Faculty Communication Knowledge, Attitudes, and Skills Around Chronic Non-Malignant Pain Improve with Online Training

Pain Med. 2016 Nov;17(11):1985-1992. doi: 10.1093/pm/pnw029. Epub 2016 Apr 1.

Abstract

Objective: Many physicians struggle to communicate with patients with chronic, non-malignant pain (CNMP). Through the use of a Web module, the authors aimed to improve faculty participants' communication skills knowledge and confidence, use of skills in clinical practice, and actual communication skills.

Subjects: The module was implemented for faculty development among clinician-educators with university faculty appointments, outpatient clinical practices, and teaching roles.

Methods: Participants completed the Collaborative Opioid Prescribing Education Risk Evaluation and Mitigation Strategy (COPE-REMS®) module, a free Web module designed to improve provider communication around opioid prescribing. Main study outcomes were improvements in CNMP communication knowledge, attitudes, and skills. Skills were assessed by comparing a subset of participants' Observed Structured Clinical Exam (OSCE) performance before and after the curriculum.

Results: Sixty-two percent of eligible participants completed the curriculum in 2013. Knowledge-based test scores improved with curriculum completion (75% vs. 90%; P < 0.001). Using a 5-point Likert-type scale, participants reported improved comfort in managing patients with CNMP both immediately post-curriculum and at 6 months (3.6 pre vs. 4.0 post vs. 4.1 at 6 months; P = 0.02), as well as improvements in prescribing opioids (3.3 vs. 3.8 vs. 3.9, P = 0.01) and conducting conversations about discontinuing opioids (2.8 vs. 3.5 vs. 3.9, P < 0.001). Additionally, CNMP-specific communication skills on the OSCE improved after the curriculum (mean 67% vs. 79%, P = 0.03).

Conclusions: Experienced clinician-educators improved their communication knowledge, attitudes, and skills in managing patients with CNMP after implementation of this curriculum. The improvements in attitudes were sustained at six months. A Web-based curriculum such as COPE-REMS® may be useful for other programs seeking improvement in faculty communication with patients who have CNMP.

Keywords: Chronic Pain; Continuing Education; Opioids; Pain Management; Pain Training Programs; Primary Care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Attitude of Health Personnel*
  • Chronic Pain / psychology
  • Chronic Pain / therapy*
  • Clinical Competence / standards*
  • Curriculum / standards
  • Faculty, Medical / education
  • Faculty, Medical / standards*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Online Systems / standards*
  • Physician-Patient Relations*

Substances

  • Analgesics, Opioid