Anesthesia — Core of Discipline

C20 Assessing, diagnosing and formulating management options for patients with common chronic pain disorders

- This EPA focuses on assessing the patient, clarifying the nature of the pain (character and severity), using appropriate pain scales, diagnosing common pain disorders, assessing the impact of pain on function, outlining appropriate management options and formulating a basic management plan.
- This EPA focuses on management of common chronic pain disorders. Examples include musculoskeletal pain, back pain, complex regional pain syndrome (CRPS), neuropathic pain, post-herpetic neuralgia, phantom limb pain, fibromyalgia, cancer pain
- Effective communication with the patient is an important aspect of this EPA.
- This EPA does not include complex chronic pain disorders, nor the breadth of interventional pain management practiced by Pain Medicine subspecialists.

Form

F1: Observation

Milestones

• ME 2.2. ME 2.2 Elicit a history, perform a physical exam and select appropriate investigations, and interpret their results for the purpose of diagnosis of chronic pain syndrome.

• ME 2.4. Formulate a basic management plan that consider all of the patient’s health problems and context, in a timely manner, in collaboration with patients and their families and, when appropriate, the interprofessional team.

• ME 3.4. Demonstrate optimal and safe use of fluoroscopy and ultrasound equipment

• ME 4.1. Diagnose and manage the complications of various chronic pain management strategies

• ME 4.1. Diagnose emergencies in the context of chronic pain, and manage and refer patient appropriately

• COL 1.2. Consult as needed with other health care professionals, including other physicians

• COL 1.3. Provide timely and necessary written information to colleagues to enable effective relationship centered care

• HA 1.1. Facilitate timely patient access to disability or other insurance benefits

• ME 2.3. Address the impact of the medical condition on the patient’s ability to pursue life goals and purposes

• ME 2.1. Actively listen and respond to patient cues

• ME 2.2. Integrate, summarize, and present the biopsychosocial information obtained from a patient-centred interview

• COM 2.2. Manage the flow of challenging patient encounters, including those with angry, anxious or distressed individuals

• COM 4.3. Use communication skills and strategies that help patients and their families make informed decisions regarding their health

Context Variables

No context variables defined.

Requirements

• Direct observation or case review and debrief by supervisor
• Use Form 1 or local alternative. Form collects information on:
• Type of pain: back; neuropathic; phantom limb; complex regional pain syndromes (CRPS); cancer; other pain
• Collect observations from a large breadth of training experiences with the expectations not all will be achieved, with a minimum of 4 observations of achievement.