Abstract
Studies suggest that pain education in physical therapy (PT) programs is often insufficient to adequately prepare graduates to understand and manage pain. The International Association for the Study of Pain recently published updated curriculum guidelines for PT pain education (PCGs), and adoption of these PCGs will improve standardization of pain education in PT curricula. However, implementation of the PCGs will require programs to overcome key barriers including: 1) faculty competence with current pain science, 2) faculty alignment and collective commitment to addressing all domains in the PCGs, and 3) time and space in the curriculum for additional content delivery. The purpose of this article is to describe the process-driven approach used in implementing the PCGs within an established PT program, emphasizing the strategies used to overcome existing barriers. Kern's Six-Step Approach to Curriculum Development, experiential learning theory, and reflective practice were the guiding theoretical models used to develop processes and overcome existing barriers. The iterative process used for curriculum integration of the PCGs improved faculty buy-in and alignment, allowed for optimal selection of resources to support the faculty, and provided the program with qualitative and quantitative data that will continue to drive curriculum management. J Allied Health 2021; 50(3):213–220. ALTHOUGH PAIN is the most common complaint treated by physical therapists (PTs), surveys of entry-level PT programs indicate that the pain education provided is often insufficient to adequately prepare graduates to understand and manage pain. (1–3) In the United States, PT programs only provide 31 hours of pain education on average, with some programs providing as few as 5 hours. (1) Further, there is inconsistency across programs in the depth, breadth, and nature of the pain content provided. Deficiency in pain education is widespread across the healthcare field, and it is not unique to the PT profession. (4,5) In fact, widespread deficiency in pain education for healthcare practitioners is considered to be a primary contributing factor to the global chronic pain epidemic and the national opioid epidemic. (6,7) To help address the deficiency in pain education, the International Association for the Study of Pain (IASP) developed interprofessional and profession-specific curriculum outlines for pain education in entry-level curric-ula. The IASP pain curriculum guidelines (PCGs) for PT pain education were updated in 2018. (8) The PCGs are structured hierarchically, consisting of 4 overarching domains, divided into 20 core competencies, with 32 main objectives and 51 sub-level objectives. (8) The IASP also proposed that the optimal approach for implementing the PCGs is to integrate the pain content throughout the program. (9) Adoption of the PCGs will assist PT programs in improving their delivery of pain education in a comprehensive and standardized manner. Improved standardization of pain education in PT curricula is necessary , and will benefit PT education as a whole, the PT profession, and the patients who we serve. Individual PT programs have described the incorporation of the PCGs into their curriculum, and specifically how they mapped the content into existing courses (10,11) or how they created a stand-alone pain course. (10,12) However, there are often significant barriers that programs must overcome to successfully implement curricular changes, and to date there are no existing descriptions in the literature on processes used to overcome these barriers for successful implementation of the PCGs. (9) Key barriers that programs are likely to face are: 1) inadequate faculty competence with current pain science, 2) lack of faculty alignment with the PCGs and collective commitment to addressing all domains and objectives in the PCGs, and 3) time and space in the program curriculum for additional content delivery.