Contemporary Pain Science Education and Physician Assistant Students

This prospective, single-cohort, longitudinal educational intervention study evaluated changes in physician assistant students' pain neuroscience knowledge and pain-related attitudes and beliefs following a multimodal contemporary pain science education session. The study was conducted within a 27-month, master's-level physician assistant program at a single university in the southeastern United States.

The educational session occurred approximately four months after students entered the program. It was delivered during the second semester and consisted of four hours of classroom instruction followed by a 30-minute laboratory component. Classroom instruction incorporated lecture, small-group active learning, discussion, and case-based application. The content presented pain as a multidimensional experience influenced by biological, psychological, social, behavioral, and contextual factors rather than solely by tissue injury or nociception.

Instruction addressed foundational pain neuroscience, pain mechanisms and phenotyping, biopsychosocial contributors to persistent pain, and guideline-informed approaches to pain management. The session also addressed potential unintended consequences of unnecessary diagnostic imaging, medication- or procedure-focused management, premature referral, and language that may increase fear or reinforce beliefs that pain necessarily indicates tissue damage. Students were introduced to selected screening tools used to identify psychosocial factors that may influence pain, function, and recovery.

The laboratory component provided experiential exposure to laterality recognition activities, quantitative sensory testing, and mirror-based techniques. These activities were intended to reinforce concepts discussed during the classroom portion of the session and to demonstrate selected approaches used in the assessment or management of persistent pain.

The study used a repeated-measures design with data collection at five points across the physician assistant curriculum: immediately before the educational session, immediately after the session, approximately four months after the session, at the completion of didactic education approximately 11 months after the session, and shortly before graduation after completion of clinical rotations approximately 23 months after the session.

All students in the cohort received the curricular education. There was no separate control or comparison group, and the intervention was not randomized. Participation in the research involved consenting to the collection and analysis of questionnaire data. Changes in scores over time were examined using repeated-measures statistical methods. Because other coursework and clinical experiences occurred during the follow-up period, the study was designed to evaluate longitudinal associations with the educational session rather than to establish that the session alone caused all observed changes.

The study was approved by the Belmont University Institutional Review Board. Informed consent was obtained from participants before research data collection.

Inclusion criteria

- Enrolled in the participating master's-level physician assistant program

Exclusion criteria

• None