637: How New Clinicians Learn to Work with People Living with Pain

Topic: Education, Societal Impact, and Others
Subtopic: Education of pain care

Background and Aims: Marked variation persists in how newly qualified clinicians feel prepared to work with people living with pain,1,2 despite increased attention to pain-related content in professional training.3 Prior national work has demonstrated substantial differences in pain-related preparedness across entry-level programs,4,5 yet little is known about how graduates themselves interpret their training or how educational and clinical environments shape the uptake and enactment of pain-related learning. This study explored recent graduates’ experiences of preparation for pain management and examined personal, contextual, and systemic influences that help explain differences in readiness during the transition to practice.

Methods: Semi-structured interviews were conducted with recent graduates from Canadian entry-level physiotherapy programs to explore experiences of preparation for pain management. Graduates were purposefully sampled from programs identified in previous work as differing in pain management education profiles, to support comparison across training contexts.6 Interviews examined how learning to work with pain was encountered, interpreted, and applied during training and early practice, including coursework, clinical placements, and program culture. Data were analyzed using an iterative qualitative content analysis with comparison across programs to identify shared and divergent experiential patterns in how learning was interpreted and taken up in practice.7

Results: Across programs, graduates described memorable encounters with people living with pain and communication styles modeled by educators as shaping how they framed pain and engaged with patients. A recurring challenge involved translating conceptual understanding into clinical interaction, particularly explaining pain and responding to patient questions despite familiarity with concepts. When examined in relation to prior program-level pain education profiles, patterned differences emerged. Graduates from programs with lower integration of pain management education more often emphasized gaps in foundational understanding, whereas those from programs with higher integration described having a conceptual base but difficulty applying knowledge in complex clinical encounters.

Conclusions: Taken together, these findings highlight how graduates describe pain learning as shaped by framing, modeling, and reinforcement across training contexts. Program-level differences in how challenges were articulated point to variation in what aspects of pain learning are foregrounded during training, including building foundational understanding or supporting application in clinical interaction. Viewing pain education through graduates’ experiences highlights the importance of examining how learning is interpreted and carried forward across educational and clinical settings, without assuming uniform uptake from similar curricular intentions.

References: 1. Synnott A, O’Keeffe M, Bunzli S, Dankaerts W, O’Sullivan P, O’Sullivan K. Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review. J Physiother. 2015;61(2):68-76. doi:10.1016/j.jphys.2015.02.016
2. Government of Canada. Chronic Pain in Canada: Laying a Foundation for Action. Canadian Pain Task Force Report: June 2019. August 8, 2019. Accessed November 25, 2021. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2019.html
3. Government of Canada. Canadian Pain Task Force Report: March 2021. May 5, 2021. Accessed November 25, 2021. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021.html
4. Wideman TH, Miller J, Bostick G, Thomas A, Bussières A, Wickens RH. The current state of pain education within Canadian physiotherapy programs: a national survey of pain educators. Disability and Rehabilitation. 2020;42(9):1332-1338. doi:10.1080/09638288.2018.1519044
5. Augeard N, Bhanji A, Miller J, et al. Integration of Pain Management Competencies in Canadian Physiotherapy Education: A National Survey of Curriculum, Teaching Practices and Educators’ Perceptions. Physiother Can. Accepted for publication. Reserved doi: 10.3138/ptc-2025-0019
6. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health. 2015;42(5):533-544. doi:10.1007/s10488-013-0528-y
7. Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8-14. doi:10.1016/j.npls.2016.01.001

Presenting Author: Nathan Augeard
Submitting Author: Nathan Augeard

Senior Author: Timothy Wideman

IASP 2026 Global Year theme of Neuropathic Pain: No

• Christian Longtin: PhD - McGill University
• Jordan Miller: PhD - Queen's University
• Geoff Bostick: PhD - University of Alberta
• Yannick Tousignant-Laflamme: PhD - Université de Sherbrooke
• Timothy Wideman: PhD - McGill University