links between ACEs and chronic pain. Adding early childhood adversities as a risk factor for chronic pain and disability to pain management competency profile to guide entry-level education (Augeard et al, 2022 ) may increase educators and future clinicians awareness and promote reflexivity.…”

Winner of the Ronald Melzack– Canadian Journal of Pain 2022 Paper of the Year Award/Récipiendaire du Prix Ronald Melzack Pour L’Annee 2022 des Articles Parus Dans la Revue Canadienne de la Douleur

“…Each year, the Canadian Pain Society (CPS) and its official journal, the Canadian Journal of Pain , present an award in honor and memory of the late Ronald Melzack, a Canadian psychologist and the world’s preeminent pioneer in pain theory, research, and management. This year, the Ronald Melzack– Canadian Journal of Pain Paper of the Year Award for articles published in 2022 was won by Nathan Augeard, Dr. Timothy Wideman, and colleagues for their article titled “Development of a National Pain Management Competency Profile to Guide Entry-Level Physiotherapy Education in Canada.” 1 The winning paper was selected by the editor-in-chief, Joel Katz, from a short-list of six original articles published in the journal in 2022 based on rankings submitted by 23 journal editorial board members who considered originality, novelty, quality, and potential impact when submitting their votes. The Augeard et al article was the clear winner based on the number of editorial board members who ranked it as their number one pick.…”

“…Specific competences for managing (persistent) pain such as assessment and treatment of relevant lifestyle factors 2 , 3 would have been useful, including a position statement about physiotherapists’ role in dealing with stress intolerance, 4 poor sleep, 5 and dietary habits 6 (beyond the mentioned physical activity). This issue is briefly acknowledged by the authors in the discussion section, 1 but a focus on competences (referred to the authors as “our focus on the does level” p. 9) in no way prevents addressing these factors in the future. The role of physiotherapists in providing such lifestyle interventions remains to be established in light of the growing evidence supporting the integration of sleep management 7 and dietary interventions 8 in the multimodal management of chronic pain.…”

“…As explained in the paper, some stakeholders wanted more detailed content (e.g., best practice recommendations) to inform the practical applications of the competency profile, 1 which will be key to develop as soon as possible, because research has informed us that physiotherapists tend to adhere poorly to best practice guidelines for the management of persistent pain. 13 , 14 Several studies have shown that physiotherapists’ attitudes and beliefs determine guideline adherence (e.g., for the management of osteoarthritis and low back pain 13 , 15–17 ); for example, physiotherapists who hold biomedical attitudes and beliefs are more likely to advise patients to restrict physical and work activities and are therefore generally less adherent to clinical guidelines.…”