Contemporary Pain Science Education and Physician Assistant Students

Overview

The goal of this clinical trial was to learn whether a pain science education session could improve physician assistant students' understanding of pain and their beliefs about people with persistent pain. The main questions were: Did students' knowledge of how pain works change after the education session? Did students' beliefs about the relationship between pain, physical impairment, and activity change after the session? Were any changes maintained during the remainder of the physician assistant program? Participants were students enrolled in one physician assistant master's degree program. All students received a four-hour pain science education session and a 30-minute hands-on laboratory session as part of their curriculum. The session explained that pain is affected by biological, psychological, and social factors. It also included case discussions, small-group activities, pain-related screening tools, and demonstrations of selected pain management techniques. Participants completed questionnaires before the session, immediately afterward, and at three later points during the program. The final questionnaires were completed shortly before graduation. Researchers compared questionnaire scores across these five time points to examine changes in pain knowledge and pain-related beliefs.

This prospective, single-cohort, longitudinal educational intervention study evaluated changes in physician assistant students' pain neuroscience knowledge and pain-related attitudes and beliefs following a multimodal contemporary pain science education session. The study was conducted within a 27-month, master's-level physician assistant program at a single university in the southeastern United States. The educational session occurred approximately four months after students entered the program. It was delivered during the second semester and consisted of four hours of classroom instruction followed by a 30-minute laboratory component. Classroom instruction incorporated lecture, small-group active learning, discussion, and case-based application. The content presented pain as a multidimensional experience influenced by biological, psychological, social, behavioral, and contextual factors rather than solely by tissue injury or nociception. Instruction addressed foundational pain neuroscience, pain mechanisms and phenotyping, biopsychosocial contributors to persistent pain, and guideline-informed approaches to pain management. The session also addressed potential unintended consequences of unnecessary diagnostic imaging, medication- or procedure-focused management, premature referral, and language that may increase fear or reinforce beliefs that pain necessarily indicates tissue damage. Students were introduced to selected screening tools used to identify psychosocial factors that may influence pain, function, and recovery. The laboratory component provided experiential exposure to laterality recognition activities, quantitative sensory testing, and mirror-based techniques. These activities were intended to reinforce concepts discussed during the classroom portion of the session and to demonstrate selected approaches used in the assessment or management of persistent pain. The study used a repeated-measures design with data collection at five points across the physician assistant curriculum: immediately before the educational session, immediately after the session, approximately four months after the session, at the completion of didactic education approximately 11 months after the session, and shortly before graduation after completion of clinical rotations approximately 23 months after the session. All students in the cohort received the curricular education. There was no separate control or comparison group, and the intervention was not randomized. Participation in the research involved consenting to the collection and analysis of questionnaire data. Changes in scores over time were examined using repeated-measures statistical methods. Because other coursework and clinical experiences occurred during the follow-up period, the study was designed to evaluate longitudinal associations with the educational session rather than to establish that the session alone caused all observed changes. The study was approved by the Belmont University Institutional Review Board. Informed consent was obtained from participants before research data collection.