title: Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study.
abstract: OBJECTIVE
  Unrelieved pain is a substantial public health concern necessitating improvements in medical education. The Advancing the Provision of Pain Education and Learning (APPEAL) study aimed to determine current levels and methods of undergraduate pain medicine education in Europe.
  
  
  METHODS
  Using a cross-sectional design, publicly available curriculum information was sought from all medical schools in 15 representative European countries in 2012-2013. Descriptive analyses were performed on: the provision of pain teaching in dedicated pain modules, other modules or within the broader curriculum; whether pain teaching was compulsory or elective; the number of hours/credits spent teaching pain; pain topics; and teaching and assessment methods.
  
  
  RESULTS
  Curriculum elements were publicly available from 242 of 249 identified schools (97%). In 55% (133/242) of schools, pain was taught only within compulsory non-pain-specific modules. The next most common approaches were for pain teaching to be provided wholly or in part via a dedicated pain module (74/242; 31%) or via a vertical or integrated approach to teaching through the broader curriculum, rather than within any specific module (17/242; 7%). The curricula of 17/242 schools (7%) showed no evidence of any pain teaching. Dedicated pain modules were most common in France (27/31 schools; 87%). Excluding France, only 22% (47/211 schools) provided a dedicated pain module and in only 9% (18/211) was this compulsory. Overall, the median number of hours spent teaching pain was 12.0 (range 4-56.0 h; IQR: 12.0) for compulsory dedicated pain modules and 9.0 (range 1.0-60.0 h; IQR: 10.5) for other compulsory (non-pain specific) modules. Pain medicine was principally taught in classrooms and assessed by conventional examinations. There was substantial international variation throughout.
  
  
  CONCLUSIONS
  Documented pain teaching in many European medical schools falls far short of what might be expected given the prevalence and public health burden of pain.
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: Emma V
authors.initials: EV
authors.lastname: Briggs
authors.affiliation: Department of Anesthesia and Intensive Care, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Battelli
authors.affiliation: Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: David
authors.initials: D
authors.lastname: Gordon
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Charité Medical University, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kopf
authors.affiliation: Medical Resident in Public Health, Estrada de Mem-Martins, Algueirão Mem-Martins, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ribeiro
authors.affiliation: Department of Anaesthesiology, Universitat Autònoma de Barcelona, Hospital del Mar, Paseo Marítimo, Barcelona, Spain.
authors.forename: Margarita M
authors.initials: MM
authors.lastname: Puig
authors.affiliation: Department of Special Anaesthesia and Pain Therapy, Medical University/AKH Vienna, Vienna, Austria.
authors.forename: Hans G
authors.initials: HG
authors.lastname: Kress
mesh_terms: D003430:Cross-Sectional Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005060:Europe; D005602:France; D006801:Humans; D010146:Pain; D011634:Public Health; D012577:Schools, Medical
keywords: MEDICAL EDUCATION & TRAINING; PAIN MANAGEMENT; Pain; Undergraduate education