1 Interprofessional Education in Pain Management Karen Hewson College of Nursing University of Saskatchewan October 26, 2012

 To provide students with the opportunity to collaborate with students and professionals from a variety of disciplines while acquiring knowledge and experience in the area of pain management  To have positive impact on the health care of individuals experiencing pain Overall Goals

Interprofessional Education (IPE) “ occasions when two or more professionals learn with, from and about one another to facilitate collaboration in practice” (CAIPE, 1997)

Why IPE? I nterprofessional collaboration Improve quality client care

Drivers of IPE WHO (1988) Government Agencies Educational Institutions

Drivers  Aging populations  Chronic illness  Complex health issues  Primary health care initiatives  Recruitment and retention of health care professionals  PATIENT SAFETY (Commission on the Future of Health Care in Canada, 2002)

Canadian Context "If health care providers are expected to work together and share expertise in a team environment, it makes sense that their education and training should prepare them for this type of working arrangement.“ Roy Romanow, Commissioner, Commission on the Future of Health Care in Canada November 28, 2002

Benefits of Teamwork Interdisciplinary teams tend to develop more creative solutions to complex problems because of their members’ diverse academic backgrounds and experience (Carr, Brockbank & Barret, 2003)

Why IPE in Pain Management?  “Pain is a multidimensional phenomena beyond professional boundaries, for doctors, nurses, physiotherapists and other professionals all have input into its management”  Despite advances in pain management, many patients continue to suffer from unrelieved pain (Carr et al., 2003)

Why IPE in Pain Management?  Inadequate knowledge among health professionals has been cited as one of the most significant factors in poor pain management  Inadequate preparation in undergraduate programs has been reported by medicine, nursing, and physiotherapy  Inadequate preparation in health science programs across Canada and the UK has been reported (Carr et al., 2003; Watt-Watson, et al.,2009; Xue et al., 2007)

Survey of 96 health professionals Inpatient oncology service (Xue et al., 2007) Educational preparation, attitudes & knowledge towards pain management 26 Med/Oncology RNs 26 Med/Oncology RNs 18 pharmacists 28 physicians Ying et al. (2007) 24 Gynecology/ Oncology RNs

ExcellentGoodFairPoor RNs Medical Oncology 4%16%60%20% RNs Gynecology/Oncology 9%30%43%17% Pharmacists 6%18%53%23% Physicians 0%31%38%31% Ratings of Adequacy of Education &Training in Cancer Pain ( Xue et al.,2007)

Knowledge of Pain Management ( Xue et al, 2007) Profession % RNs Medical Oncology60% RNs Gynecology /Oncology50% Pharmacists65% Physicians55% Overall55% NOTE: different disciplines = different knowledge

Findings: Attitudes toward Pain Management  All generally reported positive attitudes toward pain management : a) beliefs regarding patient reporting of pain b) analgesic addiction  Physicians more likely than nurses or pharmacists to believe that patients over-reported their pain (Xue et al., 2007)

Improving pain management through interprofessional education: Evaluation of a pilot project ( Carr et al., 2003) Description of Project a) Interprofessional steering group b) Senior expert lecturer c) Four half day IP pain management sessions d) Physicians, nurses, PT/OT

Findings (Carr et al., 2003)  Valued chronic pain sessions more than acute sessions  Valued learning with and from other professions  Increased documentation of pain assessments  Increased interprofessional discussion on ward, in patient rounds  Decreased referrals to pain team  Increased requests for PT, alternative strategies

Useful Links on IPE  

References Carr, E., Brockbank, K., & Barrett (2003). Improving pain management through interprofessional education: evaluation of a pilot project. Learning in Health and Social Care, 2, 1, Center for the Advancement of Interprofessional education (2002). Retrieved from Commission on the Future of Health Care in Canada: The Romanow Commission. Retrieved Patient First Review (2009)Retrieved on-line/ Watt-Watson, J., McGillion, M., Hunter, J. et al. (2009). A survey of pre-licensure pain curricula in health science faculties in Canadian universities. Pain Research & Management.