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

• Published in: Pain medicine (Malden, Mass.) Vol. 17; no. 11; pp. 1985 - 1992
• Main Authors: Donovan, Anna K., Wood, Gordon J., Rubio, Doris M., Day, Hollis D., Spagnoletti, Carla L.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.11.2016
• Subjects: Analgesics, Opioid - therapeutic use; Attitude of Health Personnel; Attitudes; Chronic Pain - psychology; Chronic Pain - therapy; Clinical Competence - standards; Communication; Curricula; Curriculum - standards; Faculty, Medical - education; Faculty, Medical - standards; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Narcotics; Online Systems - standards; Opioids; Pain; Physician-Patient Relations; Continuing Education; Pain Training Programs; Primary Care; Pain Management; Opioids; Chronic Pain
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnw029

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.