title: The Postoperative Pain Assessment Skills pilot trial.
abstract: BACKGROUND⁄
  
  
  OBJECTIVE
  Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs' assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method - deteriorating patient-based simulation (DPS) - versus SPs for improving HCPs' pain knowledge and assessment skills.
  
  
  METHODS
  Seventy-two HCPs were randomly assigned to a 3 h SP or DPS simulation intervention. Measures were recorded at baseline, immediate postintervention and two months postintervention. The primary outcome was HCPs' pain assessment performance as measured by the postoperative Pain Assessment Skills Tool (PAST). Secondary outcomes included HCPs knowledge of pain-related misbeliefs, and perceived satisfaction and quality of the simulation. These outcomes were measured by the Pain Beliefs Scale (PBS), the Satisfaction with Simulated Learning Scale (SSLS) and the Simulation Design Scale (SDS), respectively. Student's t tests were used to test for overall group differences in postintervention PAST, SSLS and SDS scores. One-way analysis of covariance tested for overall group differences in PBS scores.
  
  
  RESULTS
  DPS and SP groups did not differ on post-test PAST, SSLS or SDS scores. Knowledge of pain-related misbeliefs was also similar between groups.
  
  
  CONCLUSIONS
  These pilot data suggest that DPS is an effective simulation alternative for HCPs' education on postoperative pain assessment, with improvements in performance and knowledge comparable with SP-based simulation. An equivalence trial to examine the effectiveness of deteriorating patient-based simulation versus standardized patients is warranted.
authors.affiliation: University of Toronto, Toronto, Canada. michael.mcgillion@utoronto.ca
authors.forename: Michael
authors.initials: M
authors.lastname: McGillion
authors.forename: Adam
authors.initials: A
authors.lastname: Dubrowski
authors.forename: Robyn
authors.initials: R
authors.lastname: Stremler
authors.forename: Judy
authors.initials: J
authors.lastname: Watt-Watson
authors.forename: Fiona
authors.initials: F
authors.lastname: Campbell
authors.forename: Colin
authors.initials: C
authors.lastname: McCartney
authors.forename: Charles
authors.initials: C
authors.lastname: Victor
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wiseman
authors.forename: Linda
authors.initials: L
authors.lastname: Snell
authors.forename: Judy
authors.initials: J
authors.lastname: Costello
authors.forename: Anja
authors.initials: A
authors.lastname: Robb
authors.forename: Sioban
authors.initials: S
authors.lastname: Nelson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stinson
authors.forename: Judith
authors.initials: J
authors.lastname: Hunter
authors.forename: Thuan
authors.initials: T
authors.lastname: Dao
authors.forename: Sara
authors.initials: S
authors.lastname: Promislow
authors.forename: Nancy
authors.initials: N
authors.lastname: McNaughton
authors.forename: Scott
authors.initials: S
authors.lastname: White
authors.forename: Cindy
authors.initials: C
authors.lastname: Shobbrook
authors.forename: Lianne
authors.initials: L
authors.lastname: Jeffs
authors.forename: Kianda
authors.initials: K
authors.lastname: Mauch
authors.forename: Marit
authors.initials: M
authors.lastname: Leegaard
authors.forename: W Scott
authors.initials: WS
authors.lastname: Beattie
authors.forename: Martin
authors.initials: M
authors.lastname: Schreiber
authors.forename: Ivan
authors.initials: I
authors.lastname: Silver
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D010149:Postoperative Pain / Q000175:diagnosis*; D016544:Patient Simulation; D010865:Pilot Projects; D013223:Statistics as Topic