title: From Opiophobia to Overprescribing: A Critical Scoping Review of Medical Education Training for Chronic Pain.
abstract: BACKGROUND
  Chronic pain is a significant health problem strongly associated with a wide range of physical and mental health problems, including addiction. The widespread prevalence of pain and the increasing rate of opioid prescriptions have led to a focus on how physicians are educated about chronic pain. This critical scoping review describes the current literature in this important area, identifying gaps and suggesting avenues for further research starting from patients' standpoint.
  
  
  METHODS
  A search of the ERIC, MEDLINE, and Social Sciences Abstracts databases, as well as 10 journals related to medical education, was conducted to identify studies of the training of medical students, residents, and fellows in chronic noncancer pain.
  
  
  RESULTS
  The database and hand-searches identified 545 articles; of these, 39 articles met inclusion criteria and underwent full review. Findings were classified into four inter-related themes. We found that managing chronic pain has been described as stressful by trainees, but few studies have investigated implications for their well-being or ability to provide empathetic care. Even fewer studies have investigated how educational strategies impact patient care. We also note that the literature generally focuses on opioids and gives less attention to education in nonpharmacological approaches as well as nonopioid medications.
  
  
  CONCLUSIONS
  The findings highlight significant discrepancies between the prevalence of chronic pain in society and the low priority assigned to educating future physicians about the complexities of pain and the social context of those afflicted. This suggests the need for better pain education as well as attention to the "hidden curriculum."
authors.affiliation: Institute of Health Policy Management and Evaluation and Wilson Centre for Education Research, University of Toronto, Toronto, ON, Canada.
authors.forename: Fiona
authors.initials: F
authors.lastname: Webster
authors.affiliation: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Samantha
authors.initials: S
authors.lastname: Bremner
authors.affiliation: Department of Psychology, York University, Toronto, ON, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Oosenbrug
authors.affiliation: Institute of Health Policy Management and Evaluation and Wilson Centre for Education Research, University of Toronto, Toronto, ON, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Durant
authors.affiliation: Department of Psychology, York University, Toronto, ON, Canada.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McCartney
authors.affiliation: Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D004501:Education, Medical; D006300:Health Services Misuse / Q000517:prevention & control*; D006801:Humans; D059408:Pain Management / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic Noncancer Pain; Medical Education; Opioids; Scoping Review