{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T03:34:42Z","timestamp":1772163282633,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T00:00:00Z","timestamp":1522627200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AEM Education and Training"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our primary objective was to use the Delphi method (<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>) to choose learning objectives for an Internet\u2010based pain management teaching module for emergency care providers. The <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> is a structured communication technique that uses systematic, interactive data gathering to reach a consensus among a panel of experts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We extracted preliminary educational objectives from nationwide pain fellowship training programs. After redundant objectives and those relating to procedures outside the scope of emergency medicine (<jats:styled-content style=\"fixed-case\">EM<\/jats:styled-content>) were removed, 23 preliminary objectives remained. We enlisted experts in <jats:styled-content style=\"fixed-case\">EM<\/jats:styled-content>, medical toxicology, anesthesia, pain, psychiatry, and medical education to evaluate the objectives in repeated rounds. Based on the time we had designated for teaching (3 hours) and our estimate of 15 to 20 minutes for each learning objective, we aimed for nine to 12 final learning objectives. The expert panel rated the 23 preliminary objectives with a 5\u2010point Likert scale. Experts were blinded to each other's answers. When 80% of experts agreed with proposed objectives, objectives were considered \u201caccepted\u201d and retained. When 80% of experts disagreed with proposed objectives, the objectives were considered \u201crejected\u201d and discarded. The remaining objectives were considered in subsequent rounds. In the first round, one objective was rejected and four were accepted. In the second round, four objectives were rejected and five were accepted. Having reached nine objectives the panel unanimously agreed that the nine objectives were sufficient to be used as a foundation for teaching modules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using the <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>, our expert panel identified nine educational objectives that were used as the foundation for an educational module. Of the nine objectives, three were categorized as \u201cmedical knowledge,\u201d two as \u201cpharmacologic knowledge,\u201d two as \u201cpatient communication,\u201d and two as \u201csystems\u2010based practice.\u201d The learning objectives are as follows: recognize common barriers to treating pain; understand alternative interventional therapies used to treat different kinds of pain their implications, benefits, and risks; identify common component symptoms that may exacerbate chronic pain (i.e., depression, anxiety, delirium, cachexia, dyspnea); study the major drug groups used to treat different kinds of pain; recognize the risks of polypharmacy; set realistic expectations with patients early in their presentation to the emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>); educate patients as the risks of different classes of pain medications, including risk of addiction; understand the legal and regulatory issues that govern pain management in the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>; and understand in\u2010hospital resources available for patient follow up and referral to pain clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We successfully used the <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> to develop educational objectives for an e\u2010learning module. Further work should evaluate educational outcomes of the teaching module.<\/jats:p><\/jats:sec>","DOI":"10.1002\/aet2.10092","type":"journal-article","created":{"date-parts":[[2018,2,18]],"date-time":"2018-02-18T10:26:49Z","timestamp":1518949609000},"page":"121-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Designing and Implementing Emergency Department Pain Management Curriculum: A Delphi Approach"],"prefix":"10.1002","volume":"2","author":[{"given":"Karolina","family":"Paziana","sequence":"first","affiliation":[{"name":"Johns Hopkins University Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Timpano","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Stolbach","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,4,2]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research","author":"Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education","year":"2011"},{"key":"e_1_2_9_3_1","volume-title":"National Center for Health Statistics: Emergency Department Visits","author":"Centers for Disease Control"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.70749"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.03.009"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0865"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199709000-00009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2003.11.019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2017.01.040"},{"key":"e_1_2_9_10_1","unstructured":"The Accreditation Council of Graduate Medical Education and The American Board of Emergency Medicine.Emergency Medicine Milestones Project. Available at:https:\/\/www.abem.org\/public\/docs\/default-source\/migrated-documents-and-files\/em-milestones.pdf?sfvrsn=6. Accessed Dec 23 2017."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4300\/JGME-D-14-00438.1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2015.8.27247"},{"key":"e_1_2_9_13_1","unstructured":"National Institutes of Health.NIH Pain Consortium. Available at:http:\/\/painconsortium.nih.gov. Accessed on Sep 27 2017."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2007.11.002"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3163\/1536-5050.102.1.007"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6920-6-2"},{"key":"e_1_2_9_17_1","unstructured":"Brown B. Delphi Process: A Methodology Used for the Elicitation of Opinions of Experts: An earlier paper published by RAND.1968. Document No: P\u20103925"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1108\/13639510210450677"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020476"},{"key":"e_1_2_9_20_1","volume-title":"Delphi Surveys. Teaching material for UNIDO foresight seminars","author":"Cuhls K","year":"2005"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-37"}],"container-title":["AEM Education and Training"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Faet2.10092","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aet2.10092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:56:18Z","timestamp":1695560178000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/aet2.10092"}},"subtitle":[],"editor":[{"given":"Rebecca","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1002\/aet2.10092"],"URL":"https:\/\/doi.org\/10.1002\/aet2.10092","archive":["Portico"],"relation":{},"ISSN":["2472-5390","2472-5390"],"issn-type":[{"value":"2472-5390","type":"print"},{"value":"2472-5390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"2017-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}