Introduction
Pain is the most common complaint for which people seek medical care1. Pain in the internal medicine ward is common;
arising from different diagnoses, and sometimes standing alone as a
chronic pain syndrome. Despite its wide variety and high frequency, pain
management is often insufficient. Lack of knowledge, suspicion or
disbelief to patients complaints and prejudice that pain is not a top
priority in treatment2 might be the reason for that.
Effective pain management is divided into two important steps: The first
step is its assessment and documentation. It has been observed that data
collection and reporting by the staff was inaccurate and tended to
underestimate the level of pain reported by patients3.
A difference of nearly two points in a 0-10 visual analog scale was
observed between the intensity of pain reported by patients to the score
recorded by the nursing staff3. The second step, which
is the implementation of the appropriate treatment to the specific type
and intensity of pain. Several studies have shown that pain management
is insufficient might be due to lack of knowledge and misconceptions
regarding pain management and medication, specifically the use of
opioids4. Although almost 35% of patients suffer from
severe pain during hospitlzition5, patients in the
internal medicine wards are not properly evaluated and are undertreated
for their pain. Studies that assess the knowledge, skills and abilities
(KSA) of physicians from different medical fields, showed that pain
management is inadequate and is lacking6-7. That might
lead to unnecessary patient suffering and astronomic high costs for the
health system8.
It is evident that there is a need for a better physician education in
this field. We developed a targeted educational intervention in order to
address physician’s inappropriate knowledge, skills and attitude
regarding pain management. The aim of this study was to evaluate the
influence of that process, on internal department physician’s KSA.
Methods: This was a prospective cohort study without a randomization or
control group. 11 Physician (9 interns who were in different stages of
internship and 2 young specialists) from an internal ward department at
Bnai-Zion Medical Center, a tertiary academic center in Israel,
participated. The Institutional Ethics Committee in accordance with the
Declaration of Helsinki approved the study (0138-14-BNZ,
NIH-NCT02577328)