An Assessment of Physical Therapy Students’ Attitudes and Readiness to Manage Patients with Chronic Pain
Purpose: It is estimated that up to 30% of the US population are affected by chronic pain, costing the healthcare system up to $635B/year. Healthcare professionals need to be equipped with pain management strategies, including Pain Neuroscience Education (PNE), when working with individuals with pain, to replace the use of medications that may result in addiction. The purpose of this study was (1) to evaluate DPT student readiness, attitudes, knowledge, and beliefs about the use of PNE for the treatment of individuals with chronic pain, and (2) to determine the need for curricular enhancements to prepare DPT students to utilize PNE in patient management. Methods/Description: Mixed methods were employed in this study. We developed and distributed a survey by email to a cohort of DPT students in their final year (n=99). The survey included material from two questionnaires with previously established reliability and validity. The Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) was used to assess beliefs about the relationship between impairment and pain. The Neurophysiology of Pain Questionnaire (NPQ) tested students’ knowledge about the physiology and experience of pain. Additional open-ended questions gathered student’s perceptions about their readiness to utilize PNE and the need for curricular enhancements. Scores were compared between undergraduate direct entry and post-baccalaureate students and between students based on their personal experience of chronic pain, and exposure to patients with chronic pain during co-operative education work experience and clinical education experiences. The Mann Whitney U test was used to compare HC pairs scores between groups and an independent t test was used to compare NPQ scores between groups. Results/Outcomes: A response rate of 30% (n=29) was achieved. There was a significant difference in NPQ scores between respondents who had more overall experience and exposure to treating patients with chronic pain using PNE compared to those who had less experience, (p=.006). Students whose combined clinical and work experience using PNE to treat patients with chronic pain was <25% of their caseload (28% n=7) had an average score of 67.7% (+/-) 10.8 on the NPQ. Those students whose experiences using PNE to treat patients with chronic pain was >25% of their caseload (72% n=18) scored an average of 81.2% (+/-) 7.3 on the NPQ. There were no other significant differences between groups. Of the respondents, 80% (n=24) recommended specific strategies to enhance curricular content. The students’ suggestions for curricular enhancements included having an entire lecture on PNE, threading/incorporating PNE throughout the curriculum and having opportunities to practice PNE through simulation experiences and role playing. Conclusions/Relevance to the conference theme: The future of chronic pain management must include strategies such as PNE to allow for the management of patients with chronic pain without medications. PNE is a highly effective adjunct for the physical therapy management of patients with pain. Curricular improvements will better prepare students to utilize PNE to treat patients with chronic pain and help to address the current societal crisis surrounding the use and abuse of addictive opioid containing pain medications.