U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH NIH News National Institute on Drug Abuse

For Immediate Release: Wednesday, May 21, 2014, 11 a.m. EDT

CONTACT: NIDA Press Office, 301-443-6245, <e-mail:media@nida.nih.gov>

Interactive module improves medical student care for elderly back pain
patient "Edna"

An online training module designed for the evaluation and care of chronic
pain greatly improved medical student clinical skills, according to a report
in the Journal of the American Geriatrics Society. The module, built by the
University of Pittsburgh and using an elderly woman with chronic lower back
pain as a case study, is the first curriculum resource created through the
efforts of the National Institutes of Health Pain Consortium's Centers of
Excellence in Pain Education program (CoEPEs). The program was developed in
response to the Affordable Care Act's mandate to advance the science,
research, care and education of pain.

"Management of chronic lower back pain is one of the most common and
difficult problems that patients and health care providers face," said
Josephine P. Briggs, M.D., director of the NIH's National Center for
Complementary and Alternative Medicine (NCCAM) and member of the NIH Pain
Consortium Executive Committee. "The educational materials that have been
developed through this partnership will be a great asset in helping the next
generation of physicians build clinical skills to support their chronic pain

The CoEPEs were selected in 2012 to act as hubs for the development,
evaluation, and distribution of pain management curriculum resources for
medical, dental, nursing, and pharmacy schools. The NIH Pain Consortium
developed the centers to improve how health care professionals are taught
about pain and its treatment. The module is the first to be completed and
evaluated for effectiveness.

A team of six experts in education, information technology, pain management,
and geriatrics at the University of Pittsburgh developed the module,
focusing on common errors in clinical exams, expert modeling, interactivity,
and feedback. The module presented a standardized case of an elderly back
pain patient called Edna, with brief video clips that showed her interacting
with her clinician. The module also contains a multiple choice pre-test,
interactive questions, and a multiple choice post-test. Twenty-seven
medical students were exposed to the module and 28 were not. The students in
the group exposed to the module did significantly better on their objective
structured clinical examinations, an exam during which medical students
rotate through multiple stations, each with an objective examiner,
demonstrating clinical skills and knowledge while interviewing real or
simulated patients. Ninety-three percent of the students in the exposed
group passed the exam, compared to 60 percent of the non-exposed group. To
view the paper (published May 15), go to

"To our knowledge, this is the first study that has demonstrated the
potential of an online interactive module to improve medical student
clinical skills related to evaluating a patient with chronic pain," said the
study's lead author Debra K. Weiner, M.D. "While our module focused
specifically on an older adult with chronic low back pain, we see this type
of educational intervention as a powerful and efficient curriculum tool for
a variety of patient scenarios. We look forward to continuing to work with
the NIH Pain Consortium in its effort to improve pain care across the
country for many different pain conditions that plague patients of all

The CoEPE program is coordinated by the National Institute on Drug Abuse
(NIDA), one of 27 Institutes and Centers at the National Institutes of
Health. "We are so pleased that the first successful curriculum product
created by the CoEPEs relates to solutions for chronic back pain, one of the
most common pain conditions in America," said NIDA Director Nora D. Volkow,
M.D. "While we know opioids can be powerful clinical allies, a balanced
approach that includes a range of pain management options is needed to
ensure that people suffering from chronic pain can get the relief they need
while minimizing the potential for abuse."

The CoEPEs are creating and testing online, case-based pain education
modules for use in their own teaching institutions. Edna and several other
modules will be made available to other teaching institutions beginning in
the fall of 2014 at <http://painconsortium.nih.gov/CoEPEs.html>. These
modules are also accessible by the general public to help them learn how to
discuss chronic pain with their doctors. A preview of the module is
available at <http://bit.ly/1g3HTo4>.

Chronic pain affects approximately 100 million Americans, costing up to $635
billion in medical treatment and lost productivity and contributing to poor
quality of life. Yet, pain treatment is not taught extensively in many
health professional schools. The curriculum resources developed by the
CoEPEs aim to advance the assessment and safe treatment of multiple pain
conditions for diverse population groups, while minimizing the abuse of
opioid pain relievers. The curriculum resources developed by this program
will teach about the various types of chronic pain, medications to treat
specific pain conditions, and factors that contribute to both under- and
over-prescribing of pain medications. The courses will include the latest
research in complementary and integrative pain management.

The news release announcing the selection of the specific CoEPEs can be
found here: http://painconsortium.nih.gov/CoEPEs.html.
The sponsors of this Pain Consortium initiative are NIDA: Lead; Eunice
Kennedy Shriver National Institute of Child Health and Human Development
(NICHD), National Center for Complementary and Alternative Medicine (NCCAM),
National Institute of Dental and Craniofacial Research (NIDCR), National
Institute of Nursing Research (NINR), National Institute of Arthritis and
Musculoskeletal and Skin Diseases (NIAMS), National Institute of
Neurological Disorders and Stroke (NINDS), National Institute on Aging
(NIA), Office of Behavioral and Social Sciences Research (OBSSR), and the
Office of Research on Women's Health (ORWH).

NIH supports the full spectrum of pain research from basic understanding of
pain mechanisms through translation of discoveries into treatments and
prevention strategies. In FY 2013, NIH supported an estimated $400 million
in research focused on chronic pain, not including the related diseases that
often cause chronic pain, such as cancer, arthritis, diabetes, and stroke.
The details of individual pain-focused grants are publicly available on the
NIH RePORTER website. Enhancing education of pain care professionals was
highlighted in the June 2011 Institute of Medicine report "Relieving Pain in
America: A Blueprint for Transforming Prevention, Care, Education, and
Research," a report mandated by the 2010 Patient Protection and Affordable
Care Act.

About the NIH Pain Consortium: The NIH Pain Consortium was established to
enhance pain research and promote collaboration among researchers across the
many NIH Institutes and Centers that have programs and activities addressing
pain. Its goals include the development of a comprehensive and
forward-thinking pain research agenda for the NIH; to identify key
opportunities in pain research within NIH and the scientific community; to
increase visibility for pain research; and to pursue the pain research
agenda through Public-Private partnerships. For more information on the Pain
Consortium, visit <http://painconsortium.nih.gov/index.html>.

About the National Institutes of Health (NIH): NIH, the nation's medical
research agency, includes 27 Institutes and Centers and is a component of
the U.S. Department of Health and Human Services. NIH is the primary federal
agency conducting and supporting basic, clinical, and translational medical
research, and is investigating the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and its programs,
visit <www.nih.gov>.

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