Learning Objectives

By the end of this topic, the student should be able to:

  • Describe the role of the social worker in pain management
  • Describe the role of the nurse in pain management
  • Describe the role of the pharmacist in pain management
  • Develop an interdisciplinary case study

Key Concepts

  • This topic is a little different than the other topics in module 7. It is an activity for you to complete, which you can use to assess your ability to view a case through an interprofessional lens.
  • It is recommended to complete at least some of the other topics in module 7 before proceeding.
  • When you have finished this topic, you are encouraged to consult with a fellow learner to:
    • discuss your approach to the case given
    • share a case that you develop, and
    • discuss both cases with your fellow learner, identify alternative approaches, and decide the best course of action together.

Different Types of Interprofessional Clinical Pain Management Cases

Clinical case studies can be used to assess a student’s basic conceptual understanding, have them apply their clinical knowledge, and make decisions about treatment/therapy. Because the purpose of a clinical case study can vary, format can also vary. Different types of information can be provided, with different goals in mind for the student/reader.

Two types of cases commonly used for clinical assessments are directed cases and decision cases.

For more information about these and other types of cases and activities, see Case Types and Methods from the National Center for Case Study Teaching in Science, University at Buffalo.

Definitions

Directed cases
Directed cases are designed to test a student’s basic understanding of concepts covered in a course. Often multiple-choice questions (MCQs) follow a directed case.

For example, you might describe a person with pain symptoms and the student will indicate on an MCQ question whether those symptoms are consistent with neuropathic pain, chronic pain, acute pain, etc.
Decision cases (or dilemma cases)
Decision cases (or dilemma cases) are designed to have a student apply their clinical knowledge to a case and make decisions about ongoing therapy. For decision cases, questions can be short answer or MCQ.

For example, you might describe a person with pain symptoms and make a recommendation about a starting pain medication regimen, or a pain patient presenting with adverse effects related to their pain medications and recommend a change to their regimen, or a non-pharmaceutical intervention to help with their adverse effects.

An example of a case that is primarily a directed case (but with some aspects of a dilemma case) can be found here: A Friend in Need is a Friend Indeed.

Task #1

Work Through an Example of an Interprofessional Clinical Pain Management Case

Icon for back pain

Case Study

Sean is a 42-year-old, unemployed male who went to his family doctor in Ontario to complain about chronic back pain. After gathering some previous history, the doctor noted that Sean doesn’t have a permanent address and is staying with friends in Ontario. Two years ago, he was living in the US and then moved to the East Coast of Canada where he moved around a lot until finally settling for Ontario.

Sean was involved in a serious motor vehicle accident 20 years ago, which caused osteoarthritis in his right knee and chronic back pain. Prior to this visit, he has no previous medical records in Canada as he only goes to walk-in clinics during his temporary stays. He did report a primary care provider in Texas and said he would consent to receiving information from the clinic.

Sean reported that he experiences depression and insomnia due to the chronic back pain. He had been on a variety of opioid medications throughout his life including fentanyl patch, morphine, oxycodone with varying pain relief. He has tried to unsuccessfully taper several times.

Sean works temporary odd jobs that usually require physical tasks. Due to his chronic pain, he is unable to work consistently. He is frustrated and admits that the opioids aren’t improving his quality of life. He has had difficulty holding down a job since the accident and continues to experience PTSD when he drives a vehicle. He stated he couldn’t work right now as he was in so much pain (primarily back related), but really needed some income. He had basic support through Ontario Works.

When asked about his friends, Sean said they are actually co-workers he met while working as a temp. He said the co-workers he lives with also experience some form of chronic pain and help each other through it. One of them is on a new opioid and it’s been working well for him, so he wants to try that before trying to taper off opioids again. He is requesting suboxone to help him manage his chronic back pain better. When other treatments were discussed, he stated he had previously tried duloxetine and found it ineffective.

Modified based on cases from the Interprofessional Case Series. (2017). Opioid Education Partnership. School of Pharmacy, University of Waterloo.

Questions to Consider:

  1. What are some options you can offer Sean to help him manage his condition?
  2. What factors can impact the outcome of Sean’s pain management plan?
  3. Describe the role of the Social Worker in pain management in this case.
    1. What have you learned about the role of the Social Worker in pain management while working through this case?
    2. Do you have further questions about the role of the Social Worker in pain management?
  4. Describe the role of the Nurse in pain management
    1. What have you learned about the role of the Nurse in pain management while working through this case?
    2. Do you have further questions about the role of the Nurse in pain management?
  5. Describe the role of the Pharmacist in pain management in this case.
    1. What have you learned about the role of the Pharmacist in pain management while working through this case?
    2. Do you have further questions about the role of the Pharmacist in pain management?
  6. What opportunities for care collaboration exist in this case?

Task #2

Develop an Interprofessional Clinical Pain Management Case

Your task is to develop a directed or dilemma case that involves a pain patient and at least two professions (nursing, social work, pharmacy).

Try writing an MCQ question to go with your case and share with a fellow learner.

References

Cliff, W. & Wright, A. (2005). A Friend in Need Is a Friend Indeed: A Case Study on Human Respiratory Physiology. National Centre for Case Study Teaching in Science. Retrieved online from: https://sciencecases.lib.buffalo.edu/files/3-respiration.pdf

Interprofessional Case Series. (2017). Opioid Education Partnership. School of Pharmacy, University of Waterloo.

University at Buffalo Libraries. (2021). Case Types and Methods. National Centre for Case Study Teaching in Science. https://sciencecases.lib.buffalo.edu/collection/types.html