No pain no gain: Student performance over time on the Revised Neurophysiology of Pain Questionnaire

Purpose/Hypothesis: Core competencies in pain management for pre-licensure health professional education have been established. The purpose of this study was to assess the effect of 10-hours of pain neurophysiology education (PNE) on physical therapy students\u27 understanding of pain and retention of key concepts. Number of Subjects: Thirty-three second-year physical therapy students. Materials and Methods: Ten hours of PNE was embedded in a clinical neuroscience course which included a 2-hour lab assignment called “The Matrix”. The content was guided by key principles recommended by the International Association for the study of Pain (IASP). The lab assignment included case studies that required students to apply the didactic material, summarize it on whiteboards and present it to the class. The Revised Neurophysiology of Pain Questionnaire (RNPQ) was used given its ability to assess an individual’s conceptualization of biological pain mechanisms in addition to having acceptable psychometric properties. The RNPQ comprises 13 true, false, or undecided items related to the neurophysiology of pain. A correct response scores one point, whereas incorrect or undecided responses score zero points. Students completed the RNPQ across 3-time points: 1) before delivery of course material, 2) following delivery of course material; and 3) 7 months post to assess baseline knowledge and retention of concepts over time. Results: A repeated-measures ANOVA with Bonferroni correction analyzed RNPQ scores. Between-group differences were significant (p Conclusions: Despite the available evidence, pain has been referred to as an orphan subject that has been squeezed into crowded curricula. While it may not be feasible for programs to cover IASP recommendations in their entirety, our findings showed that a condensed modular format in a course that complements the key components led to enhanced understanding. However, many textbooks still equate pain with nociception consequently this may explain item 2 data despite the module providing evidence to the contrary. Clinical Relevance: Students need to understand the multidimensional aspects of pain. Fundamental to this understanding is the ability to explain the biology of chronic pain and how a myriad of factors can exacerbate the pain state; this education is used clinically as a mechanism to reduce pain. Our results show that students shifted their conceptualization of pain from that of an indicator of tissue damage or disease to that of a perceptual need to protect body tissue and that pain can be overprotective. Failure to expose students to these concepts does little to promote appropriate care for patients