Equipping medical students to manage cancer pain: A comparison of three educational methods

Abstract

A Cancer Pain Structured Clinical Instruction Module (SCIM), with skills stations incorporating actual cancer patients, has been developed to enhance cancer pain education among our medical students. The Cancer Pain SCIM has not been compared with more traditional cancer pain education, thus the purpose of this study was to assess the effectiveness and durability of three educational methods for teaching cancer pain management to medical students compared with a control group. Four consecutive rotations of 32 third-year medical students participated in one of four cancer pain educational strategies: 1) control group with no formal cancer pain education, 2) CD-ROM self-instruction module on cancer pain, 3) a 2-hour Cancer Pain SCIM plus the CD-ROM information, and 4) Cancer Pain SCIM, plus CD-ROM, plus a structured home-hospice patient visit. The effectiveness of the educational interventions was assessed at 4 months post-instruction using a 4-component Cancer Pain Objective Structured Clinical Examination (OSCE). The main findings of this educational study are that: 1) all three educational groups performed better on the Cancer Pain OSCE at 4 months than the control group (P<0.05); 2) medical students receiving structured education on cancer pain management significantly out-performed students at 4 months compared with control or traditional instructional formats; 3) students receiving the Cancer Pain SCIM plus home visit performed highest on the pain management, physical exam, and communication stations of the OSCE; and 4) the SCIM format of education shows durability as assessed at 4 months post-instruction. The Cancer Pain SCIM has a unique potential to substantially improve the quality of cancer pain education.

Perioperative Pain Management Education: A Short Structured Regional Anesthesia Course Compared with Traditional Teaching Among Medical Students

“…In addition, our previous research with the 2-hour structured teaching format has consistently demonstrated its superiority over more traditional methods of instruction. 16 For example, Sloan et al 16 demonstrated that senior medical students who received a 2-hour structured education on cancer-pain management significantly outperformed students who received traditional instruction and tested with a cancer-pain OSCE at 4 months after instruction. They concluded that the SCIM format of teaching substantially improved the quality of cancer-pain education and showed durability at 4 months after instruction.…”

Training medical students to manage a chronic pain patient: both knowledge and communication skills are needed

“…Self-reported knowledge may be sufficient but the students may be not able to implement their knowledge to clinical practice. The students should learn from tests and receive feedback on which to build their knowledge and skills (Sloan et al, 2004;Mavis et al, 2002;Wass et al, 2001). On the other hand, the assessment drives learning (Wass et al, 2001).…”

“…The current medical education in pain evaluation and management does not provide physicians with the skills that are needed in the clinical practice (Turner and Weiner, 2002). According to previous studies (Turner and Weiner, 2002;Pö yhiä and Kalso, 1999;Watt-Watson et al, 2003;Sloan et al, 2004;Pö yhiä et al, 2005) teaching of pain related topics in the medical schools is fragmented, important topics are poorly covered and specific curricula for pain are uncommon. This is surprising, as the International Association for the Study of Pain (IASP) published a core curriculum on pain for the international needs of medical schools already over 15 years ago (Pilowsky, 1988).…”

“…However, we have no written educational program for teaching pain. The feasibility of OSCE has been demonstrated in cancer pain (Sloan et al, 2004) but not in non-cancer chronic pain. Objective structured clinical examination (OSCE) can be used to measure complex communication skills (Aspegren, 1999).…”

Using Structured Clinical Instruction Modules (SCIM) in Teaching Palliative Care to Undergraduate Medical Students

“…8 They have been used in the teaching of pain management, cancer care, and surgical techniques and have been evaluated as an effective, sustainable tool delivering durable skills and knowledge improvements. [9][10][11][12] To date, this literature has focused on the use of SCIMs to teach various aspects of a single topic. The SCIM program developed for the palliative care attachment is novel, as it covered numerous aspects of knowledge and skills essential for end-of-life care.…”