1. Training them early EPM Lite Bridging the gap in Undergraduate Pain Training
Helen Makins
Consultant in Pain Medicine, Gloucestershire Hospitals NHS Foundation Trust
Sailesh Mishra
Consultant in Pain Medicine and Anaesthesia, Newcastle University Hospitals

2. EPM Lite What is it and why is it needed?
Background to the course and Faculty of Pain Medicine involvement
UK Pilot
National uptake (Newcastle example)
Making it work
What next?

3. Do you recall receiving specific, formal undergraduate training in the multidisciplinary management of pain?
Yes/No

4. Do you feel that your personal undergraduate training in Pain Management was adequate?
Yes/No

5. Do you feel that UK undergraduates in all healthcare professions currently receive adequate training in the multidisciplinary management of pain?
Yes/no

6. How it all started Australian and New Zealand College of Anaesthetists
Roger Goucke
Wayne Morriss
First Course in Papua New Guinea in 2010
SE Asia, Mongolia, Pacific Islands, Uganda, Rwanda
2013 UK EPM working group – Africa
Development of EPM Lite – Linda Huggins

7. What is EPM Lite? Essential Pain Medicine Lite Half day course
For medical students
Appropriate for all medical professionals
Bridges a gap between theory and practise
Standardised, multidisciplinary approach
Acronym
UK med students at present but completely adaptable for all professionals – at undergrad and postgrad level
Physiology/pathophysiology/pharmacology well taught
Translating the facts into managing a patient not formally or universally taught

8. What EPM Lite covers What is pain and why treat it?
Classification of Pain
Pain physiology and pathology
Treatment
Management

9. Management
“ABC” approach
Recognise
Assess
Treat

10. Faculty of Pain Medicine Royal College of Anaesthetists
2008 Chief Medical Officers Report highlighted need for improved Pain Education
<1% of training time at undergraduate level spent on pain*
Project for medical schools in the UK
To reflect the biopsychosocial nature of pain and the multidisciplinary approach to management
Standardised approach
* Briggs et al; Survey of Undergraduate Pain Curricula for Undergraduate Healthcare Professionals in the UK
2008 – plight of patients with pain highlighted by Sir Liam Donaldson
First recommendation was improved education in Pain management for all undergraduate healthcare professionals
Physios and vets have more training time at Uni than Doctors or nurses
Standardised teaching means all professionals managing and understanding in a similar way resulting in improved communication and care

11. Course Materials Student manual Instructor manual Slide set
Evaluation form
Certificate of attendance
All materials provided – only familiarisation needed

13. All resources available on RCOA website

15. Bristol Pilot 2014 Enthusiastic Year 4 curriculum lead
4 teaching sessions throughout the year
Anaesthetic module
60 students each session
Year 4 curriculum lead for Bristol Uni happened to be an Anaesthetist – always useful to have a friend or contact

16. Session Structure Total length 3 hours MCQ at beginning and end
Time
Duration (mins)
Lecture / Discussion
Instructor/s 15
Welcome, Introduction & Pre-test
Helen 20
What is pain and why should we treat it? (a)
All – small groups
Classification of pain
Mike
Pain physiology and pathology - revision
Sarah
Tea
Pain Treatment Overview 10
RAT approach to pain management
Ann 50
RAT approach to pain management (b) 25
Post-test, answers & feedback (c)
Total length 3 hours
MCQ at beginning and end
2 small group sessions totalling 1h 10mins
20 minute tea break
Otherwise lecture based

17. What the students said Content was generally useful
Level was mostly right although some felt too simple
Liked the small group discussions
Opportunity to learn from experienced physicians was very enjoyable
Understanding improved

18. Tutor Reflection
Lectures too long but content needed to remain to cater for all knowledge levels
Small group sizes were good – max 15 students
Pre-course information hadn’t been read
MCQ questions were pitched incorrectly

19. 2015 Revisions Curriculum all changed
Anaesthetics all taught in the Academies
Fought for our spot
Central Study days in year 3
Had to teach the whole year (240 students) together

20. New timetable Small group session time increased to 1hour 30 mins
Incorporated an additional small group session on the use of opiates in pain management – using case studies and with points to cover for tutors
Re-vamped MCQs
No food or drink!

21. The Venue More like a wedding venue than a teaching environment
Bearing in mind the wish to increase the small group element, it was a challenge to achieve this with 240 students in one room
contact list of all those who might be interested in helping – nurses and Doctors – Consultants, Anaesthetic Trainees, Pain Specialist Nurses (prescribers)
Ended up with 17 tutors and groups of max 14 students

22. Feedback Generally extremely positive Lecture length good
Experienced tutors valued
Small groups allow flexibility
MCQs too long
MCQs pre and post for evaluation and assessment reasons – technology failed! Long and boring to go through the same test 3 times.
Flexibility of small groups good to cater for all levels of knowledge, making session challenging for all

23. Sailesh’s part here

24. Uptake so far Aberdeen Bristol Birmingham Edinburgh Leeds Newcastle
Nottingham
Oxford
Plymouth
St Andrews
Plenty of gaps!

25. Next…….. Tutors needed for all existing programmes
Local leads needed for Medical Schools in other regions
Find an opportunity
Adapt to local need
We will support
Existing programmes need help to run – especially if teaching multiple times per year.
Those areas not yet covered, we would be happy to assist anyone who is enthusiastic to get started
Fitting it into the curriculum may be the hardest part
Use contacts/networks to approach the University for direct inclusion in curriculum
Teach during the Anaesthetic module – centrally or through academies/individual hospitals

26. Other Healthcare Professionals
Use the resources
Adapt accordingly
Improve management of pain in your Institute or Department
We will support

27. Please get in touch Faculty of Pain Medicine website Jchand@rcoa.ac.uk