“If you give a man a fish, he is hungry again in an hour. If you teach him to catch a fish you do him a good turn”. This statement credited to popular 19th century novelist, Anne Isabella Thackeray Ritchie, puts in perspective, the principle of alleviating poverty by encouraging self-sufficiency. Similarly, the poverty of pain management can be alleviated by facilitating knowledge acquisition as the study, Project OPUS, set out to successfully achieve. The project focus was “Development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings”
Pain is a common and distressing symptom found to affect many patients in daily medical practice. However, it remains largely untreated or undertreated in many low-middle income countries (LMICs) like those found in Africa, for many reasons. Chief among these reasons is the high levels of poor knowledge and negative attitudes towards pain management found among clinicians, medical students and other medical staff which remains the most significant obstacle to care of the patient with pain and most times translates to poor pain management practices among new graduates of medicine.
In an attempt to remedy the situation, our team sought to go to the root cause which was the lack of a pain curriculum in Nigerian medical schools. Our study, funded by a grant from the International Association for the Study of Pain (IASP), led to the novel development and use of a pain curriculum utilizing the IASP Curriculum Outline on Pain for Medicine as a backbone as well as significant inputs from the Beating Pain booklet of the African Palliative Care Association (APCA).
Employing a research-led development process with input from experts in the field, the curriculum was created and hosted on a virtual platform provided by InStrat Global Health Solutions. 219 fifth-year medical students, out of a total of 659 eligible students from five colleges of medicine in Nigeria, completed the six pain modules within a 12-week time frame.
The e-Learning course significantly increased the knowledge of pain management across all five participating schools. When participants were asked about their experience of using the platform, it was reported as engaging and perceived as valuable for their learning. Suggestions for further development were also captured, such as creating access points for downloading content. Perceived usefulness of e-Learning is known to have a strong impact on students’ e-Learning intention. We believe this study provides good evidence for policymakers in the tertiary education sector and institutional heads in the colleges of medicine to explore adoption of this approach to support pain education.
However, this needs to be done alongside efforts to advocate for inclusion of pain education as a core component of medical curricula nationwide. We believe that the platform has value for other LMICs in Africa.
Our next steps will be to ensure equitable access to this e-learning opportunity by extending the virtual pain training to other colleges of medicine in Nigeria whilst exploring adaptation to its delivery to ensure increased uptake and engagement by medical undergraduates.
Tonia C. Onyeka is an Associate Professor of Anaesthesia, Pain Medicine and Palliative Medicine at the University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria.