Contemporary Pain Science Education and Physician Assistant Students

NCT07735663 | Completed

• 1 other identifier: 1093
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial was to learn whether a pain science education session could improve physician assistant students' understanding of pain and their beliefs about people with persistent pain. The main questions were: Did students' knowledge of how pain works change after the education session? Did students' beliefs about the relationship between pain, physical impairment, and activity change after the session? Were any changes maintained during the remainder of the physician assistant program? Participants were students enrolled in one physician assistant master's degree program. All students received a four-hour pain science education session and a 30-minute hands-on laboratory session as part of their curriculum. The session explained that pain is affected by biological, psychological, and social factors. It also included case discussions, small-group activities, pain-related screening tools, and demonstrations of selected pain management techniques. Participants completed questionnaires before the session, immediately afterward, and at three later points during the program. The final questionnaires were completed shortly before graduation. Researchers compared questionnaire scores across these five time points to examine changes in pain knowledge and pain-related beliefs.

Conditions

Focus of Study Pain Knowledge

Keywords

Pain science education; Physician assistant students; Pain neuroscience; Biopsychosocial model

Outcome Measures

Primary Outcomes (2)

• Revised Neurophysiology of Pain Questionnaire (rNPQ)

  The 12-item Revised Neurophysiology of Pain Questionnaire was used to assess pain neuroscience knowledge and has a possible total score ranging from 0 (no items answered correctly) to 12 (all items answered correctly). Each correct answer receives 1 point; incorrect or "undecided" responses receive 0 points. Higher scores represent a better outcome, indicating greater knowledge and understanding of pain neurophysiology

  Over 23 months, from study enrollment to graduation from the academic program

• Health Care Provider's Pain and Impairment Relationship Scale (HC-PAIRS)

  The 15-item Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) has a possible total score ranging from 15 to 105: Minimum: 15 - strongest disagreement that pain justifies impairment, disability, or activity limitation Maximum: 105 - strongest agreement that pain justifies impairment, disability, or activity limitation Each item is rated on a 7-point Likert scale, from 1 (completely disagree) to 7 (completely agree). Higher scores represent a less favorable outcome, indicating stronger beliefs that persistent pain warrants disability and activity restriction. Therefore, lower scores are generally considered more consistent with contemporary biopsychosocial pain care.

  Over 23 months, from study enrollment to graduation from the academic program

Interventions

Pain education OTHER

Participants received a 4.5-hour multimodal contemporary pain science education session consisting of four hours of classroom instruction and a 30-minute laboratory. The classroom portion used lecture, small-group activities, discussion, and case-based application to address pain neuroscience, pain mechanisms, biopsychosocial contributors to persistent pain, guideline-informed care, screening tools, nocebo language, and potential harms of unnecessary imaging, medications, procedures, and referrals. The laboratory provided hands-on exposure to laterality recognition, quantitative sensory testing, and mirror-based techniques.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of 40 students enrolled in a single cohort of a 27-month, master's-level physician assistant program at one university in the southeastern United States. Participants had a mean age of 24.9 years; 60% identified as female and 40% as male. Thirty-five participants provided complete data across all five study time points.

You may not qualify if:

• \- None

Sponsors & Collaborators

• Belmont University: lead

Study Sites (1)

Belmont University

Nashville, Tennessee, 37212, United States

Location

Related Publications (14)

• Zimney K, Louw A, Johnson J, Peppers S, Farrell K. Effects of Pain Neuroscience Education on Physician Assistant Students Understanding of Pain and Attitudes and Beliefs About Pain. S D Med. 2018 Nov;71(11):506-511.

  PMID: 30742750 BACKGROUND

• Kiesel JD, Stevens D, Elwood C. Impact of biopsychosocial pain education on Physician assistant students' pain knowledge, pain attitudes, and recommendations for lower back pain. J Physician Assist Educ [Internet]. 2024 Jul 26;35(4):386. Available from: http://dx.doi.org/10.1097/JPA.0000000000000600

  BACKGROUND

• Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain. 2012 Jan;16(1):3-17. doi: 10.1016/j.ejpain.2011.06.006.

  PMID: 21719329 BACKGROUND

• Yealy JK, Martinasek M, Doran T. The Current State of Physician Assistant Pain Curriculum: A National Survey. J Physician Assist Educ. 2019 Mar;30(1):20-26. doi: 10.1097/JPA.0000000000000237.

  PMID: 30801555 BACKGROUND

• Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct 15;38(22):1939-46. doi: 10.1097/BRS.0b013e3182a42eb6.

  PMID: 23883826 BACKGROUND

• Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013 Nov-Dec;11(6):527-34. doi: 10.1370/afm.1518.

  PMID: 24218376 BACKGROUND

• Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007 Jul;133(4):581-624. doi: 10.1037/0033-2909.133.4.581.

  PMID: 17592957 BACKGROUND

• Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians; Denberg TD, Barry MJ, Boyd C, Chow RD, Fitterman N, Harris RP, Humphrey LL, Vijan S. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.

  PMID: 28192789 BACKGROUND

• King NMA, Habeeb M, Helps S. The contribution of physician associates or assistants to the emergency department: A systematic scoping review. J Am Coll Emerg Physicians Open. 2023 Jun 22;4(3):e12989. doi: 10.1002/emp2.12989. eCollection 2023 Jun.

  PMID: 37360223 BACKGROUND

• Fellner A, Kim HS. Usual Care for Low Back Pain at United States Emergency Departments, 2016-2022. Ann Emerg Med. 2025 Dec;86(6):639-645. doi: 10.1016/j.annemergmed.2025.06.005. Epub 2025 Jul 12.

  PMID: 40650645 BACKGROUND

• Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, Halonen P, Takala J. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001 Jan;89(2-3):175-80. doi: 10.1016/s0304-3959(00)00361-4.

  PMID: 11166473 BACKGROUND

• Voon P, Karamouzian M, Kerr T. Chronic pain and opioid misuse: a review of reviews. Subst Abuse Treat Prev Policy. 2017 Aug 15;12(1):36. doi: 10.1186/s13011-017-0120-7.

  PMID: 28810899 BACKGROUND

• Pitcher MH, Von Korff M, Bushnell MC, Porter L. Prevalence and Profile of High-Impact Chronic Pain in the United States. J Pain. 2019 Feb;20(2):146-160. doi: 10.1016/j.jpain.2018.07.006. Epub 2018 Aug 7.

  PMID: 30096445 BACKGROUND

• Florence C, Luo F, Rice K. The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug Alcohol Depend. 2021 Jan 1;218:108350. doi: 10.1016/j.drugalcdep.2020.108350. Epub 2020 Oct 27.

  PMID: 33121867 BACKGROUND

Study Officials

• Sue E Curfman, PT, DHSc

  Belmont University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 21, 2026
• First Posted: July 30, 2026
• Study Start: September 7, 2019
• Primary Completion: August 19, 2021
• Study Completion: August 19, 2021
• Last Updated: July 30, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ANALYTIC CODE
• Time Frame: Published July 14, 2026, and available indefinitely.
• Access Criteria: Interested individuals may access the IPD at Curfman, Sue; Best, Will (2026), "Contemporary pain science education and physician associate/assistant students: a longitudinal educational intervention study", Mendeley Data, V1, doi: 10.17632/68ghnjyk7h.1

Locations

US (1)