As you subscribe to my website, you are aware that significant steps have been taken by educators and the APTA to advance pain education in Doctor of Physical Therapy (DPT) programs. This shift includes adding essential pain education content with the aim to produce graduates who are competent in contemporary pain management.
Despite various trends, past surveys have demonstrated minimal pain content in entry-level physical therapist education programs. Our investigation examined: 1) the learning content of pain education and faculty expertise teaching core pain content, 2) whether pain education content is sufficient to prepare physical therapists to meet the needs of contemporary pain management, and 3) whether standardization of pain education in entry level DPT programs is advantageous.
We developed a pain education survey which was sent to all accredited DPT program directors in New York State. The survey included questions related to content and hours devoted to teaching 1) pain science, 2) pain education, 3) psychosocial factors, 4) biopsychosocial model, 5) cognitive-behavioral techniques, 6) advanced faculty training, and 7) challenges adding pain education to the curriculum.
The Journal of Allied Health Sciences and Practice published our study results in June 2022. Key findings include:
- 60% reported they do not have a course dedicated to pain science
- 60% reported < 10 hours of pain education
- 60% reported a class on psychosocial factors
- 50% reported < 10 hours on the biopsychosocial model
- Cognitive- behavioral techniques varied between 10-30 hours
- 70% of faculty received advanced training, and
- Challenges to adding pain education included time, a dense curriculum, and pain content is not part of NPTE exam questions.
The biopsychosocial model of pain, foundational pain education, and cognitive-behavioral techniques for pain management are part of many entry-level DPT education programs in New York State.
What This Means for Physical Therapists
New York State DPT programs are preparing physical therapists with entry-level knowledge to evaluate, treat, and manage both acute and chronic pain. The majority of programs include pain education, although content, time, and methods vary greatly. Even though all accredited DPT programs included educational content about pain the breadth and depth of content varied greatly from 10-40 hours depending on the content. These finding are somewhat similar to past investigations in a variety of licensed health professionals. Increased standardization for pain education would create consistency across all U.S. DPT programs.
Future Directions for Physical Therapy Education and Practice
Pain is a multidimensional condition which requires a multimodal approach.
Findings from the New York survey serve as a reference to improve pain education within DPT entry level curricula. With an aim to improve professional competencies of physical therapists to effectively treat chronic pain, it may be necessary to create new “gold educational standards.” These gold standards should include (a) strategies to promote physical activity and other lifestyle interventions; (b) evidence-based cognitive processes of change known to impact pain and disability outcomes; (c) cognitive behavioral techniques with empirically demonstrated links to behavior change; (d) information delivered in the context of physical therapist education and practice; and (e) pain education and treatment sensitive to the needs of people living with pain. Based on the findings from the study, an investigation should be undertaken to determine if more specific standards for pain education are advantageous for the entry level DPT curricula.
Stay tuned for exciting updates later in 2022! We have already published studies on nutrition and mindfulness and acceptance-based approaches for pain. We have other investigations in the peer-review process regarding ACT for the physical therapist, new perspectives in applying biopsychosocial methods, and innovative models to target persistent pain.
To learn about biopsychosocial training opportunities including the certification in Psychologically-Informed Pain Care click here!
Finally, just a note to acknowledge the dedication and teamwork by the co-authors of this study, Marcia Spoto, PT, DC and Joseph Lorenzetti, PT, DPT. We hope this small but significant investigation inspires more physical therapists to investigate how we can improve pain care and serve individuals and populations with pain on a broader scale.
Wishing you well,
Joe Tatta, PT, DPT