Abstract
BACKGROUND⁄ Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs' assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method - deteriorating patient-based simulation (DPS) - versus SPs for improving HCPs' pain knowledge and assessment skills. Seventy-two HCPs were randomly assigned to a 3 h SP or DPS simulation intervention. Measures were recorded at baseline, immediate postintervention and two months postintervention. The primary outcome was HCPs' pain assessment performance as measured by the postoperative Pain Assessment Skills Tool (PAST). Secondary outcomes included HCPs knowledge of pain-related misbeliefs, and perceived satisfaction and quality of the simulation. These outcomes were measured by the Pain Beliefs Scale (PBS), the Satisfaction with Simulated Learning Scale (SSLS) and the Simulation Design Scale (SDS), respectively. Student's t tests were used to test for overall group differences in postintervention PAST, SSLS and SDS scores. One-way analysis of covariance tested for overall group differences in PBS scores. DPS and SP groups did not differ on post-test PAST, SSLS or SDS scores. Knowledge of pain-related misbeliefs was also similar between groups. These pilot data suggest that DPS is an effective simulation alternative for HCPs' education on postoperative pain assessment, with improvements in performance and knowledge comparable with SP-based simulation. An equivalence trial to examine the effectiveness of deteriorating patient-based simulation versus standardized patients is warranted.
Highlights
Thuan Dao DMD MSc Dip Prostho PhD FRCDC1, Sara Promislow MEd PhD1, Nancy McNaughton MEd PhD(c)1, Scott White BMUS1, Cindy Shobbrook RN(EC) MN CHPCN(c) CON(c)6, Lianne Jeffs RN PhD7, Kianda Mauch RN MScN/ONP7, Marit Leegaard RN CRNA PhD8, W Scott Beattie MD FRCPC PhD1,5, Martin Schreiber MD MEd FRCPC1, Ivan Silver MD MEd FRCPC(c
Knowledge of pain-related misbeliefs was similar between groups. concLuSionS: These pilot data suggest that deteriorating patientbased simulation (DPS) is an effective simulation alternative for health care professionals (HCPs)’ education on postoperative pain assessment, with improvements in performance and knowledge comparable with standardized patients (SPs)-based simulation
A combination of checklist and global rating components should be used. We found no such combined evaluation method for examining HCP’s postoperative pain assessment skills
Summary
Michael McGillion RN PhD1, Adam Dubrowski PhD1,2, Robyn Stremler RN PhD1, Judy Watt-Watson RN PhD1, Fiona Campbell BSc MD FRCA1,2, Colin McCartney MBChB FRCA FCARCSI FRCPC1,3, J Charles Victor MSc1, Jeffrey Wiseman MD MScEd FRCPC FACP4, Linda Snell MD MHPE FRCPC FACP4, Judy Costello RN MScN5, Anja Robb MEd1, Sioban Nelson PhD RN1, Jennifer Stinson RN PhD CPNP1,2, Judith Hunter BScPT PhD1, Thuan Dao DMD MSc Dip Prostho PhD FRCDC1, Sara Promislow MEd PhD1, Nancy McNaughton MEd PhD(c), Scott White BMUS1, Cindy Shobbrook RN(EC) MN CHPCN(c) CON(c), Lianne Jeffs RN PhD7, Kianda Mauch RN MScN/ONP7, Marit Leegaard RN CRNA PhD8, W Scott Beattie MD FRCPC PhD1,5, Martin Schreiber MD MEd FRCPC1, Ivan Silver MD MEd FRCPC(c). The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method – deteriorating patientbased simulation (DPS) – versus SPs for improving HCPs’ pain knowledge and assessment skills. The purpose of the present study was to examine the efficacy of an alternate simulation method – deteriorating patientbased simulation (DPS) – versus SPs for improving HCPs’ pain knowledge and assessment skills. Interventions The aim of the simulation interventions (SP and DPS) was to improve participants’ pain assessment skills and knowledge of common painrelated misbeliefs that interfere with optimal pain assessment and management These interventions were delivered in small groups (five to eight participants) by an expert facilitator at the study site. Two SPs were trained to portray the patient and two were trained to portray the patient’s sister, who was part of the case
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