Pain Neuroscience Knowledge and Pain Perspectives: A Longitudinal Study of Dpt Students and Faculty
Purpose/Hypothesis: The apparent increase in the prevalence of persistent pain coupled with the current opioid crisis has led to CDC guidelines recommending nonpharmacologic therapy for persistent pain. Therefore, more now than ever, it is critical that DPT programs provide students with the most current information about pain neuroscience (PN) emphasizing a biopsychosocial approach. The purposes of this study were to determine: 1) if student knowledge about PN, and attitudes and beliefs about patients in persistent pain change when pain is taught as a cross-curricular thread across three years of DPT education and 2) if knowledge, attitudes and beliefs about pain differ between students and faculty. Number of Subjects: Subjects included 50 DPT students (avg age=24.2) and 12 faculty (5 terminal doctorates, 7 DPT’s and 10 ABPTS specialists) from a single DPT program between 2016-2019. Materials and Methods: Subjects completed the Revised Neurophysiologic Pain Questionnaire (NPQ), Health-care Provider’s Pain and Impairment Relationship Scale (HC-PAIRS) and Pain Attitudes and Beliefs Scale for Physiotherapists (PABS) at the start of the program (T1), and at the end of the first (T2), second (T3) and third years (T4). Repeated measures ANOVA was used to analyze results over time. When significant differences were found, pairwise comparisons were made using the Bonferroni method to adjust for multiple comparisons. Results: There were significant differences (p<0.01) across time among student NPQ (ranged 6.93 - 10.05), HC-PAIRS (ranged 58.14 - 50.24) and PABS (69.03 - 59.49) scores. There were significant differences (p<0.01) in student NPQ scores between T1 and T2, T1 and T3, and between T1 and T4. There were significant differences in student HC-PAIRS scores between T1 and T3 (p=0.01), and betweenT1 and T4 (p<0.01), between T2 and T3 (p=0.01), and between T2 and T4 (p=0.01). There were significant differences in student PABS scores between T1 and T3 (p<0.01), between T1 and T4 (p<0.01), between T2 and T3 (p=0.00), and between T2 and T4 (p=0.01). There were no significant differences across time among faculty for NPQ, HC-PAIRS or PABS scores. There were significant differences in NPQ scores between students and faculty at T1 (p<0.01), HC-PAIRS scores between students and faculty at T1 (p=0.02) and T2 (p=0.00) and PABS scores between students and faculty at T1 (p=0.02) and T2 (p=0.01). Conclusions: Student PN knowledge improved during the first year of the DPT program to the level of the faculty and was maintained throughout their time in the program. Student attitudes and beliefs became informed over a longer time period, with significant changes occurring during the second year. This change indicates greater biopsychosocial perspective and was maintained during the third year, which primarily involves clinical experiences. Clinical Relevance: DPT programs can develop sustained PN knowledge and biopsychosocially informed attitudes and beliefs about patients with persistent pain among students when teaching this content as a curricular thread.