Interventional Pain Management Skills Competency in Pain Medicine Fellows

The purposes of this project were to propose an educational module to instruct pain medicine fellows in the appropriate performance of interventional pain management techniques and to verify procedural competency through objective evaluation methodology. Eight board-certified pain medicine physicians spanning two fellowship programs trained seven fellows using a standardized competency-based module. Assessment tools address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (American Board of Anesthesiology Pain Medicine Content Outline). The seven fellows demonstrated proficiency in every segment of the evaluation module. Objective measures compared the fellows' performance on standardized procedure checklists administered 9 mos into training; fellows in the 2012-2013 academic year also received testing at the 3-mo mark. Support for the assessment module is demonstrated by appropriate performance of interventional procedures, with improvement noted from 3-mo to 9-mo testing, successful completion of chart-stimulated oral examinations, proper performance of relevant physical examination maneuvers, and completion of program-specific medical knowledge written tests. The fellows were evaluated via patient surveys and 360-degree global rating scales, maintained procedure logs, and completed two patient-care reports; these were reviewed by program directors to ensure adequate completion. The standardized educational module and evaluation methodology presented provide a potential framework for the definition of baseline competency in the clinical skill area of interventional pain management.