TEACHING CANCER PAIN MANAGEMENT - DURABILITY OF EDUCATIONAL-EFFECTS OF A ROLE-MODEL PROGRAM

BACKGROUND. Inadequate management of cancer related pain has resulted primarily from attitudinal barriers and a lack of knowledge about clin ical assessment, the administration of analgesics, and therapeutic int erventions. METHODS. Fifty health-care providers (13 physicians, 21 nu rses, and 16 pharmacists), working as a team, participated in a Role M odel Program that presented principles of cancer pain management. A qu estionnaire that evaluated the fund of knowledge and attitudes regardi ng cancer pain management was administered prior to the 1-day workshop , at the end of the workshop, and at 4 and 12 months follow-up. The wo rkshop consisted of lectures and discussion groups; in the discussion groups, concepts were clarified, cases presented, and barriers to opti mal cancer pain management identified. RESULTS. Significant improvemen ts in attitudes (P < 0.01), knowledge (P < 0.01), and total scores (P < 0.002) were observed when the preworkshop responses were compared wi th those obtained immediately after instruction. Scores on the questio nnaire were the same or slightly better at both 4 and 12 months in fol lowup, demonstrating no loss in acquired knowledge or attitude. Compar ison of the postworkshop scores with those at 12 months follow-up were significantly better in attitude (P < 0.03), and in total score (P < 0.01); improvements in knowledge also approached significance (P < 0.0 6). These represented continuing improvements because significant diff erences in the attitude scores (P < 0.05) and the total score (P < 0.0 5) were observed when the 4-month and 12-month follow-up responses wer e evaluated. The effectiveness of the program in the transference of k nowledge was also measured; in the first year of the program, more tha n 4500 health-care professionals were subsequently informed about canc er pain management from the Role Model Participants. CONCLUSIONS. Sign ificant improvements were observed immediately in both attitude and kn owledge of cancer pain management principles after the 1-day Role Mode l Workshop. These improvements continued, as determined at 4 and 12 mo nths follow-up. The Role Model Participants were highly motivated to s hare the learned principles of cancer pain management with other healt h-care professionals. These results are consistent with other Role Mod el Programs that both instruct and involve the participants. The Role Model Program is an efficient and effective means of educating health- care professionals in the concepts of cancer pain management. (C) 1996 American Cancer Society.