Introducing Simulation-Based Learning for Trainees in Chronic Pain Medicine: Needs Assessment and Suggestions for Training Scenarios

IntroductionManaging patients with chronic pain can be complex and requires specialized clinical knowledge and advanced communication skills. Simulation-based learning has been shown to improve learning outcomes for complex competencies and could be a valuable resource for trainees in chronic pain medicine.MethodsWe assessed the need for a simulation-based course for trainees in chronic pain medicine at McMaster University in Canada. The needs assessment consisted of three steps: (1) literature review to identify preexisting needs assessments, (2) targeted interviews with six healthcare professionals in chronic pain management, and (3) an analysis of 366 routinely collected patient experience surveys.ResultsThe systematic review identified a small body of related literature and no previous needs assessment. We identified the following key competencies and skills that trainees in pain medicine need to develop: (1) communicating with distressed patients using skills such as de-escalation, active listening, and motivational interviewing, (2) managing patients in difficult emotional situations such as poorly controlled pain or showing signs of opioid misuse, and (3) recognizing and managing mental health issues related to chronic pain using appropriate instruments.DiscussionSuggestions for scenarios included the following: (1) consulting a patient with poor pain control and running out of treatment options, (2) managing a patient with suspected inappropriate opioid use, and (3) diagnosing depression in a patient suffering from chronic pain and developing an appropriate treatment plan.ConclusionWe propose the development of suggested scenarios into simulation-based courses, and test and refine them together with trainees and experts in pain medicine.