{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T23:59:21Z","timestamp":1771459161440,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,7,19]]},"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Unrelieved pain is a substantial public health concern necessitating improvements in medical education. The Advancing the Provision of Pain Education and Learning (APPEAL) study aimed to determine current levels and methods of undergraduate pain medicine education in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>Using a cross-sectional design, publicly available curriculum information was sought from all medical schools in 15 representative European countries in 2012\u20132013. Descriptive analyses were performed on: the provision of pain teaching in dedicated pain modules, other modules or within the broader curriculum; whether pain teaching was compulsory or elective; the number of hours\/credits spent teaching pain; pain topics; and teaching and assessment methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Curriculum elements were publicly available from 242 of 249 identified schools (97%). In 55% (133\/242) of schools, pain was taught only within compulsory non-pain-specific modules. The next most common approaches were for pain teaching to be provided wholly or in part via a dedicated pain module (74\/242; 31%) or via a vertical or integrated approach to teaching through the broader curriculum, rather than within any specific module (17\/242; 7%). The curricula of 17\/242 schools (7%) showed no evidence of any pain teaching. Dedicated pain modules were most common in France (27\/31 schools; 87%). Excluding France, only 22% (47\/211 schools) provided a dedicated pain module and in only 9% (18\/211) was this compulsory. Overall, the median number of hours spent teaching pain was 12.0 (range 4\u201356.0\u2005h; IQR: 12.0) for compulsory dedicated pain modules and 9.0 (range 1.0\u201360.0\u2005h; IQR: 10.5) for other compulsory (non-pain specific) modules. Pain medicine was principally taught in classrooms and assessed by conventional examinations. There was substantial international variation throughout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Documented pain teaching in many European medical schools falls far short of what might be expected given the prevalence and public health burden of pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006984","type":"journal-article","created":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T20:40:37Z","timestamp":1439239237000},"page":"e006984","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":110,"title":["Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study"],"prefix":"10.1136","volume":"5","author":[{"given":"Emma V","family":"Briggs","sequence":"first","affiliation":[{"name":"Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK"}]},{"given":"Daniele","family":"Battelli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, University of Modena e Reggio Emilia, Modena, Italy"}]},{"given":"David","family":"Gordon","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark"}]},{"given":"Andreas","family":"Kopf","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Charit\u00e9 Medical University, Berlin, Germany"}]},{"given":"Sofia","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Medical Resident in Public Health, Estrada de Mem-Martins, Algueir\u00e3o Mem-Martins, Portugal"}]},{"given":"Margarita M","family":"Puig","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Universitat Aut\u00f2noma de Barcelona, Hospital del Mar, Paseo Mar\u00edtimo, Barcelona, Spain"}]},{"given":"Hans G","family":"Kress","sequence":"additional","affiliation":[{"name":"Department of Special Anaesthesia and Pain Therapy, Medical University\/AKH Vienna, Vienna, Austria"}]}],"member":"239","published-online":{"date-parts":[[2015,8,10]]},"reference":[{"key":"2025120520331935000_5.8.e006984.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.06.009"},{"key":"2025120520331935000_5.8.e006984.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"2025120520331935000_5.8.e006984.3","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1186\/1471-2458-9-299","article-title":"Chronic pain in primary care. German figures from 1991 and 2006","volume":"9","author":"Friessem","year":"2009","journal-title":"BMC Public Health"},{"key":"2025120520331935000_5.8.e006984.4","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ejpain.2011.07.006","article-title":"Socio-economic burden of patients with a diagnosis related to chronic pain\u2014register data of 840,000 Swedish patients","volume":"16","author":"Gustavsson","year":"2012","journal-title":"Eur J Pain"},{"key":"2025120520331935000_5.8.e006984.5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jpain.2011.10.004","article-title":"The economic cost of chronic noncancer pain in Ireland: results from the PRIME study, part 2","volume":"13","author":"Raftery","year":"2012","journal-title":"J Pain"},{"key":"2025120520331935000_5.8.e006984.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.03.009"},{"key":"2025120520331935000_5.8.e006984.7","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp001"},{"key":"2025120520331935000_5.8.e006984.8","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer116"},{"key":"2025120520331935000_5.8.e006984.9","unstructured":"International Society for the Study of Pain. Declaration of Montreal. Declaration that access to pain management is a fundamental human right. IASP, 2010. http:\/\/www.iasp-pain.org\/DeclarationofMontreal (accessed 17 June 2015)."},{"key":"2025120520331935000_5.8.e006984.10","first-page":"393","article-title":"The challenges of pain management in primary care: a pan-European study","volume":"6","author":"Johnson","year":"2013","journal-title":"J Pain Res"},{"key":"2025120520331935000_5.8.e006984.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2011.01.006"},{"key":"2025120520331935000_5.8.e006984.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(98)00160-2"},{"key":"2025120520331935000_5.8.e006984.13","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.pain.2005.02.033","article-title":"The outcome of pain related undergraduate teaching in Finnish medical faculties","volume":"115","author":"P\u00f6yhi\u00e4","year":"2005","journal-title":"Pain"},{"key":"2025120520331935000_5.8.e006984.14","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1111\/j.1526-4637.2010.00961.x","article-title":"The first national pain medicine summit\u2014final summary report","volume":"11","author":"Lippe","year":"2010","journal-title":"Pain Med"},{"key":"2025120520331935000_5.8.e006984.15","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.jpain.2011.06.006","article-title":"Pain education in North American medical schools","volume":"12","author":"Mezei","year":"2011","journal-title":"J Pain"},{"key":"2025120520331935000_5.8.e006984.16","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1155\/2009\/307932","article-title":"A survey of prelicensure pain curricula in health science faculties in Canadian universities","volume":"14","author":"Watt-Watson","year":"2009","journal-title":"Pain Res Manag"},{"key":"2025120520331935000_5.8.e006984.17","unstructured":"Global Consensus for Social Accountability of Medical Schools. Dec 2010. http:\/\/healthsocialaccountability.org (accessed 17 Jun 2015)."},{"key":"2025120520331935000_5.8.e006984.18","unstructured":"United Nations Statistics Division. Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupin gs. United Nations, 2012. http:\/\/unstats.un.org\/unsd\/methods\/m49\/m49regin.htm (accessed 17 Jun 2015)."},{"key":"2025120520331935000_5.8.e006984.19","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s00482-013-1343-9","article-title":"[Cross-sectional field 14 pain medicine. Implementation of the German Pain Society (DGSS) core curriculum in the model study course MaReCuM]","volume":"27","author":"Dusch","year":"2013","journal-title":"Schmerz"},{"key":"2025120520331935000_5.8.e006984.20","unstructured":"European Parliament and the Council of the European Union. Directive 2005\/36\/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications. Official Journal of the European Union 2005;30 Sept:L255\/22\u2013142."},{"key":"2025120520331935000_5.8.e006984.21","unstructured":"European Federation of IASP\u00ae Chapters. The Pain Management Core Curriculum for European Medical Schools. Diegen, Belgium;EFIC\u00ae. June 2013. http:\/\/www.efic.org\/index.asp?sub=40275570Ac7l08 (accessed 17 Jun 2015)."},{"key":"2025120520331935000_5.8.e006984.22","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1111\/pme.12107","article-title":"Core competencies for pain management: results of an interprofessional consensus summit","volume":"14","author":"Fishman","year":"2013","journal-title":"Pain Med"},{"key":"2025120520331935000_5.8.e006984.23","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/pme.12051","article-title":"Recommendations for a new curriculum in pain medicine for medical students: toward a career distinguished by competence and compassion","volume":"14","author":"Murinson","year":"2013","journal-title":"Pain Med"},{"key":"2025120520331935000_5.8.e006984.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.07.010"},{"key":"2025120520331935000_5.8.e006984.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.06.030"},{"key":"2025120520331935000_5.8.e006984.26","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/j.1526-4637.2010.01050.x","article-title":"A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development","volume":"12","author":"Murinson","year":"2011","journal-title":"Pain Med"},{"key":"2025120520331935000_5.8.e006984.27","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/j.1526-4637.2011.01104.x","article-title":"Web-based elective courses for medical students: an example in pain","volume":"12","author":"Puljak","year":"2011","journal-title":"Pain Med"},{"key":"2025120520331935000_5.8.e006984.28","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1089\/jpm.2011.0536","article-title":"Pediatric pain management education in medical students: impact of a web-based module","volume":"15","author":"Ameringer","year":"2012","journal-title":"J Palliat Med"},{"key":"2025120520331935000_5.8.e006984.29","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.jpain.2013.01.005","article-title":"Pain education at the University of Washington School of Medicine","volume":"14","author":"Tauben","year":"2013","journal-title":"J Pain"},{"key":"2025120520331935000_5.8.e006984.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.08.006"},{"key":"2025120520331935000_5.8.e006984.31","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/j.1533-2500.2012.00580.x","article-title":"Acute pain in undergraduate medical education: an unfinished chapter!","volume":"12","author":"Vadivelu","year":"2012","journal-title":"Pain Pract"},{"key":"2025120520331935000_5.8.e006984.32","doi-asserted-by":"publisher","DOI":"10.1177\/2049463712444062"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-006984","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:33:29Z","timestamp":1764995609000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-006984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2015,8,10]]},"published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1136\/bmjopen-2014-006984"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-006984","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8]]}}}