Simulated conversations about chronic pain

With 28 million people in the UK experiencing chronic pain, it’s vital that students develop the skills relevant to the real caseloads they’ll encounter when they begin to practice.  

Yet there are too few specialist chronic pain posts for current and future patient volumes, which are predicted to continue to grow with many more patients experiencing chronic pain as part of a broader set of comorbidities. 

That’s why, working with local practice educators, we’ve developed a specific simulated learning approach for students to develop their skills in discussing and understanding chronic pain. 

We began by working with a local expert clinician to understand their role and skills and responded to their desire to enable new graduate physio therapists to confidently use a central sensitisation explanation using the patient story and lived examples. Then, we co-created an authentic simulation scenario in partnership with the practice educators who host our students in pain management placements. 

The simulation session opens with a pre-brief, which is evidence-based, to support psychological safety on the day. Pre-simulation learning involved watching a film of a simulated interaction where the physiotherapist works with a patient and explains what persistent pain is. 

While peer role play can be effective, we recruited and trained four volunteers to act in the role of the patient: the use of an unknown simulated patient was transformative for student learning. Learning was further enhanced by asking the simulated patients to complete an anonymous CARE Measure questionnaire, as in clinical practice, to provide feedback. 

There are too few specialist chronic pain posts for current and future patient volumes, which are predicted to continue to grow; with many more patients experiencing it as part of a broader set of comorbidities

Finally, we used feedback from our participants to inform the experience for future cohorts: firstly, by enhancing pre-simulation awareness of local pain management services and how other healthboards structure theirs, and secondly by interviewing our students who had experienced a placement in a chronic pain service to provide insight on how to conduct an intervention. 

In this way, we hope to prepare our students to meet the needs of patients living with persistent pain.