The care of patients with persistent pain is frequently a challenge for even the most expert clinician.  But what constitutes expertise?  Does a longer duration of clinical experience equal advanced clinical practice?  Or is it possible to have only a few years under your belt, yet achieve a high level of expertise in the treatment of patients with complex pain conditions?   The content of this course demonstrates how, with a robust, evidence-based foundation of pain neuroscience, and a solid clinical decision-making strategy, advanced clinical practice can be achieved at many stages of one’s professional journey. 

This eight-week, faculty-led session will explore the characteristics that distinguish novice practice from expert level practice in the evaluation and provision of care for those struggling with persistent pain. Via journal articles, online discussions, written case reports and video-taped clinician/patient interactions, students will have the opportunity to analyze the clinical decision-making process of advanced clinical practitioners as they determine plans of care for patients with persistent and/or complex pain states. They will reflect on their own practice and discover tools to take next steps to elevate their performance to that of an expert clinician.  

Video-based lectures will lay the foundational concepts of Advanced Clinical Practice in week one, with discussion boards provided for students to answer specific questions pertaining to videos and required readings throughout the eight weeks.  An advanced clinical reasoning process developed by Mark Jones and the faculty at the University of South Australia will be introduced in week two and applied by expert clinicians in a case-study format in week three.  A lecture on advanced categorization using pain phenotypes will be featured in week four, and a lecture on recognizing bias will accompany a case study in week five.  Weeks five through eight feature video-recorded patient/practitioner interactions to foster observational and reflective learning.  A lecture on knowledge and influence of diversity, equity and inclusion in are for the advanced practitioner. In addition to a clinical case presentation in week 7, a robust review of patient safety practices is provided. Students will be guided through an evaluative process to explore elements of advanced practice as well as areas of bias observed in the recorded interactions. 

By the end of the course, a successful learner will be able to:

• Appraise various aspects of clinical practice and define attitudes and behaviors that constitute expert versus novice practice in the treatment of patients with complex and/or persistent pain states.
• Reflect and identify characteristics of their own clinical performance which constitute expert practice, as well as characteristics that require further growth and development.
• Analyze and interpret clinical decisions of expert practitioners using the University of South Australia (UNISA) form/reasoning process.
• Evaluate all aspects of sample video-recorded patient/provider encounters, including assessment and treatment, and will distinguish those elements which exemplify expertise.
• Demonstrate an understanding of advanced pain phenotype classification and will categorize patients accordingly.
• Articulate an understanding of various forms of clinician bias and how it can impact the clinical decision-making process.
• Perform a thorough cardiovascular, red flag, suicide, polypharmacy, balance and falls, safety, and health inequities screening in preparation for virtual rounds
• Utilize the knowledge obtained in this course to formulate a plan to elevate their current practice to a higher level of expertise in preparation for Virtual Rounds.
• Have an understanding and appreciation of diversity, equity and inclusion in care.