Results of a Team Objective Structured Clinical Examination (OSCE) in a Patient with Pain
Abstract Purpose As rates of chronic pain and opioid use disorder continue to rise, improved pain education is essential. Using an interprofessional team objective structured clinical examination (OSCE) simulation, this study evaluates whether prior exposure to a case-based learning module improves...
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Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2021-12, Vol.22 (12), p.2918-2924 |
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creator | Barreveld, Antje M Flanagan, Jane M Arnstein, Paul Handa, Shruti Hernández-Nuño de la Rosa, María F Matthews, Michele L Shaefer, Jeffry R |
description | Abstract
Purpose
As rates of chronic pain and opioid use disorder continue to rise, improved pain education is essential. Using an interprofessional team objective structured clinical examination (OSCE) simulation, this study evaluates whether prior exposure to a case-based learning module improves students’ assessment and treatment planning of a standardized patient prescribed chronic opioids presenting with acute pain.
Methods
A quasi-experimental mixed method approach using convenience sampling was employed to evaluate student performance and the impact of the educational intervention.
Results
Fourteen (intervention) and 16 (control) nurse practitioner, physician assistant, medical, pharmacy, and dental students in the final pre-licensure program years completed the team OSCE. Demographics, OSCE learning scores, Interprofessional Attitudes Scale scores, and pain management plans did not differ between groups. All students evaluated the activity highly. Qualitative analysis did not demonstrate differences between groups, but did identify similar themes: students missed opportunities to establish patient-provider rapport and educate across disciplines; opioid use disorder was assumed with chronic opioid therapy; team discussions improved treatment plans; moderators variably influenced team discussion.
Conclusions
This novel approach to interprofessional training in pain management using a team OSCE is promising, with modifications suggested. A case-based learning module without structured education prior to the OSCE did not improve students’ assessment and pain management skills compared to a control group. Nonetheless, important themes emerged including biases towards the standardized patient. Additional research is needed to develop effective curricular initiatives to foster and improve interprofessional collaboration in assessing and managing a standardized patient with acute and chronic pain. |
doi_str_mv | 10.1093/pm/pnab199 |
format | Article |
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Purpose
As rates of chronic pain and opioid use disorder continue to rise, improved pain education is essential. Using an interprofessional team objective structured clinical examination (OSCE) simulation, this study evaluates whether prior exposure to a case-based learning module improves students’ assessment and treatment planning of a standardized patient prescribed chronic opioids presenting with acute pain.
Methods
A quasi-experimental mixed method approach using convenience sampling was employed to evaluate student performance and the impact of the educational intervention.
Results
Fourteen (intervention) and 16 (control) nurse practitioner, physician assistant, medical, pharmacy, and dental students in the final pre-licensure program years completed the team OSCE. Demographics, OSCE learning scores, Interprofessional Attitudes Scale scores, and pain management plans did not differ between groups. All students evaluated the activity highly. Qualitative analysis did not demonstrate differences between groups, but did identify similar themes: students missed opportunities to establish patient-provider rapport and educate across disciplines; opioid use disorder was assumed with chronic opioid therapy; team discussions improved treatment plans; moderators variably influenced team discussion.
Conclusions
This novel approach to interprofessional training in pain management using a team OSCE is promising, with modifications suggested. A case-based learning module without structured education prior to the OSCE did not improve students’ assessment and pain management skills compared to a control group. Nonetheless, important themes emerged including biases towards the standardized patient. Additional research is needed to develop effective curricular initiatives to foster and improve interprofessional collaboration in assessing and managing a standardized patient with acute and chronic pain.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnab199</identifier><identifier>PMID: 34145890</identifier><language>eng</language><publisher>OXFORD: Oxford University Press</publisher><subject>Anesthesiology ; Care and treatment ; Chronic pain ; Chronic Pain - diagnosis ; Chronic Pain - drug therapy ; Clinical Competence ; Drug abuse ; Drug addiction ; Educational aspects ; Educational Measurement ; General & Internal Medicine ; Humans ; Learning ; Life Sciences & Biomedicine ; Medical cooperation ; Medical education ; Medical students ; Medicine, General & Internal ; Methods ; Narcotics ; Nursing education ; Opioids ; Pain ; Pain management ; Patients ; Physical Examination ; Science & Technology ; Standardized tests ; Students ; Substance use disorder</subject><ispartof>Pain medicine (Malden, Mass.), 2021-12, Vol.22 (12), p.2918-2924</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>6</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000743612400019</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c412t-c6329796cf06bb9aaf842274cf202d56fdd9291dc430abb8becc91fa82663b063</citedby><cites>FETCH-LOGICAL-c412t-c6329796cf06bb9aaf842274cf202d56fdd9291dc430abb8becc91fa82663b063</cites><orcidid>0000-0003-2560-9974 ; 0000-0003-1126-2797</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,27929,27930,39263</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34145890$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barreveld, Antje M</creatorcontrib><creatorcontrib>Flanagan, Jane M</creatorcontrib><creatorcontrib>Arnstein, Paul</creatorcontrib><creatorcontrib>Handa, Shruti</creatorcontrib><creatorcontrib>Hernández-Nuño de la Rosa, María F</creatorcontrib><creatorcontrib>Matthews, Michele L</creatorcontrib><creatorcontrib>Shaefer, Jeffry R</creatorcontrib><title>Results of a Team Objective Structured Clinical Examination (OSCE) in a Patient with Pain</title><title>Pain medicine (Malden, Mass.)</title><addtitle>PAIN MED</addtitle><addtitle>Pain Med</addtitle><description>Abstract
Purpose
As rates of chronic pain and opioid use disorder continue to rise, improved pain education is essential. Using an interprofessional team objective structured clinical examination (OSCE) simulation, this study evaluates whether prior exposure to a case-based learning module improves students’ assessment and treatment planning of a standardized patient prescribed chronic opioids presenting with acute pain.
Methods
A quasi-experimental mixed method approach using convenience sampling was employed to evaluate student performance and the impact of the educational intervention.
Results
Fourteen (intervention) and 16 (control) nurse practitioner, physician assistant, medical, pharmacy, and dental students in the final pre-licensure program years completed the team OSCE. Demographics, OSCE learning scores, Interprofessional Attitudes Scale scores, and pain management plans did not differ between groups. All students evaluated the activity highly. Qualitative analysis did not demonstrate differences between groups, but did identify similar themes: students missed opportunities to establish patient-provider rapport and educate across disciplines; opioid use disorder was assumed with chronic opioid therapy; team discussions improved treatment plans; moderators variably influenced team discussion.
Conclusions
This novel approach to interprofessional training in pain management using a team OSCE is promising, with modifications suggested. A case-based learning module without structured education prior to the OSCE did not improve students’ assessment and pain management skills compared to a control group. Nonetheless, important themes emerged including biases towards the standardized patient. Additional research is needed to develop effective curricular initiatives to foster and improve interprofessional collaboration in assessing and managing a standardized patient with acute and chronic pain.</description><subject>Anesthesiology</subject><subject>Care and treatment</subject><subject>Chronic pain</subject><subject>Chronic Pain - diagnosis</subject><subject>Chronic Pain - drug therapy</subject><subject>Clinical Competence</subject><subject>Drug abuse</subject><subject>Drug addiction</subject><subject>Educational aspects</subject><subject>Educational Measurement</subject><subject>General & Internal Medicine</subject><subject>Humans</subject><subject>Learning</subject><subject>Life Sciences & Biomedicine</subject><subject>Medical cooperation</subject><subject>Medical education</subject><subject>Medical students</subject><subject>Medicine, General & Internal</subject><subject>Methods</subject><subject>Narcotics</subject><subject>Nursing education</subject><subject>Opioids</subject><subject>Pain</subject><subject>Pain management</subject><subject>Patients</subject><subject>Physical Examination</subject><subject>Science & Technology</subject><subject>Standardized tests</subject><subject>Students</subject><subject>Substance use disorder</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkV9rFDEUxQex2Fp98QNIQIRa2Tb_JjN5LMOqhcKKrQ8-hSSTaJaZZJpkrP32zbprsSIi9-HeXH7ncsipqhcIniDIyek0nk5eKsT5o-oA1ZgtKCPN492MSVPvV09TWkOIGG3Jk2qfUETrlsOD6ssnk-YhJxAskODKyBGs1Nro7L4bcJnjrPMcTQ-6wXmn5QCWP-TovMwueHC0uuyWb4DzRfqxrIzP4Mblb-Xh_LNqz8ohmee7flh9fre86j4sLlbvz7uzi4WmCOeFZgTzhjNtIVOKS2lbinFDtcUQ9zWzfc8xR72mBEqlWmW05sjKFjNGFGTksDra3p1iuJ5NymJ0SZthkN6EOQlcU0IpatoN-uoPdB3m6Is7gVvEKaWM_kZ9lYMRztuQo9Sbo-KsgbDlCNe4UCd_oUr1ZnQ6eGNd2T8QHG8FOoaUorFiim6U8VYgKDY5imkUuxwL_HLndFaj6e_RX8EVoN0CN0YFm3T5e23uMQhhQwlDmJYJ8c7ln4F1Yfa5SN_-v7TQr7d0mKd_Ob4Dn6vDMA</recordid><startdate>20211211</startdate><enddate>20211211</enddate><creator>Barreveld, Antje M</creator><creator>Flanagan, Jane M</creator><creator>Arnstein, Paul</creator><creator>Handa, Shruti</creator><creator>Hernández-Nuño de la Rosa, María F</creator><creator>Matthews, Michele L</creator><creator>Shaefer, Jeffry R</creator><general>Oxford University Press</general><general>Oxford Univ Press</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2560-9974</orcidid><orcidid>https://orcid.org/0000-0003-1126-2797</orcidid></search><sort><creationdate>20211211</creationdate><title>Results of a Team Objective Structured Clinical Examination (OSCE) in a Patient with Pain</title><author>Barreveld, Antje M ; Flanagan, Jane M ; Arnstein, Paul ; Handa, Shruti ; Hernández-Nuño de la Rosa, María F ; Matthews, Michele L ; Shaefer, Jeffry R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-c6329796cf06bb9aaf842274cf202d56fdd9291dc430abb8becc91fa82663b063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesiology</topic><topic>Care and treatment</topic><topic>Chronic pain</topic><topic>Chronic Pain - diagnosis</topic><topic>Chronic Pain - drug therapy</topic><topic>Clinical Competence</topic><topic>Drug abuse</topic><topic>Drug addiction</topic><topic>Educational aspects</topic><topic>Educational Measurement</topic><topic>General & Internal Medicine</topic><topic>Humans</topic><topic>Learning</topic><topic>Life Sciences & Biomedicine</topic><topic>Medical cooperation</topic><topic>Medical education</topic><topic>Medical students</topic><topic>Medicine, General & Internal</topic><topic>Methods</topic><topic>Narcotics</topic><topic>Nursing education</topic><topic>Opioids</topic><topic>Pain</topic><topic>Pain management</topic><topic>Patients</topic><topic>Physical Examination</topic><topic>Science & Technology</topic><topic>Standardized tests</topic><topic>Students</topic><topic>Substance use disorder</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barreveld, Antje M</creatorcontrib><creatorcontrib>Flanagan, Jane M</creatorcontrib><creatorcontrib>Arnstein, Paul</creatorcontrib><creatorcontrib>Handa, Shruti</creatorcontrib><creatorcontrib>Hernández-Nuño de la Rosa, María F</creatorcontrib><creatorcontrib>Matthews, Michele L</creatorcontrib><creatorcontrib>Shaefer, Jeffry R</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barreveld, Antje M</au><au>Flanagan, Jane M</au><au>Arnstein, Paul</au><au>Handa, Shruti</au><au>Hernández-Nuño de la Rosa, María F</au><au>Matthews, Michele L</au><au>Shaefer, Jeffry R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of a Team Objective Structured Clinical Examination (OSCE) in a Patient with Pain</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><stitle>PAIN MED</stitle><addtitle>Pain Med</addtitle><date>2021-12-11</date><risdate>2021</risdate><volume>22</volume><issue>12</issue><spage>2918</spage><epage>2924</epage><pages>2918-2924</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract
Purpose
As rates of chronic pain and opioid use disorder continue to rise, improved pain education is essential. Using an interprofessional team objective structured clinical examination (OSCE) simulation, this study evaluates whether prior exposure to a case-based learning module improves students’ assessment and treatment planning of a standardized patient prescribed chronic opioids presenting with acute pain.
Methods
A quasi-experimental mixed method approach using convenience sampling was employed to evaluate student performance and the impact of the educational intervention.
Results
Fourteen (intervention) and 16 (control) nurse practitioner, physician assistant, medical, pharmacy, and dental students in the final pre-licensure program years completed the team OSCE. Demographics, OSCE learning scores, Interprofessional Attitudes Scale scores, and pain management plans did not differ between groups. All students evaluated the activity highly. Qualitative analysis did not demonstrate differences between groups, but did identify similar themes: students missed opportunities to establish patient-provider rapport and educate across disciplines; opioid use disorder was assumed with chronic opioid therapy; team discussions improved treatment plans; moderators variably influenced team discussion.
Conclusions
This novel approach to interprofessional training in pain management using a team OSCE is promising, with modifications suggested. A case-based learning module without structured education prior to the OSCE did not improve students’ assessment and pain management skills compared to a control group. Nonetheless, important themes emerged including biases towards the standardized patient. Additional research is needed to develop effective curricular initiatives to foster and improve interprofessional collaboration in assessing and managing a standardized patient with acute and chronic pain.</abstract><cop>OXFORD</cop><pub>Oxford University Press</pub><pmid>34145890</pmid><doi>10.1093/pm/pnab199</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2560-9974</orcidid><orcidid>https://orcid.org/0000-0003-1126-2797</orcidid></addata></record> |
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subjects | Anesthesiology Care and treatment Chronic pain Chronic Pain - diagnosis Chronic Pain - drug therapy Clinical Competence Drug abuse Drug addiction Educational aspects Educational Measurement General & Internal Medicine Humans Learning Life Sciences & Biomedicine Medical cooperation Medical education Medical students Medicine, General & Internal Methods Narcotics Nursing education Opioids Pain Pain management Patients Physical Examination Science & Technology Standardized tests Students Substance use disorder |
title | Results of a Team Objective Structured Clinical Examination (OSCE) in a Patient with Pain |
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