title: Pain management in urology training: A national survey of senior residents.
abstract: BACKGROUND
  We explore the attitudes and experience of urology residents toward acute and chronic pain management during their training.
  
  
  METHODS
  A convenience sample of Canadian Urology chief residents were invited to complete an anonymous questionnaire involving both open and closed-ended questions using a 5-point Likert scale. Descriptive and quantitative statistics were used to analyze the attitudes toward pain management, including their experience and training issues.
  
  
  RESULTS
  The response rate was 97%. Most residents agreed or strongly agreed that more formal training in acute pain (77% agreement, mean 4.03 ± 0.98 SD) and chronic pain (68%, 3.97 ± 0.95) management would be valuable in urology residency with only 1 respondent disagreeing that training should be mandatory. There was a significant difference of training experience in chronic versus acute pain management, with only 13% agreement (2.99 ± 0.67) that their training in chronic pain was adequate. Most residents agreed (74%, 3.84 ± 1.00) that most of their training in pain management came from their senior residents or fellows. Many of the residents (65%, 3.61 ± 0.84) felt that they could manage their patients' acute pain issues independently, even in the absence of an acute pain service, although apparent knowledge of opioids was poor.
  
  
  CONCLUSIONS
  The results of this survey suggest that urology residents attain their knowledge of pain management experientially with what may be insufficient formal training, particularly in chronic pain. These observations are limited by the relatively small number of respondents and by the nature of a cross-sectional, self-reported survey; however, they would appear to underscore a need to redouble efforts in residency education.
authors.affiliation: Department of Urology, Queen's University, Kingston, ON;
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pace
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON.
authors.forename: Melanie
authors.initials: M
authors.lastname: Jaeger
authors.affiliation: Department of Urology, Queen's University, Kingston, ON;
authors.forename: J Curtis
authors.initials: JC
authors.lastname: Nickel
authors.affiliation: Department of Urology, Queen's University, Kingston, ON;
authors.forename: D Robert
authors.initials: DR
authors.lastname: Siemens