(Re)Development of Pain Target Competencies in a Contemporary, Multi-Centre Undergraduate Medical Curriculum: The Importance of Local Cultural Requirements

Abstract

Pain is the most common reason to seek healthcare assessment, however pain teaching is often not prominent in medical school curricula. This project reviewed an existing medical curriculum to develop a comprehensive pain curriculum that consolidated pain learning across a medical degree delivered on geographically-distinct campuses, looking to provide a contemporary pain learning that was culturally appropriate in a local context. A cross-campus, interdisciplinary pain working group (PWG) was established to work across the two program stages (pre-clinical, clinical) and three clinical campuses. The PWG undertook a three-phase project to i) develop a range of potential target competencies based on expert input and international pain curricula, ii) identify and review existing pain competencies, and iii) undertake iterative review of information, consult with stakeholders, and propose revised competencies. Eight pain competencies were identified within the extant curriculum. Recommendations included two existing competencies remained unchanged, four be modified, two merged, and 26 new competencies adopted including some specific to local Indigenous Māori and Pacific Island communities. The 33 pain target competencies were structured across different teaching domains: science, research, and scholarship (n=5); population health and epidemiology (n=3); clinical skills (n=5); and diagnostics and therapeutics (n=20). Contemporary pain learning, including around Indigenous health, was not adequately represented. New target competencies were adopted to ensure pain learning is appropriate for medical practice in Aotearoa New Zealand, containing competencies specific to Māori and Pacific Island communities. Curricula review needs to consider local cultural requirements while integrating international best practice to ensure pain learning is appropriate. PerspectiveA comprehensive pain curriculum was developed across a multi-campus medical school setting. Through a three-phase project, existing pain competencies were reviewed and new target competencies developed, including those specific to local Indigenous communities. Findings highlight the importance of ensuring contemporary curricula include pain learning that is culturally focused and relevant.