{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:50:22Z","timestamp":1791370222268,"version":"4.3.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":279,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Despite advances in pain science education, evidence\u2010based approaches to chronic pain are not consistently translated into physical therapy practice. Physical therapist (PT) clinical instructors (CIs) occupy a unique role as both clinicians and mentors of future practitioners. This study examined PT CIs\u2019 pain knowledge, pain\u2010related beliefs, confidence, and self\u2010reported use of pain neuroscience education (PNE) and explored perceived barriers to implementing evidence\u2010informed persistent pain management and preparing students to care for individuals with persistent pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This convergent mixed\u2010methods study used an anonymous online survey to collect quantitative and qualitative data from 30 PT CIs. Quantitative measures assessed pain neurophysiology knowledge, pain\u2010related beliefs, pain care confidence, and reported use of PNE. Open\u2010ended responses explored challenges in chronic pain management and student mentorship. Quantitative data were summarized descriptively, qualitative responses were analyzed using reflexive thematic analysis, and findings were integrated through SCT to examine factors contributing to the evidence\u2010to\u2010practice gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants demonstrated high pain care confidence, moderate\u2010to\u2010high pain neurophysiology knowledge, low disability\u2010oriented beliefs, and moderate use of PNE. Qualitative themes identified challenges in pain communication, management of complex presentations, and patient engagement that are compounded by clinical constraints. CIs also perceived that students possessed foundational pain knowledge but struggled to apply it through communication, treatment progression, and PNE. Integrated findings revealed a mismatch between knowledge and confidence and the application of biopsychosocial pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The evidence\u2010to\u2010practice gap in chronic pain management may reflect more than inadequate pain knowledge. While CIs reported strong confidence and generally contemporary beliefs, they continued to experience difficulty with communication, adaptability, patient engagement, and implementation within constrained clinical environments. Strategies to improve pain management should therefore extend beyond knowledge acquisition and include applied communication training, context\u2010sensitive clinical decision\u2010making, and support for clinicians who model pain care for future PTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/6171019","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:00:16Z","timestamp":1791367216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding the Evidence\u2010to\u2010Practice Gap in Persistent Pain Management"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7284-0330","authenticated-orcid":false,"given":"Virginia K.","family":"Henderson","sequence":"first","affiliation":[{"name":"College of Nursing, Health and Human Services Texas A&amp;M University-Texarkana  Texarkana Texas USA  tamut.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5501-0858","authenticated-orcid":false,"given":"Christopher","family":"Covert","sequence":"additional","affiliation":[{"name":"Bert Bradford School of Health Sciences University of Charleston  Charleston West Virginia USA  ucwv.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5498-2550","authenticated-orcid":false,"given":"Ryan","family":"Pontiff","sequence":"additional","affiliation":[{"name":"School of Health Professions The University of Texas Medical Branch  Galveston Texas USA  utmb.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4888-8040","authenticated-orcid":false,"given":"Rebecca","family":"Greenwood","sequence":"additional","affiliation":[{"name":"College of Health Sciences Sam Houston State University  Conroe Texas USA  shsu.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"crossref","DOI":"10.15620\/cdc\/169630","volume-title":"Chronic Pain and High-Impact Chronic Pain in U.S. Adults, 2023. NCHS Data Brief, No. 518","author":"Lucas J. W.","year":"2024"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7215a1"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2018.01.017"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.17925\/USN.2016.12.02.98"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.603420"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2021.9804"},{"key":"e_1_2_11_7_2","volume-title":"Pain Education Manual for Physical Therapist Professional Degree Programs","author":"Shepherd M.","year":"2021"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021634"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14090903"},{"key":"e_1_2_11_10_2","article-title":"Exploring Clinical Instructors\u2019 Views on Effective Role Modeling in Physical Therapy Education: Insights from a Qualitative Study Through the Lens of Social Cognitive Theory","author":"Gunterstockman B. M.","year":"2025","journal-title":"Internet Journal of Allied Health Sciences and Practice23"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-3332192\/v1"},{"key":"e_1_2_11_12_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4018\/978-1-6684-6756-5.ch004","volume-title":"The Lifelong Learning Journey of Health Professionals: Continuing Education and Professional Development","author":"Mangal J. P.","year":"2024"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-018-1251-x"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.17496\/kmer.24.001"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.46743\/1540-580X\/2016.1546"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTE.0000000000000356"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTE.0000000000000106"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6920-13-52"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.69863\/dim.2025.e556"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001416-200810000-00002"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-025-07816-1"},{"key":"e_1_2_11_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-019-1820-7"},{"key":"e_1_2_11_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.07.023"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1249\/01.mss.0001157672.73270.8c"},{"key":"e_1_2_11_25_2","volume-title":"Social Foundations of Thought and Action: A Social Cognitive Theory","author":"Bandura A.","year":"1986"},{"key":"e_1_2_11_26_2","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell J. W.","year":"2017"},{"key":"e_1_2_11_27_2","doi-asserted-by":"publisher","DOI":"10.7899\/JCE-22-28"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.02.008"},{"key":"e_1_2_11_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTE.0000000000000191"},{"key":"e_1_2_11_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_11_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13186"},{"key":"e_1_2_11_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2025.103422"},{"key":"e_1_2_11_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2022.2154626"}],"container-title":["Pain Research and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/6171019","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/prm\/6171019","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/6171019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:00:23Z","timestamp":1791367223000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/prm\/6171019"}},"subtitle":[],"editor":[{"given":"Carlos","family":"Bernal-Utrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/prm\/6171019"],"URL":"https:\/\/doi.org\/10.1155\/prm\/6171019","archive":["Portico"],"relation":{},"ISSN":["1203-6765","1918-1523"],"issn-type":[{"value":"1203-6765","type":"print"},{"value":"1918-1523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6171019"}}