- Pain Science and Practice Course
University of Pennsylvania School of Nursing, School of Dental Medicine, and Perelman School of Medicine
This interprofessional course focuses on the biopsychosocial aspects of pain and pain management from the perspectives of individualized pain care, scientific discoveries, evidence-based practice, and cross-disciplinary learning. Content includes an integrated overview of the neurobiology of pain, psychosocial aspects of the pain experience, pain assessment and outcomes measurement, pharmacological and nonpharmacological approaches to the treatment of acute and chronic pain syndromes, national health policies for pain, evidence-based guidelines and best practices, and interprofessional care delivery models. Peripheral and central modulation of pain, neuroanatomical pathways, neurochemical mediators, and genetics are examined as the basis for explaining pain perception, behaviors, and responses to treatments. Pain assessment and management for vulnerable populations are addressed along with strategies to reduce pain treatment disparities. Several acute and chronic (persistent) pain syndromes are discussed across the continuum of care (e.g., primary care, hospital, outpatient pain centers, and home care). Current research findings and evidence-based guidelines are applied to interprofessional collaboration and clinical decision-making to promote optimal care and outcomes for persons experiencing pain. Through case-based and directed learning, classroom simulation, and interactive discussions with national leaders spanning multiple disciplines, students acquire a strong scientific and practice foundation in the clinical care of persons with acute and chronic pain.
This course prepares students with advanced knowledge of pain assessment, pharmacotherapy, nonpharmacological therapies, and interventional techniques to address the increasing and complex needs of persons with acute and chronic pain. Safe and effective pain care is based on rational therapeutics grounded in the neurobiology of pain, pathophysiological mechanisms of pain, pain assessment practices, and principles underlying various treatment options. Students learn from nationally and internationally recognized pain experts who present the latest scientific discoveries and research related to the understanding of various pain acute and chronic pain states and pain therapies including multimodal analgesia. Through interactive, problem-based, and independent-guided learning, students apply research and evidence-based content to the care of patients in primary care, hospital, and other healthcare settings. Students acquire in-depth knowledge of a pain problem or issue of interest through a group assignment.
- Explain the pathophysiological mechanisms of pain contributing to central sensitization, neural plasticity and wind-up, and other abnormal pain states.
- Differentiate mechanisms and characteristics of physiological sources of pain (i.e., somatic, visceral, and neuropathic pain).
- Apply accepted pain taxonomy (e.g., definitions, pain classifications, and terminology) to discussions of pain mechanisms, assessment, treatment, and specific pain conditions.
- Evaluate appropriate pain and symptom measures on the basis of the psychometric properties and clinical applications for use in various patient populations considering age, cognitive status, socioeconomic status, educational level, and ethnocultural orientation.
- Describe psychosocial influences on perceptions of pain and behavioral and cognitive therapies to improve the quality of life of individuals with pain.
- Discuss pharmacological classes of analgesics including indications, pharmacodynamics, mechanisms of action, dosing parameters, adverse effects, and patient monitoring.
- Examine the role of rational therapeutics, multimodal therapy, technology-supported pain care, interventional techniques, and nonpharmacological approaches for acute and chronic pain.
- Distinguish differences between physical dependence, tolerance, pseudoaddiction, and addiction and their relevance to designing plans of care.
- Examine health professional-, systems-, and societal-related barriers to the effective management of pain and influences of research and health policy to overcome pain treatment disparities.
- Investigate Internet-based professional and patient resources.
- Translate evidence-based practice guidelines into the clinical care of patients with various types of pain.
- Engage in cross-disciplinary case-based discussions of acute and chronic pain states to formulate individualized pain treatment plans across the continuum of care.
Specific Course Content
- National and international health policies to address issues related to pain
- International Association for the Study of Pain (IASP) pain nomenclature and classification systems
- Neurobiology of pain including cellular mechanisms for pain, pain pathways, pain modulation, and pathophysiological states (central sensitization, wind-up, and neuralplasticity)
- Acute pain (postoperative, procedure-related, and trauma) and chronic (persistent) noncancer and cancer pain states
- Influence of genetics on pain susceptibility and response to pain treatments
- Consequences of untreated or poorly managed acute and persistent pain
- Clinical assessment and measurement of pain
- Pharmacological classes of analgesics (e.g., nonopioids, opioids, and adjuvant agents)
- Multimodal analgesic therapy
- Nonpharmacological and interventional techniques and alternative and complementary approaches to pain management
- Issues in pain care for vulnerable populations
- Evidence-based practice guidelines for pain assessment and management
- Models for interprofessional care delivery for acute pain, chronic pain, and palliative care
- Advocacy and resources for patients experiencing pain
- Societal and ethical issues related to pain management
Lecture, interactive discussions with faculty and students, problem-based and directed learning, classroom simulation experiences, and independent-guided learning.