How do medical students use and understand pain rating scales?

Conclusions The study requires replication, particularly for clinical experience, where we found no significant difference in estimation of another's pain over the first three years of medical students’ clinical exposure, but the comparison was underpowered. Despite no systematic individual difference in using pain ratings, there was a marked effect of rating another's worst pain higher when the rater had previously rated his/her own worst pain. This suggests anchoring estimate of another's pain in personal pain experience, and a possible way to mitigate clinicians’ underestimation of patients’ pain. Medical students’ recognition of the importance of facial expression in indicating another's pain severity was encouraging, but most students anticipated only a narrow range of behaviours associated with extreme pain, thereby excluding other authentic behaviours. Implications Many clinical guidelines mandate regular pain assessment for hospital inpatients, and encourage routine assessment in community and outpatient settings, in order to decide on and monitor treatment. Replication and elaboration of this study could extend our understanding of how clinicians interpret pain scales completed by patients, and how they estimate patients’ pain.
Source: Scandinavian Journal of Pain - Category: Anesthesiology Source Type: research