Focus of Study Pain KnowledgeNCT07735663
Contemporary Pain Science Education and Physician Assistant Students
An observational study of Focus of Study Pain Knowledge, run by Belmont University at 1 site in United States.
Trial summary
The goal of this clinical trial was to learn whether a pain science education session could improve physician assistant students' understanding of pain and their beliefs about people with persistent pain. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Focus of Study Pain Knowledge
- What is being tested?
- Pain education
- How many people
- 40 participants
- Where
- 1 siteUnited States
- Study dates
- 7 Sep 2019to 19 Aug 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: The study population consisted of 40 students enrolled in a single cohort of a 27-month, master's-level physician assistant program at one university in the southeastern United States. Participants had a mean age of 24.9 years; 60% identified as female and 40% as male. Thirty-five participants provided complete data across all five study time points.
Who may be able to join
None listed.
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Effect of Pain Neuroscience Education in Masters PA Medicine Education
The goal of this clinical trial was to learn whether a pain science education session could improve physician assistant students' understanding of pain and their beliefs about people with persistent pain.
The main questions were:
Read more
Did students' knowledge of how pain works change after the education session? Did students' beliefs about the relationship between pain, physical impairment, and activity change after the session? Were any changes maintained during the remainder of the physician assistant program?
Participants were students enrolled in one physician assistant master's degree program. All students received a four-hour pain science education session and a 30-minute hands-on laboratory session as part of their curriculum. The session explained that pain is affected by biological, psychological, and social factors. It also included case discussions, small-group activities, pain-related screening tools, and demonstrations of selected pain management techniques.
Participants completed questionnaires before the session, immediately afterward, and at three later points during the program. The final questionnaires were completed shortly before graduation. Researchers compared questionnaire scores across these five time points to examine changes in pain knowledge and pain-related beliefs.
Read the detailed description
This prospective, single-cohort, longitudinal educational intervention study evaluated changes in physician assistant students' pain neuroscience knowledge and pain-related attitudes and beliefs following a multimodal contemporary pain science education session. The study was conducted within a 27-month, master's-level physician assistant program at a single university in the southeastern United States.
The educational session occurred approximately four months after students entered the program. It was delivered during the second semester and consisted of four hours of classroom instruction followed by a 30-minute laboratory component. Classroom instruction incorporated lecture, small-group active learning, discussion, and case-based application. The content presented pain as a multidimensional experience influenced by biological, psychological, social, behavioral, and contextual factors rather than solely by tissue injury or nociception.
Instruction addressed foundational pain neuroscience, pain mechanisms and phenotyping, biopsychosocial contributors to persistent pain, and guideline-informed approaches to pain management. The session also addressed potential unintended consequences of unnecessary diagnostic imaging, medication- or procedure-focused management, premature referral, and language that may increase fear or reinforce beliefs that pain necessarily indicates tissue damage. Students were introduced to selected screening tools used to identify psychosocial factors that may influence pain, function, and recovery.
The laboratory component provided experiential exposure to laterality recognition activities, quantitative sensory testing, and mirror-based techniques. These activities were intended to reinforce concepts discussed during the classroom portion of the session and to demonstrate selected approaches used in the assessment or management of persistent pain.
The study used a repeated-measures design with data collection at five points across the physician assistant curriculum: immediately before the educational session, immediately after the session, approximately four months after the session, at the completion of didactic education approximately 11 months after the session, and shortly before graduation after completion of clinical rotations approximately 23 months after the session.
All students in the cohort received the curricular education. There was no separate control or comparison group, and the intervention was not randomized. Participation in the research involved consenting to the collection and analysis of questionnaire data. Changes in scores over time were examined using repeated-measures statistical methods. Because other coursework and clinical experiences occurred during the follow-up period, the study was designed to evaluate longitudinal associations with the educational session rather than to establish that the session alone caused all observed changes.
The study was approved by the Belmont University Institutional Review Board. Informed consent was obtained from participants before research data collection.
- Conditions
- Focus of Study Pain Knowledge
- Being tested
- Pain education
- Keywords
- Pain science education, Physician assistant students, Pain neuroscience, Biopsychosocial model
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pain educationOther
Participants received a 4.5-hour multimodal contemporary pain science education session consisting of four hours of classroom instruction and a 30-minute laboratory. The classroom portion used lecture, small-group activities, discussion, and case-based application to address pain neuroscience, pain mechanisms, biopsychosocial contributors to persistent pain, guideline-informed care, screening tools, nocebo language, and potential harms of unnecessary imaging, medications, procedures, and referrals. The laboratory provided hands-on exposure to laterality recognition, quantitative sensory testing, and mirror-based techniques.
What is being measured
The primary outcome is the main question the study is designed to answer.
Revised Neurophysiology of Pain Questionnaire (rNPQ)
The 12-item Revised Neurophysiology of Pain Questionnaire was used to assess pain neuroscience knowledge and has a possible total score ranging from 0 (no items answered correctly) to 12 (all items answered correctly). Each correct answer receives 1 point; incorrect or "undecided" responses receive 0 points. Higher scores represent a better outcome, indicating greater knowledge and understanding of pain neurophysiology
Measured: Over 23 months, from study enrollment to graduation from the academic program
Health Care Provider's Pain and Impairment Relationship Scale (HC-PAIRS)
The 15-item Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) has a possible total score ranging from 15 to 105:
Minimum: 15 - strongest disagreement that pain justifies impairment, disability, or activity limitation Maximum: 105 - strongest agreement that pain justifies impairment, disability, or activity limitation
Each item is rated on a 7-point Likert scale, from 1 (completely disagree) to 7 (completely agree). Higher scores represent a less favorable outcome, indicating stronger beliefs that persistent pain warrants disability and activity restriction. Therefore, lower scores are generally considered more consistent with contemporary biopsychosocial pain care.
Measured: Over 23 months, from study enrollment to graduation from the academic program
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jul 2026
- Study start7 Sep 2019
- Primary completion19 Aug 2021
- Study completion19 Aug 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (14)Papers the sponsor has linked to this study.
- Other trials for Focus of Study Pain KnowledgeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Belmont University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Sue E Curfman, PT, DHSc, Principal investigator, Belmont University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07735663
- Sponsor's protocol ID
- 1093
- Status last verified
- Jul 2026
- First submitted
- 21 Jul 2026
- Last updated
- 30 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The datasets generated and/or analyzed during the current study are available in Mendeley Data.
Publications
Zimney K, Louw A, Johnson J, Peppers S, Farrell K. Effects of Pain Neuroscience Education on Physician Assistant Students Understanding of Pain and Attitudes and Beliefs About Pain. S D Med. 2018 Nov;71(11):506-511.
PubMed 30742750Kiesel JD, Stevens D, Elwood C. Impact of biopsychosocial pain education on Physician assistant students' pain knowledge, pain attitudes, and recommendations for lower back pain. J Physician Assist Educ [Internet]. 2024 Jul 26;35(4):386. Available from: http://dx.doi.org/10.1097/JPA.0000000000000600
Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain. 2012 Jan;16(1):3-17. doi: 10.1016/j.ejpain.2011.06.006.
PubMed 21719329Yealy JK, Martinasek M, Doran T. The Current State of Physician Assistant Pain Curriculum: A National Survey. J Physician Assist Educ. 2019 Mar;30(1):20-26. doi: 10.1097/JPA.0000000000000237.
PubMed 30801555Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct 15;38(22):1939-46. doi: 10.1097/BRS.0b013e3182a42eb6.
PubMed 23883826Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013 Nov-Dec;11(6):527-34. doi: 10.1370/afm.1518.
PubMed 24218376Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007 Jul;133(4):581-624. doi: 10.1037/0033-2909.133.4.581.
PubMed 17592957Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians; Denberg TD, Barry MJ, Boyd C, Chow RD, Fitterman N, Harris RP, Humphrey LL, Vijan S. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.
PubMed 28192789King NMA, Habeeb M, Helps S. The contribution of physician associates or assistants to the emergency department: A systematic scoping review. J Am Coll Emerg Physicians Open. 2023 Jun 22;4(3):e12989. doi: 10.1002/emp2.12989. eCollection 2023 Jun.
PubMed 37360223Fellner A, Kim HS. Usual Care for Low Back Pain at United States Emergency Departments, 2016-2022. Ann Emerg Med. 2025 Dec;86(6):639-645. doi: 10.1016/j.annemergmed.2025.06.005. Epub 2025 Jul 12.
PubMed 40650645Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, Halonen P, Takala J. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001 Jan;89(2-3):175-80. doi: 10.1016/s0304-3959(00)00361-4.
PubMed 11166473Voon P, Karamouzian M, Kerr T. Chronic pain and opioid misuse: a review of reviews. Subst Abuse Treat Prev Policy. 2017 Aug 15;12(1):36. doi: 10.1186/s13011-017-0120-7.
PubMed 28810899Pitcher MH, Von Korff M, Bushnell MC, Porter L. Prevalence and Profile of High-Impact Chronic Pain in the United States. J Pain. 2019 Feb;20(2):146-160. doi: 10.1016/j.jpain.2018.07.006. Epub 2018 Aug 7.
PubMed 30096445Florence C, Luo F, Rice K. The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug Alcohol Depend. 2021 Jan 1;218:108350. doi: 10.1016/j.drugalcdep.2020.108350. Epub 2020 Oct 27.
PubMed 33121867
Study at a glance
From the registry record, last updated by the sponsor on 30 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Pain Neuroscience Education in Masters PA Medicine Education
- ClinicalTrials.gov ID
- NCT07735663
- Acronym / sponsor ID
- 1093
- Conditions
- Focus of Study Pain Knowledge
- Keywords
- Pain science education, Physician assistant students, Pain neuroscience, Biopsychosocial model
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Belmont UniversityUniversity, hospital or other
- Study start
- 7 Sep 2019 (actual)
- Primary completion
- 19 Aug 2021 (actual)
- Study completion
- 19 Aug 2021 (actual)
- First posted
- 30 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial was to learn whether a pain science education session could improve physician assistant students' understanding of pain and their beliefs about people with persistent pain.
The main questions were:
Did students' knowledge of how pain works change after the education session? Did students' beliefs about the relationship between pain, physical impairment, and activity change after the session? Were any changes maintained during the remainder of the physician assistant program?
Participants were students enrolled in one physician assistant master's degree program. All students received a four-hour pain science education session and a 30-minute hands-on laboratory session as part of their curriculum. The session explained that pain is affected by biological, psychological, and social factors. It also included case discussions, small-group activities, pain-related screening tools, and demonstrations of selected pain management techniques.
Participants completed questionnaires before the session, immediately afterward, and at three later points during the program. The final questionnaires were completed shortly before graduation. Researchers compared questionnaire scores across these five time points to examine changes in pain knowledge and pain-related beliefs.
Detailed description
This prospective, single-cohort, longitudinal educational intervention study evaluated changes in physician assistant students' pain neuroscience knowledge and pain-related attitudes and beliefs following a multimodal contemporary pain science education session. The study was conducted within a 27-month, master's-level physician assistant program at a single university in the southeastern United States.
The educational session occurred approximately four months after students entered the program. It was delivered during the second semester and consisted of four hours of classroom instruction followed by a 30-minute laboratory component. Classroom instruction incorporated lecture, small-group active learning, discussion, and case-based application. The content presented pain as a multidimensional experience influenced by biological, psychological, social, behavioral, and contextual factors rather than solely by tissue injury or nociception.
Instruction addressed foundational pain neuroscience, pain mechanisms and phenotyping, biopsychosocial contributors to persistent pain, and guideline-informed approaches to pain management. The session also addressed potential unintended consequences of unnecessary diagnostic imaging, medication- or procedure-focused management, premature referral, and language that may increase fear or reinforce beliefs that pain necessarily indicates tissue damage. Students were introduced to selected screening tools used to identify psychosocial factors that may influence pain, function, and recovery.
The laboratory component provided experiential exposure to laterality recognition activities, quantitative sensory testing, and mirror-based techniques. These activities were intended to reinforce concepts discussed during the classroom portion of the session and to demonstrate selected approaches used in the assessment or management of persistent pain.
The study used a repeated-measures design with data collection at five points across the physician assistant curriculum: immediately before the educational session, immediately after the session, approximately four months after the session, at the completion of didactic education approximately 11 months after the session, and shortly before graduation after completion of clinical rotations approximately 23 months after the session.
All students in the cohort received the curricular education. There was no separate control or comparison group, and the intervention was not randomized. Participation in the research involved consenting to the collection and analysis of questionnaire data. Changes in scores over time were examined using repeated-measures statistical methods. Because other coursework and clinical experiences occurred during the follow-up period, the study was designed to evaluate longitudinal associations with the educational session rather than to establish that the session alone caused all observed changes.
The study was approved by the Belmont University Institutional Review Board. Informed consent was obtained from participants before research data collection.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- The study population consisted of 40 students enrolled in a single cohort of a 27-month, master's-level physician assistant program at one university in the southeastern United States. Participants had a mean age of 24.9 years; 60% identified as female and 40% as male. Thirty-five participants provided complete data across all five study time points.
Key inclusion criteria (0 listed)
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Pain educationParticipants received a 4.5-hour multimodal contemporary pain science education session consisting of four hours of classroom instruction and a 30-minute laboratory. The classroom portion used lecture, small-group activities, discussion, and case-based application to address pain neuroscience, pain mechanisms, biopsychosocial contributors to persistent pain, guideline-informed care, screening tools, nocebo language, and potential harms of unnecessary imaging, medications, procedures, and referrals. The laboratory provided hands-on exposure to laterality recognition, quantitative sensory testing, and mirror-based techniques. | Other | – |
Primary outcome
Revised Neurophysiology of Pain Questionnaire (rNPQ)
Time frame: Over 23 months, from study enrollment to graduation from the academic program
The 12-item Revised Neurophysiology of Pain Questionnaire was used to assess pain neuroscience knowledge and has a possible total score ranging from 0 (no items answered correctly) to 12 (all items answered correctly). Each correct answer receives 1 point; incorrect or "undecided" responses receive 0 points. Higher scores represent a better outcome, indicating greater knowledge and understanding of pain neurophysiology
Health Care Provider's Pain and Impairment Relationship Scale (HC-PAIRS)
Time frame: Over 23 months, from study enrollment to graduation from the academic program
The 15-item Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) has a possible total score ranging from 15 to 105: Minimum: 15 - strongest disagreement that pain justifies impairment, disability, or activity limitation Maximum: 105 - strongest agreement that pain justifies impairment, disability, or activity limitation Each item is rated on a 7-point Likert scale, from 1 (completely disagree) to 7 (completely agree). Higher scores represent a less favorable outcome, indicating stronger beliefs that persistent pain warrants disability and activity restriction. Therefore, lower scores are generally considered more consistent with contemporary biopsychosocial pain care.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jul 2026.
- Background: PubMed 30742750Zimney K, Louw A, Johnson J, Peppers S, Farrell K. Effects of Pain Neuroscience Education on Physician Assistant Students Understanding of Pain and Attitudes and Beliefs About Pain. S D Med. 2018 Nov;71(11):506-511.
- BackgroundKiesel JD, Stevens D, Elwood C. Impact of biopsychosocial pain education on Physician assistant students' pain knowledge, pain attitudes, and recommendations for lower back pain. J Physician Assist Educ [Internet]. 2024 Jul 26;35(4):386. Available from: http://dx.doi.org/10.1097/JPA.0000000000000600
- Background: PubMed 21719329Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain. 2012 Jan;16(1):3-17. doi: 10.1016/j.ejpain.2011.06.006.
- Background: PubMed 30801555Yealy JK, Martinasek M, Doran T. The Current State of Physician Assistant Pain Curriculum: A National Survey. J Physician Assist Educ. 2019 Mar;30(1):20-26. doi: 10.1097/JPA.0000000000000237.
- Background: PubMed 23883826Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct 15;38(22):1939-46. doi: 10.1097/BRS.0b013e3182a42eb6.
- Background: PubMed 24218376Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013 Nov-Dec;11(6):527-34. doi: 10.1370/afm.1518.
- Background: PubMed 17592957Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007 Jul;133(4):581-624. doi: 10.1037/0033-2909.133.4.581.
- Background: PubMed 28192789Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians; Denberg TD, Barry MJ, Boyd C, Chow RD, Fitterman N, Harris RP, Humphrey LL, Vijan S. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.
- Background: PubMed 37360223King NMA, Habeeb M, Helps S. The contribution of physician associates or assistants to the emergency department: A systematic scoping review. J Am Coll Emerg Physicians Open. 2023 Jun 22;4(3):e12989. doi: 10.1002/emp2.12989. eCollection 2023 Jun.
- Background: PubMed 40650645Fellner A, Kim HS. Usual Care for Low Back Pain at United States Emergency Departments, 2016-2022. Ann Emerg Med. 2025 Dec;86(6):639-645. doi: 10.1016/j.annemergmed.2025.06.005. Epub 2025 Jul 12.
- Background: PubMed 11166473Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, Halonen P, Takala J. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001 Jan;89(2-3):175-80. doi: 10.1016/s0304-3959(00)00361-4.
- Background: PubMed 28810899Voon P, Karamouzian M, Kerr T. Chronic pain and opioid misuse: a review of reviews. Subst Abuse Treat Prev Policy. 2017 Aug 15;12(1):36. doi: 10.1186/s13011-017-0120-7.
- Individual participant dataSharing planned: Yes. The datasets generated and/or analyzed during the current study are available in Mendeley Data.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sue E Curfman, PT, DHSc principal investigator
Belmont University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Focus of Study Pain Knowledge, run by Belmont University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Revised Neurophysiology of Pain Questionnaire (rNPQ) (time frame: Over 23 months, from study enrollment to graduation from the academic program). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07735663, which also lists 14 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jul 2026.