Patient Perception of Acute Pain Management: Data from Three Tertiary Care Hospitals.

Introduction. The primary objectives of this study were to assess patients' description of their acute pain intensity; patients' attitude towards their pain management during hospitalization; and their overall satisfaction with pain treatment. Methodology. A cross-sectional questionnaire-based study was conducted between October 2014 and March 2015 in three medical centers in Lebanon. All participants' responses were reported using descriptive statistics. The association between categorical variables was evaluated using Pearson χ2 test or Fisher's exact test where the expected cell count was < 5. Results. A total of 119 women on the maternity services and 177 patients on the orthopedic services were surveyed. Around 50% of obstetric and 37% of orthopedic patients reported pain to be severe at its highest intensity. In maternity and orthopedic patients, respectively, unfavorable practices included pain not being assessed prior to pain medication administration (19.3% and 30.5%), having to wait for ≥30 minutes before getting the pain medication (14.2% and 11.3%), and pain score not being documented on medical chart (95% and 93.2%). Surprisingly, 94.1% of the maternity and 89.2% of orthopedic patients were satisfied to strongly satisfied with their pain management. Conclusion. Pre- and postoperative pain remain a prevalent problem that requires a consensus and joint efforts for improvement.

Physicians' Attitudes to Clinical Pain Management and Education: Survey from a Middle Eastern Country.

Despite promising initiatives to advance the practice of pain management in Middle Eastern countries, their pain care lags behind developed countries. The objectives of this study are to evaluate physicians' assessment of their own competency in pain management, to assess physicians' practice related to pain management, and to identify physician-related barriers to effective pain control. A cross-sectional survey was conducted in 3 teaching medical centers in Lebanon targeting the above-mentioned outcomes and assessing the impact of physicians' years in practice on the studied end-points. A total of 69 physicians were surveyed. Fifty-seven percent reported "very good to excellent" pain management skills; only 25% of them described the need for continuing professional development. When treating patients with pain, 52% of physicians refer to updated international guidelines, whereas 43% rely on their own judgment. Physicians were more likely to consult with another physician (65%) rather than a pharmacist (12%) when treating patients with pain. Fear of adverse effects of analgesics was the most commonly reported barrier (45%) to pain control among physicians from different career stages. Based on these survey findings, national pain management and practice policies are needed to optimize this area of deficiency in patient care.

Mapping of the biomedical literature evaluation competencies based on pharmacy students' feedback.

BACKGROUND: This study aims to map the learned curriculum based on students' feedback regarding the biomedical literature evaluation competencies in a pharmacy curriculum, to evaluate teaching methods and to report students' longitudinal self-assessment of their achievement of related learning outcomes as they progress from didactic to experiential courses. METHODS: The biomedical literature evaluation competencies were mapped in three courses delivered during different pharmacy professional years (PPY): Drug Information and Literature Evaluation (PHA421) offered in the second PPY, Pharmacoeconomics (PHA557) and Professional Pharmacy Practice Experience-Hospital/Drug Information Services (PHA570) offered in the third PPY. A unified survey was developed to collect information from students at the beginning and completion of these courses. Survey results were then compared to school assessment data of identified courses for triangulation of findings. RESULTS: Listed student learning outcomes are consistently achieved through all three courses with more assertion from the students at the completion of the applied experiential course PHA 570 (>90 % agree or strongly agree). In terms of delivery methods, 84 % of students perceived the benefits of active learning methods in reinforcing acquired skills and increasing confidence in knowledge and critical thinking in a less stressful learning environment. Results shown at the end of each course indicate a favorable student response from one course to the next where almost all students replied with 'agree to strongly agree' to survey questions assessing their readiness to critically evaluating trials (72 %, 96 % and 92 %) in PHA421, PHA557 and PHA570, respectively. Study findings are in congruence with school assessment database of the selected courses. CONCLUSION: Formative assessment results demonstrated acquisition of required analytical skills, and completion of course learning outcomes as students progressed from introductory to advanced courses covering the biomedical literature component.

Mapping and assessment of personal and professional development skills in a pharmacy curriculum.

BACKGROUND: Health sciences programs are increasingly expanding their curricula to bridge foundational scientific knowledge with needed skills to practice and patient care. The primary objectives of this study are to 1) assess whether the personal and professional development (PPD) subdomains (self-assessment, leadership, innovation and entrepreneurship, and professionalism) are integrated in a pharmacy curriculum; and 2) identify any gaps related to the subdomains' learning objectives. METHODS: Four different mapping activities were completed to create a comprehensive mapping plan regarding the integration of the PPD subdomains in the curriculum. The first mapping activity entailed matching the school's program educational outcomes (PEOs) to these subdomains (Step 1). Mapping of the enacted curriculum by faculty (Step 2) and learned curriculum by students (Step 3) were also completed in order to evaluate the integration of these subdomains in the curriculum. Finally, Step 4 involved mapping of the assessed curriculum by analyzing the progress of students on PPD-related competencies using standardized scoring rubrics and the correlation between students' and facultys' assessments with regard to matching competencies. The Cochrane's Q test and the Cohen's kappa coefficient were used in the statistical analysis of parametric data. RESULTS: The subdomains were found to be woven across curricular, co-curricular, and extra-curricular activities based on the four different mapping activities. Faculty and students agreed that the PPD competencies are integrated in the curriculum; provided example courses, experiences and activities; and identified areas of further improvements. The completed mapping activities drove the development of action plans for remediation of identified gaps in the curriculum. CONCLUSION: Mapping activities showed the sequential integration of the PPD skills at different depths and breadths in the curriculum. This study provides an example to health sciences schools on the incorporation of the PPD skills in their curricular, co-curricular and extra-curricular activities as current accreditation standards have directed Pharmacy programs to integrate and enforce them in their curricula.