This post is a summary of CHAMP research published in the journal Pediatric Rheumatology.

Our goal

Past research has demonstrated that healthcare professionals receive little training about pain during their undergraduate studies. The CHAMP research team were particularly interested in investigating whether this lack of pain training was addressed when healthcare professionals started to specialise in specific medical disciplines, such as paediatric rheumatology.

In paediatric rheumatology, professionals receive a wide range of referrals for long-term conditions in which persistent or recurring pain in the bones, muscles and tissues (chronic musculoskeletal pain) is a feature. We were interested in this as the ultimate aim of our research is to improve pain assessment and communication, which requires a healthcare professional to be educated about and trained in how to perform effective assessments and communication about pain.

What we did

In this study, we identified a range of curricula and competency documents guiding the education and training of postgraduate healthcare professionals in paediatric rheumatology. We investigated how often terms such as ‘pain’ and associated terms such as ‘assessment’, ‘communication’ and ‘management’ featured in the documents. In the instances where these terms were identified, our research team explored the context in which these terms were used.

We identified nine documents that were used to guide the education and training of doctors, nurses, physiotherapists and occupational therapists specialising in paediatric rheumatology. Out of all the text included within the nine documents, only 1.5% of the content of the text was related to pain.

When we looked at the context of this pain information, we found that it used in very interesting ways. For example, pain was mostly separated into ‘inflammatory’ vs ‘non-inflammatory’ contexts, which was interesting as that could prompt healthcare professionals to perceive pain as being a feature of only one of these types of conditions, not both (when pain can be a feature of either type of condition).

Pain was also described as a ‘somatic’ symptom, which is defined as a symptom which is ‘related to the body and distinct from the mind’. This perspective of pain is problematic as pain has biological, psychological and social components, and referring to pain as a ‘somatic’ symptom ignores the psychological aspects to it.

Areas for change

In summary, our findings highlighted how pain-related content is lacking in the education and training documents guiding healthcare professionals in paediatric rheumatology, and the context of pain information was problematic.

We concluded our study by highlighting how education and training in this discipline would benefit from updates, incorporating more modern pain theory and evidence-based theory. By improving the education and training of healthcare professionals in pain, we can ultimately improve patient pain care, as we equip our healthcare professionals to be able to better understand, assess, communicate and manage pain.

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