The development of a stakeholder-endorsed national strategic plan for advancing pain education across Canadian physiotherapy programs

Figures & data

Table 1. Description of stakeholders that participated in the strategic plan development

Stakeholder group	Relationship to PT pain education	Description of participating stakeholder representatives (number of representatives)
People living with pain	People living with pain are the downstream “targets” of entry-level pain education	The president of a national advocacy group representing Canadians living with pain (1)
Physiotherapy (PT) students and recent PT graduates	PT students are the direct “targets” of entry-level pain education, and recent PT graduates are uniquely able to assess how their entry-level training prepares them for clinical pain management	The president of the National Student Assembly (which represents student members in the Canadian Physiotherapy Association) and a recent PT graduate and practicing clinician with an interest in pain management (2)
PT pain educators	Deliver PT pain education	One PT pain educator from each of the 14 PT entry-level training programs in Canada (14)
PT program directors	Responsible for overseeing entry-level PT programs in Canada, including the coordination and delivery of all pain-related curricula	Members of the Canadian Council of Physiotherapy University Programs, which is a national committee formed by the directors from each of the PT programs across Canada (14)
National PT professional association	National advocate for PTs and PT students	One senior staff member and one elected board member of the Canadian Physiotherapy Association, which represents more than 14,000 physiotherapy professionals across Canada (2)

Figure 1. Overview of the methods used to develop the stakeholder-endorsed strategic plan.

Table 2. Number of iterative versions involved in the development of each strategic priority

Strategic priority	Number of iterative versions
Strategic priority 1	5
Strategic priority 2	4
Strategic priority 3	4
Strategic priority 4	4
Strategic priority 5	3

Figure 2. Strategic priorities (SP) included in the Pain Education in Physiotherapy Strategic Plan. SP1 supports stakeholder groups that govern the physiotherapy (PT) profession in Canada (i.e. National Physiotherapy Advisory Group members) by identifying and addressing best evidence related to pain education. SP2 integrates evidence-based pain management competencies and encourages best educational practices within individual physiotherapy programs. SP3 supports partnerships with people living with pain in planning and implementing educational strategies. SP4 promotes evidence-based advocacy regarding the value of PTs in effective pain management. SP5 promotes research and evaluation in relation to pain education and strategic plan implementation.

Table

Strategic priority 1: · Version 1: Integrate pain competencies into national accreditation standards, examination blueprint, and physiotherapy curriculum guidelines. · Version 2: Establish consensus on pain competencies for entry-level physiotherapists and facilitate their integration within the national curriculum guidelines, accreditation standards, and the examination blueprint. · Version 3: Confirm stakeholder support of pain management competencies for entry-level physiotherapists and facilitate their integration within the national curriculum guidelines, accreditation standards, and the examination blueprint. · Version 4: Facilitate the integration of pain management competencies within the national curriculum guidelines, accreditation standards, and the examination blueprint. · Version 5 (Final): Support members of the National Physiotherapy Advisory Group (NPAG) in identifying and addressing current clinical and educational best evidence related to pain management.

Strategic priority 2: · Version 1: Encourage the development of best teaching practices, resources, and self-assessment for pain education. · Version 2: Facilitate the integration of competency-based pain curriculum within individual training programs and encourage the development of best teaching practices, educational resources, and self-assessment in relation to pain education. · Version 3: Facilitate the integration of pain management competencies within individual physiotherapy programs and interprofessional education initiatives and encourage the use of best teaching and assessment practices. · Version 4 (Final): Facilitate the integration of pain management competencies within individual entry-to-practice physiotherapy programs and their associated interprofessional educational programs and encourage the use of best teaching and assessment practices.

Strategic priority 3: · Version 1: Partner with people living with pain. · Version 2: Engage people living with pain as partners in the design and implementation of curriculum. · Version 3: Engage people living with pain as partners in the design and implementation of curricula. · Version 4 (Final): Engage people living with pain as partners in the design and implementation of curricula to ensure strong alignment with patient needs and priorities.

Strategic priority 4: · Version 1: Build awareness of the importance of pain education for physiotherapists. · Version 2: Build awareness, understanding, and support for the importance of pain management and the essential role of physiotherapists in managing pain among physiotherapy professionals, other health professionals, and the community at large. · Version 3: Advocate for the importance of pain management and the essential role of physiotherapists in managing pain among physiotherapy professionals, other health professionals, and the community at large. · Version 4 (Final): Highlight the urgent need for improved pain education by advocating for the importance of pain management competencies and the essential role of physiotherapists in managing pain to (a) physiotherapy professionals, (b) other health professionals, and (c) the community at large.

Strategic priority 5: · Version 1: Set clear goals and assess outcomes. · Version 2: Advance research on pain education and follow best practice guidelines in implementing knowledge translation activities. · Version 3 (Final): Evaluate and report on the PEP (Pain Education in Physiotherapy) strategic plan implementation and advance research in the area of pain education.

Version 1 is the strategy generated at the 2016 Pain Education in Physiotherapy workshop; Version 2 is the strategic priority that was generated by the working group following stakeholder interviews; Versions 3 to 5 were generated following stakeholder input on the previous version. Table 3 includes the final version of each strategic priority as well as their corresponding key supporting strategies.

Table 3. Stakeholder-endorsed strategic plan for improving pain education in Canadian PT programs

Strategic priority 1: Support members of the National Physiotherapy Advisory Group (NPAG) in identifying and addressing current clinical and educational best evidence related to pain management.

Key strategies: Help NPAG members identify best evidence related to pain management by generating consensus recommendations and/or providing resources related to pain education. Support NPAG members in developing strategies for addressing best evidence on pain management within their respective national governance and regulatory resources, such as the NPAG Competency Profile for Physiotherapists in Canada, Entry-to-Practice Physiotherapy Curriculum guidelines, Accreditation Standards for Physiotherapy Education Programs in Canada, and/or the Physiotherapy Competency Examination Blueprint.

Strategic priority 2: Facilitate the integration of pain management competencies^a within individual entry-to-practice physiotherapy programs and their associated interprofessional educational programs and encourage the use of best teaching and assessment practices.

Key strategies: Develop a community of practice for pain educators and clinical supervisors across Canada that promotes mentorship, sharing of resources, best practices in teaching and assessment, and connections with local networks that support implementation. Provide exemplars outlining different models of how pain management competencies can be integrated within physiotherapy training curricula. Offer training on the development and assessment of curricula based on pain management competencies. Develop guidelines for incorporating pain management competencies within interprofessional education initiatives.

Strategic priority 3: Engage people living with pain as partners in the design and implementation of curricula to ensure strong alignment with patient needs and priorities.

Key strategies: Partner with organizations and/or individuals who aim to support people living with pain. Develop a network of people living with pain that can partner with local physiotherapy programs to improve pain education. Create resources that can facilitate this partnership. Develop teaching materials (e.g., videos, case studies, online learning modules) that focus on the experiences and perspectives of people living with pain that can be shared across programs.

Strategic priority 4: Highlight the urgent need for improved pain education by advocating for the importance of pain management competencies and the essential role of physiotherapists in managing pain to (a) physiotherapy professionals, (b) other health professionals, and (c) the community at large.

Key strategies: Develop stakeholder consensus on core advocacy messages, desired media, and target audiences. Partner with key stakeholders, special interest groups, professional associations, and health regulators that are well positioned to build awareness and support for effective pain management among each of the targeted groups. Provide these partners with key messages and resources to support dissemination.

Strategic priority 5: Evaluate and report on the Pain Education in Physiotherapy (PEP) strategic plan implementation and advance research in the area of pain education.

Key strategies: Establish stakeholder consensus on a framework for assessing and reporting outcomes related to the PEP strategic plan. Facilitate research funding applications, project implementation, and translation of findings on research programs relating to pain education in physiotherapy, such as: Evaluating the process through which physiotherapy students’ develop pain management competencies over the course of their professional training and the outcomes of this training. Evaluating the impact of further integrating pain management competencies within Canadian physiotherapy programs. Determining best practices for implementing pain education, partnering with people living with pain on physiotherapy training, and advocating for the physiotherapy management of pain.

^aPain management competencies refers to the interprofessional core competencies for pain management that are described by Fishman et al.⁶