Virtual Rounds is an advanced clinical practice experience in the Pain Sciences Fellowship focusing on critical thinking and advanced clinical reasoning regarding patient care in a collaborative virtual environment. Fellows-in-Training (FiTs) are expected to demonstrate pragmatic application of effective clinical reasoning using a patient-centered framework within the biopsychosocial model, which integrates up-to-date evidence-informed practice, experienced-based evidence, and ultimate patient values.  This practical application of the cumulative knowledge and understanding developed during the Therapeutic Pain Specialist and Pain Sciences Fellowship highlights actual patient case presentations and collaborative reflective feedback amongst their fellowship cohort and course faculty.  

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

• Employ a clinical reasoning framework in a consistent manner, gathering accurate data to define patient presentations and provide evidence for clinical decision-making.  
• Synthesize data gathered throughout the examination and integrate the appraised data throughout the examination and intervention process, making sound clinical judgments regarding patient/client management.  
• Demonstrate continuity of the progression of patient care from the subjective interview through the initial intervention, responding appropriately to emerging evidence as it presents itself.  
• Demonstrate an evolution of clinical decision-making skills, including clinical reasoning, judgment, and reflective practice (metacognition and critical thinking skills).  
• Demonstrate an appreciation for higher-level clinical decision making in a variety of pain conditions, with appropriate incorporation of pain neuroscience education and “PNE Plus” interventions. 
• Demonstrate the ability to respond to emerging data throughout the course of care, making appropriate and timely modifications to patient concerns, diagnostic hypotheses, presentation of the condition, prognosis, and plan of care.  
• Understand and apply principles of pain classification and phenotypes.  
• Present a patient case that demonstrates sound clinical reasoning and contains essential elements of the history and physical examination, including valid and reliable tests and measures, diagnosis, prognosis, and plan of care.  
• Participate in peer-assessment and provide feedback to colleagues that encourages the application of sound critical thinking, clinical reasoning, current best evidence into practice.  
• Show growth and maturity in leadership roles throughout course.