Medical students' attitudes toward pain before and after a brief course on pain

The effectiveness of a brief clinical and basic science seminar on pain for 1st year medical students was examined by comparing attitudes about pain prior to the seminar to attitudes 5 months after the seminar. The 6-h course combined written materials conveying facts about behavioral, social and biological aspects of pain with clinical observations of an acute and a chronic pain treatment team. Examination of responses to a questionnaire assessing attitudes toward pain patients revealed that medical students have limited personal experience with pain and medications for pain, and limited knowledge about pain. Pre-course attitudes toward pain patients were dominated by perceived negative characteristics of pain patients and the belief that working with such patients is difficult. Attitudes measured 5 months after the course reflected increased complexity, greater emphasis that pain is real and not imaginary, and stronger belief that working with pain patients is rewarding. Five months after the seminar, students reported more accurate estimates of the frequency of problems with addiction stemming from acute pain treatment and exaggerated the prevalence of pain problems in the society. The importance of integrating clinical and basic science experiences in order to influence long-term clinical attitudes and produce lasting changes in clinically relevant knowledge is discussed.