601: Determinants of pain management competency following health professional education: A national study

Topic: Education, Societal Impact, and Others
Subtopic: Education

Background and Aims: National pain strategies consistently emphasize the urgent need to improve how health professionals are initially trained to understand and manage pain.1,2 These calls are based on the assumption that increasing the time and content dedicated to pain management within pre-licensure curriculum will improve pain management competency among graduating health professionals. However, this relationship has yet to be evaluated. This study aimed to fill this gap by conducting the first standardized assessment of pain management competency across health professional programs that varied in pre-licensure pain management curriculum.

Methods: This study examined the relationship between pre-licensure pain management curriculum and end-of-training pain management competency across Canadian physical therapy (PT) programs. PT faculty from each program completed a standardized survey to quantify how pain was integrated into curricula (e.g. time and content dedicated to pain management).3-5 Graduating PT students from each program completed a 2-hour, validated and standardized, assessment (consisting of 28 multiple-choice questions and 3 simulation-based clinical scenarios) to evaluate pain management competency.6 Hierarchical linear modeling (HLM) was used to determine the relationship between program-level curricula and student competency, while controlling for potential confounders (e.g. grade point average).

Results: Thirteen of the 15 Canadian PT programs participated in the study, and 539 students with complete competency data were included. Program-level analyses revealed significant differences across programs in relation to the pain management competency levels among their graduating PT students. However, contrary to expectations, the characteristics of pain management curriculum (i.e. the time and content dedicated to pain) failed to predict competency levels in final HLM models. Secondary analysis revealed an unexpected finding in which programs that integrated people living with pain into their curricula, graduated students with significantly higher competency levels compared to other programs.

Conclusions: These findings challenge foundational assumptions underlying national pain strategies that address health professional education. They show that more curriculum time and content addressing pain management does not always correspond to higher pain management competency among graduating health professionals. They also suggest that recently developed educational interventions that integrate people living with pain within the design and delivery of health professional pain education may be a promising new strategy to improve health professional competency levels.7 This study will help inform future research and health education policy in developing new evidence-based strategies to improve care for people living with pain.

References: 1. Canadian Pain Task Force. An action plan for pain in Canada. Health Canada
2021.https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-canada/publicengagement/external-advisory-bodies/canadian-pain-task-force/report-2021-rapport/report-rapport- 2021-eng.pdf.

2. The National Institutes of Health, National Pain Strategy - A Comprehensive Population Health -Level Strategy for Pain. 2016, The National Institutes of Health.
3. Augeard N, Bostick G, Miller J, Walton D, Tousignant-Laflamme Y, Hudon A, Bussières A,
Cooper L, McNiven N, Thomas A, Singer L, Fishman SM, Bement MH, Hush JM, Sluka KA, Watt-Watson J, Carlesso LC, Dufour S, Fletcher R, Harman K, Hunter J, Ngomo S, Pearson N, Perreault K, Shay B, Stilwell P, Tupper S, Wideman TH. Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada. Can J Pain. 2022;6(1):1-11. DOI:10.1080/24740527.2021.2004103

4. Augeard N, Bhanji A, Miller J, Bostick G, Tousignant-Laflamme Y, Thomas A, Amari F, Wideman T. Integration of Pain Management Competencies in Canadian Physiotherapy Education: A National Survey of Curriculum, Teaching Practices and Educators' Perceptions. Physiother Can. 2025; DOI:10.3138/ptc-2025-0019

5. Wideman, T.H., et al., The current state of pain education within Canadian physiotherapy programs: a national survey of pain educators. Disabil Rehabil, 2019: p. 1-7.
6. Augeard N, Miller J, Bostick G, St-Onge C, Tousignant-Laflamme Y, Hudon A, Walton D,
Singer L, Cooper L, Bussières A, Thomas A, Perreault K, Tupper S, Carlesso LC, Stilwell P, Amari F, Varette K, Ashton-James C, Wideman TH. Development of a pain management competency assessment for physiotherapy students: Integrating simulation and written assessments. Canadian Journal of Pain. 2025;9(1); DOI:10.1080/24740527.2025.2512728

7. Longtin C, Bhanji A, Houston E, Augeard N, Amari F, Singer L, Cooper L, Ashton-James C,
Miller J, Towle A, Bostick G, Wideman TH. Integrating people living with pain into pre-licensure pain education: a novel learning activity for health professional students. Disability and Rehabilitation. 2025; 1-19; DOI: 10.1080/09638288.2025.2563770

Presenting Author: Timothy Wideman
Submitting Author: Timothy Wideman

Senior Author: Timothy Wideman

IASP 2026 Global Year theme of Neuropathic Pain: No

• Timothy Wideman: PhD - McGill University
• Nathan Augeard: PhD - McGill University
• Alaanah Bhanji: MSc - McGill University
• Fatima Amari: MSc - McGill University
• Geoffrey Bostick: PhD - University of Ottawa
• Lynn Cooper: BA - McGill University
• Jordan Miller: PhD - Queen’s University
• Lesley Singer: MSc - McGill University