An estimated 116 million US adults suffer from chronic pain at an estimated cost of $635 billion and, unfortunately, existing pain management training is not adequately preparing health professionals to address this area [1]. To address this gap we propose to create iPad EMR Pain Management Simulator, an iPad- based application to provide a learning and shared experience environment for health professional students to enhance their skills related to pain assessment and control. The simulated EMR will echo core features of any EMR used in clinical practice and present case simulations. For learners it will provide easy and affordable access to standardized skill-based pain management training. For faculty/educators it will assess: 1) a student's clinical competence and skills in diagnosing and treating patients with pain, while 2) decreasing the chance of opioid misuse and diversion. For each iPad EMR simulated pain management case, health professional students will collect data, examine the patient, choose the appropriate course of action, outline a treatment plan, and receive feedback. Feedback from choices and decisions made will be based on best practice. The instructor will have control over the clinical components of the application by providing increasing or decreasing clinical information, challenge, feedback, or prompts. Phase I will develop a prototype and perform basic usability of the potential intervention based on the active involvement of different target audiences: 1) health professional students in medicine and nursing, and 2) educators in medicine and nursing. Phase I will proceed with a carefully planned formative analysis involving needs analysis surveys, semi-structured interviews, guidance from consultants, creation of prototype experiences, and usability assessments. Phase II will complete the program and conduct an evaluation using a randomized, cross-over [wait-list control], pretest-posttest design with an estimated 60 participants from medicine and nursing. We will specifically assess if the simulated learning and shared experience environment positively impacts target clinical skills and increases core competencies related to assessment and treatment of pain. Phase III will market the product actively via existing and novel partnerships with Clinical Tools. We will pursue additional tailoring of the content to specific audiences beyond physicians and nurses such as dentists, P.A.s, physical therapists and others. Our solution will support ongoing assessment of the training to determine areas of weakness which can be refined and improved over time.

Public Health Relevance

The agony that is life with chronic pain is made worse by a health care system ill-equipped to assist. The gap in quality care due to poor training of future health providers will remain until solutions are pursued. This product will enhance the education of health care providers via a simulated Electronic Medical Record (sEMR) environment that provides simulated patient experiences. Health professional trainees will develop proper pain management skills including screening, full assessment, treatment interventions, and making a referral to treatment when appropriate. Future health professionals who are more proficient in core competencies related to pain management will be better equipped to reduce the suffering and costs of inadequate pain treatment.

National Institute of Health (NIH)
National Center for Advancing Translational Sciences (NCATS)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-HDM-K (10))
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Brazhnik, Olga
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Clinical Tools, Inc.
Chapel Hill
United States
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