A national initiative to advance pain education across Canadian physiotherapy programs

Integrating best evidence on pain management within the entry-level training of healthcare professionals is arguably one of the most comprehensive and effective ways of closing the knowledge-to-practice gap within our field. This, however, is no simple feat. One important challenge is that there are a multitude of factors and invested stakeholders that influence what goes into clinical training programs. Clearly, coordinated action is needed. In Canada, we’ve recently taken some exciting steps toward this goal by holding a national workshop to improve pain education within entry-level physiotherapy programs across the country.

The workshop, which was the first of its kind in Canada, brought together stakeholders from across the country to identify barriers, facilitators, strategies and priorities for advancing pain education.  Workshop participants were national leaders associated with key pain and physiotherapy stakeholder groups. This included people living with pain; physiotherapy students and recent graduates; pain educators; the national network of physiotherapy program directors; the national accreditor of entry-level physiotherapy programs; the national regulator of physiotherapy practice; and the Canadian Physiotherapy Association.

The workshop yielded several important outcomes. First, it helped identify barriers and facilitators related to advancing pain education within Canadian physiotherapy programs. These include: (1) the recent revolution in biopsychosocial pain management research, which has created excitement for change, but has also increased the knowledge-to-practice gap; (2) the regulatory processes governing physiotherapy education, which are influenced by multiple stakeholders, but are currently being revised; and (3) the educational institutions and physiotherapy programs, which each have different resources and capacity to change curriculum and educate students about pain; and (4) the targets of pain education (i.e. physiotherapy students and people living with pain), which each have varying interests and capacity to facilitate change.

Second, it helped identify potential strategies for advancing pain education, including: (1) integrating established pain management competencies into the standards and regulatory frameworks that are used to govern the physiotherapy profession so that class time in physiotherapy programs can be consistently allocated to pain management; (2) developing teaching practices and resources to help educators effectively instruct physiotherapy students on pain management; (3) partnering with people living with pain so that the physiotherapy curriculums are aligned to what is most important to our patients and (4) building broad awareness of the importance of pain education and evidence-informed pain management, so that all physiotherapists can think of themselves as having expertise in pain management.

The workshop also generated an important consensus statement that was developed and supported by participating stakeholder groups. The consensus statement focused on three main areas: (1) identifying pain education as a core component of physiotherapy training and practice; (2) recognizing the important variability across Canadian university programs in the quantity and content of pain education; and (3) calling for a national reference standard in pain education to guide and improve the consistency of entry-level pain education across training programs.

Since holding this workshop, our group has been working to translate this preliminary work into a national strategic plan for improving pain education across Canadian physiotherapy programs. Toward this goal, we’ve conducted a series of one-on-one and group interviews with stakeholders to explore how the strategies identified at the workshop could potentially be implemented. Data from these interviews and the workshop are now being combined to generate a high-level plan that can be used by different stakeholder groups to advance different aspects of pain education within physiotherapy training programs across Canada. Once created, a coordinated, multi-pronged approach will be used to facilitate implementation.

Coordinating and improving how clinicians are first taught about pain across a national professional group is the type of change that will not happen overnight, but rather, will require considerable input and support from a broad range of individuals over the coming years. With that in mind, our team is quite keen to connect and collaborate with other researchers and educators that are interested in working toward similar goals, perhaps related to their own professions within different regions around the world. We’re also actively looking for research trainees to help contribute to this initiative. So please don’t hesitate to reach out! Our hope is that through a collaborative and sustained effort that we can better prepare the next generation of clinicians to tackle the challenges of effectively managing persistent pain and disability.

About Timothy Wideman

Timothy H. Wideman is a physiotherapist and assistant professor at McGill University.

You can reach him via email at timothy.wideman@mcgill.ca.

Reference

This work was recently published within Physiotherapy Canada 2018 Volume 70 Issue 1, Winter 2018, pp. 24-33 (DOI: 10.3138/ptc.2016-57). It was co-authored by Jordan Miller, Geoff Bostick, Aliki Thomas and André Bussières, supported by a national network of pain educators and researchers across Canada (i.e. the Pain Education in Physiotherapy Curriculum initiative) and funded through the Richard and Edith Strauss Foundation, the Canadian Institutes of Health Research and the Fond de recherche du Québec – Santé.

Wideman TH, Miller J, Bostick G, Thomas A, Bussières A.(2018) Advancing Pain Education in Canadian Physiotherapy Programmes: Results of a Consensus-Generating WorkshopPhysiother Can. 2018;70(1):24-33. doi: 10.3138/ptc.2016-57.