The purpose of this quantitative quasi-experimental pretest-posttest study was to examine the short-term effects of providing a brief online education program about pain neuroscience and biopsychosocial oriented practice on knowledge, beliefs and attitudes, and treatment orientation in a student cohort.
A convenient and purposeful sample of PTA and OTA students (n = 183) was drawn from three different colleges located throughout the New England region of the U.S., each instituting a new online pain curriculum. Several validated questionnaires were administered prior to, then again within two weeks of training completion to assess immediate effects. Pain neuroscience knowledge was assessed using the Neurophysiology of Pain Questionnaire (NPQ), with higher scores indicating higher levels of knowledge. Treatment orientation was assessed by the Pain Attitudes and Beliefs Scale (PABS), consisting of biomedical (PABS-BM) and biopsychosocial (PABS-BPS) subscales, with higher scores indicating increased treatment orientation toward each respective construct. Attitudes and beliefs about the relationship between pain and physical function were assessed with the HealthCare Providers Pain and Impairment Relationship Scale (HC-PAIRS), with higher scores indicating stronger beliefs that pain should affect daily function. Independent samples t-tests were used to compare baseline characteristics. Mixed model analyses of variance models consisting of between [groups: 1) year in program (first or second); 2) program (PTA or OTA)] and within [time: pre-training, post-training] factors were used to assess short-term training effects.
At baseline, second-year PTA students displayed higher NPQ (t(83) = -2.86, p = .005) and lower HC-PAIRS (t(82) = 2.20, p = .031) scores, compared to first year PTA students. Second-year PTA students also displayed significantly higher NPQ scores compared to second-year OTA students (t(66) = -2.684, p = .009). No other baseline differences between first and second-year, or PTA and OTA student cohorts were observed. Main effects for time were observed in all ANOVA models (p < .001) with improvement demonstrated in each dependent variable. No significant three-way interactions were observed for short-term training effects (p > 0.05). However, significant two-way time-by-program interactions were observed for NPQ (F(1,126) = 10.58, p = .001, ES = .08), PABS-BPS (F(1,129) = 6.15, p = .014, ES = .05), and PABS-BM (F(1,127) = 5.17, p = .025, ES = .04) scores. Only main effects for time were observed for HC-PAIRS scores (F(1,129) = 165.20, p < .001, ES .56).
Conclusions/Relevance to the conference theme:
This study suggests that there may be a need to provide physical and occupational therapy assistant students with more pain education to effectively treat patients with chronic pain. The study results also allowed for the development of specific pedagogical recommendations for teaching physical and occupational therapy students about pain.