Presented at the 2012 AAPM Annual Meeting « Back

The Pain Portfolio: A Highly Effective Assessment of Medical Student Development

Beth B. Murinson, MD PhD, bmurins1@jhmi.edu¹, Lina Mezei, BS², Sharon L Kozachik, PhD RN², Luis Buenaver, PhD¹, Sarah N. De Silva, Undergraduate¹, (1) Johns Hopkins School of Medicine, Baltimore, Maryland, (2) Johns Hopkins University, Baltimore, Maryland

Pain is characterized by both sensory-discriminative and affective components. For example, it is widely appreciated that patients with pain and their physicians confront special challenges in practice as pain is so profoundly unpleasant. Although much progress has been made in defining the content that medical trainees need to know about pain (1), relatively little is known about how best to shape personal and professional development to result in competent and compassionate pain care (2). A variety of approaches have been identified as potentially beneficial, including exposure to exceptional clinical role models (3), Balint groups and reflective writing. In this report of IRB-reviewed research, we describe the development and implementation of a student portfolio that uses multiple approaches to both gauge and prompt students’ affective development vis-à-vis pain. The student portfolio is designed to be utilized during an 18-hour pain course delivered during the first year of medical school. The portfolio incorporates a variety of activities, including small group discussions, reflections on an experiential pain lab, writing a short pain narrative, reflections on the role of compassion and empathy in medicine and observations regarding exceptional clinical role models. Following implementation of the portfolio, the effectiveness of various activities was evaluated by a focus group of experienced portfolio readers and plans for revision discussed. Overall, the portfolio was found to be an innovative and highly effective method for prompting medical student engagement in acknowledging the affective impact of pain and preparing to manage pain more effectively in the clinical setting. References: 1) Murinson BB, Nenortas E, Mayer ES, Mezei L, Kozachik S, Nesbit S, Haythornthwaite JA, Campbell JN. A New Program in pain medicine for medical students: Integrating core curriculum knowledge with emotional and reflective development. Pain Med. 2011 Feb;12 2)Murinson BB, Agarwal A, Haythornthwaite JA. Cognitive Expertise, Emotional Development and Reflective Capacity: Clinical Skills for Improved Pain Care. J Pain. 2008 Nov;9(11):975-83. 3)Murinson BB, Klick B, Haythornthwaite JA, Shochet R, Levine RB, Wright SM. Formative experiences of emerging physicians: Gauging the impact of events that occur during medical school. Acad Med. 2010 Aug;85(8):1331-7.

Funding: Mayday Fund Milbank Fund for Rehabilitation Research Blaustein Fund