Pain Management Electives and Selectives

Attendance:  Students may not take time off on the start date but must attend check-in and system orientation with Visiting Student Affairs.  Students may not take time off during this rotation.  See the Attendance Policy for other details.

Location:  Carilion Institute of Orthopaedics and Neurosciences (ION), Riverside 1, CRCH

Available:  July – June

Duration:   2 or 4 weeks, starting any Monday and ending Friday

Number of students per rotation:  1

Prerequisites:  3rd year core requirements

Overview: 

The Pain Management elective is a two week rotation where students and residents will explore a multi-disciplinary approach to chronic pain. Working alongside pain specialists, students and residents will work in the outpatient setting.  They will develop an understanding of both medical and procedural management to pain including nerve block techniques and proper opioid prescribing. The student and resident will gain experience on assessment of chronic pain syndrome and development of a multi-disciplinary treatment plan.

Goal: Exposure to a diverse patient population with a wide-variety of painful disorders in the outpatient clinic setting.

Objectives:  At the end of the elective the student will be able to:

Patient Care

  1. Obtain a focused history and physical exam from patients with chronic pain complaints.
  2. Provide patient care that is compassionate, appropriate, and effective for the promotion of health and the treatment of pain related diseases.

Medical Knowledge

  1. Identify and describe the conditions commonly encountered in the practice of pain medicine.
  2. Describe the etiologies of common pain syndromes, presentation, and their treatment options.
  3. Describe appropriate use of opioids in the outpatient setting as well as understanding tolerance, dependence and addiction.
  4. Identify and assess pain using validated scales to monitor treatment efficacy.
  5. Identify psychosocial components of chronic pain, as well as focus on not just reduction of pain, but improving quality of life and function.
  6. Apply the principles of pharmacology to evaluate options for safe, rational, and optimally beneficial pain care.
  7. Identify and describe common procedures in pain medicine including trigger point injections, joint injections, fluoroscopic and ultrasound guided injections, nerve blocks, radiofrequency ablations, neuro-stimulation and -modulation, and implantable intrathecal drug delivery systems.

Professionalism

  1. Carry out professional responsibilities and an adherence to ethical principles.
  2. Exhibit compassion, integrity, and respect for others.
  3. Exhibit respect for patient privacy and autonomy.
  4. Exhibit sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in age, sex, culture, race, religion, disabilities, and sexual orientation.
  5. Maintain comprehensive, timely, and legible medical records.

Interpersonal and Communication Skills:

  1. Apply interpersonal and communication skills that result in collaboration and the effective exchange of information with patients, their families, and health professionals.
  2. Obtain a complete history and physical as well as effectively present to faculty.

Practiced Based Learning:

  1. Explain current practice guidelines in pain management
  2. Use medical literature to address gaps in medical knowledge

System Based Practice:

  1. Identify the referral issues encountered by patients seeking admission to the Pain Clinic
  2. Utilize and incorporate treatment modalities using PT, OT, durable medical equipment, nutrition, and so on.
  3. Explain utility of other specialties such as primary care, surgery, neurology, PM&R, psychiatry/psychology, addiction medicine.
  4. Describe the larger context and system of health care, and call effectively on other resources in systems available to provide optimal health care.
  5. Work effectively in various health care delivery settings and systems where pain medicine is provided.
  6. Coordinate pain care within the health care system.
  7. Schedule:  Monday to Wednesday, 8am – 5pm, ION location

                     Thursday to Friday, 7:30 am to 4pm, Roanoke Community Hospital

  Pain Grand Rounds, Pain Boards (Multidisciplinary Patient Care Conference), procedure shadowing, and other teaching opportunities on the outpatient service.

Feedback: Students will receive feedback as warranted through formative assessments throughout the rotation

Grading: Grading is pass/fail and based on summative assessments including observed performance by supervising clinical trainees and faculty.

Resources/Textbook: Literature as per clerkship director(s) and preceptor(s).