Undergraduate Physiotherapy Pain Science Curriculum Augmentation Project

The UPPScAle strategic partnership is a transnational collaboration aiming to innovate, improve and standardise Bachelor Physiotherapy pain science curricula across Europe. Pain science is a core field in a physiotherapy curriculum and physiotherapists are essential members of healthcare teams managing people with pain. Chronic pain affects millions of people worldwide across the lifespan and is a global cause of disability in the developed and developing world. Pain management is the primary reason people attend physiotherapy for treatment. However, there is currently no standardised curriculum or common training framework for physiotherapists, with professional education about pain management repeatedly documented as inadequate worldwide. Hence the inequities in pain science knowledge across Europe results in inequitable health service delivery and costs and most importantly to significant differences in patients quality of life. Greater connectivity between higher education systems with standardised curricula will also reduce obstacles that face physiotherapists applying to practise their profession across geographical borders in EU member states.

The UPPScAle project objectives focused on harmonising pain science education in Physiotherapy programmes across Europe by offering a roadmap for academics UPPScAle had three main objectives: Objective 1: Curriculum benchmarking of Bachelor Physiotherapy pain science curricula against international best practice (European Pain Federation EFIC Pain Physiotherapy curriculum) to identify gaps in learning; Objective 2: Augmenting knowledge and skills through evidence-based professional practices Objective 3: Enhancing and standardising teaching and learning by developing an Open Education Resource that addresses identified limitations to support academics with student learning across Europe and beyond.

(i)PA1: Needs Analysis: A curriculum mapping matrix was developed and undertaken to identify limitations in current teaching and learning in pain science and management. This included partners (i) mapping the content of their pain science curricula against the European Pain Federation EFIC Physiotherapy core curriculum, (ii) identifying the stage where pain science was taught (iii) the number of teaching hours and (iv) how pain science was taught (clinical education, lecture, practical session etc). Partners circulated the mapping matrix to their relevant colleagues in their department to complete A 3 day curriculum planning session was then undertaken with partners. The results of the mapping matrix were reviewed and common content taught as well as and limitations identified. Stakeholder feedback was also sought as to curriculum content requirements. This involved a one day workshop with partners and stakeholders [current physiotherapy students / recent graduates from all Partner organisations, along with people living with pain (recruited from Ireland) to inform the curriculum content]. This one day stakeholder session was facilitated by experts in curriculum design in NUID UCD Teaching and Learning Centre. The 3 day meeting was held 03/2022 (Dublin, UCD). (WP1). This took place at the end of the pandemic but to be cautious the stakeholder session took place virtually. A positive of this is that it allowed students from the five partner sites to meet and discuss their physiotherapy programmes, as well as hearing the 'patient's' voice. The partners met in person. (ii) PA2: Capacity Building: Based on the identified common limitations in the partners curricula (PA1) two week long in-person Train-the Trainer Pain Schools were developed and run in order to standardise and up-skill academic partners with both theoretical and hands-on skills development sessions.The first School was held in September 2022 (Utrecht, HU) (TtT1) the second in January 2023 (Ljubljana) Advanced TtT. Comprehensive School manuals were developed to support participants' learning that included key learning objectives, references, self-assessment section for each lecture / practical session. A reflective journal (not part of the original grant) was also developed to allow participants to reflect after each lecture, at the end of each day and at the end of the School on what they had learnt and how it could be integrated into their own Physiotherapy programme. Bringing together academic and clinical education staff facilitated intercultrual learning throughout the duration of the Schools (iii) PA3: The UPPScAle team planned and developed an Open Education Resource (OER) that housed the materials developed during PA2 Train-the-Trainer Pain Schools and was widely disseminated through national and international conferences and via the projects social media platforms (twitter, facebook). Feedback about the OER content was sought and where appropriate implemented into the individual lectures to enhance the content.

1. Open educational Resource We developed the UPPScAe OER to house all educational outputs from the UPPScAle project. This included (i) the content developed for the two Train-the Trainer Pain Schools that had been identified during the curriculum review process (PA1) which will support key competences development and new pain science and management teaching and learning (ii) Pain School manuals- developed to comprehensively support the knowledge and skills content of the Pain Schools They includes learning objectives, key references and a self assessment quiz for each lecture. (iii) Reflective Journals - allow those reviewing the platform to consider their new learning and plan for new teaching (translated into partners language) This will augment and promote excellence on pain science learning, teaching and skills development that healthcare professionals, patients and health services will ultimately benefit from. (iv) New EFIC core curriculum for pain science education in Bachelor / pre-registration physiotherapy programmes (not in original grant) The OER is hosted by UCV and is fully accessible. https://uppscale.eu/ 2. Open source files accessibility All resources from the UPPScAle Project (submitted academic paper, content from the Train-the Trainer Pain Schools including a comprehensive supporting manual and a reflective journal, and the EFIC core curriculum for Undergraduate / pre-registration physiotherapy programmes are all freely available for institutions removing the barrier of funding issues that arise in institutions across Europe 3. Special interest group A New network of Physiotherapists in pain science education has been approved within the European Network of Physiotherapists in Higher Education (ENPHE). This was established and is being led by the HU Partner lead Harriet Wittink. The first meeting is in April 2024 (annex, dissemination). This is a significant sustainable development as it will help academics and clinical education staff to engage with each other, sharing knowledge on the topic within a large European organisation (156 member institutions and representing 31 countries). It will promote the UPPScAle OER and the new EFIC BSc Pain Science Physiotherapy curriculum. Going forward it will also allow for discussion around the development of a common training framework for physiotherapy education. This would ultimately enhance patient care, reduce healthcare costs and limit obstacles faced by physiotherapists seeking to have their qualifications recognised when they wish to practice professionally across geographical borders of European Union member states. 4. Interconnectivity Greater interconnectivity was achieved through (i) academics and clinical education staff meeting and networking during the Pain Schools (ii) The ENPHE pain education network group will ensure that thoose teaching pain science can formally meet to network, learn and lead on the development of pain education in physiotherapy programmes across Europe. ENPHE holds two meetings annually. (iii) Through the promotion of the UPPScAle project and dissemination of results through multiple outlets: international conferences, social media, the Erasmus+ results platform and posting on https://use.edusources.nl/instellingen/hu-nl which is a national Dutch platform for sharing higher education resources, this project will further enhance inter-connectively and teaching excellence between universities in Europe, increasing their capacity to operate jointly at transnational level, boosting internationalisation of their educational and research activities, and through exchanging or developing new practices and methods as well as sharing and confronting ideas. Interconnectivity between the UPPScAle partners has led to future projects. The UPPScAle Partners have agreed to continue to work together to enhance pain science education. Led by the University of Applied Science, Zagred, Croatia we have submitted an application for Erasmus Blended Intensive Programme in Higher Education (BIP) for a BSc Physiotherapy students pain science summer School (August 2024, see annex). This will bring students together from the five Partner sites to learn together. The Partners have also joined the University College Dublin Centre for Translational Pain Research to continue to collaborate in the future on research studies (www.ucd.ie/CTPR)