The effect of pain neurophysiology education on healthcare students’ knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial

Abstract

Objective1) To investigate the effects of a brief pain neuroscience education (PNE) lecture on multi-disciplinary healthcare students' knowledge, attitudes and behaviours towards people with pain post intervention and at 6-months follow-up, 2) To explore students’ perceptions of PNE. DesignMixed-methods randomized controlled trial. SettingUK university. ParticipantsThirty-seven students (30♀, mean age 30 years) from six healthcare disciplines. Intervention70-min PNE lecture (intervention group) or a 70-min control education. Main outcome measures1) Knowledge: The Revised Pain Neurophysiology Quiz (RPNQ); 2) Attitudes: Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS); 3) Behaviours: A case vignette to assess clinical recommendations; and 4) Thematic analysis of semi-structured interviews (n = 12). ResultsThe intervention group increased knowledge compared to the control, post-intervention [mean difference 3.7 (95% CI, 2.4, 5.0), P < 0.001] but not at 6-months (0.1 (−1.1, 1.3), P = 0.860). Greater improvements in attitudes for the intervention group were seen post-intervention [-10.4 (−16.3, −4.6), P < 0.001] and at 6-months [-5.8 (−11.5, −0.2), P < 0.044]. There was no difference in behaviours between groups. Thematic analysis identified increased patient empathy, partial and patchy reconceptualisation of pain and increased confidence in recommending an active management programme following PNE. ConclusionThis study adds to existing knowledge by demonstrating that a 70-min PNE lecture can have a short-term effect on knowledge and positively shift attitudes towards people with pain in the short and medium-term. It also resulted in some students’ reconceptualisation of pain, increased empathy, and confidence to recommend activity. The effect of PNE on clinical behaviours was unclear.