Don’t miss this discussion of the new COVID-19 guidelines for pain management between Dr. Steven P. Cohen of Johns Hopkins, Dr. Friedhelm Sandbrink of the Veterans Health Administration, and "Pain Rounds" host Dr. Shravani Durbhakula. Click here for Video. Drs. Cohen and Sandbrink are among the authors of “Pain Management Best Practices from Multispecialty Organizations […]Read More
Don’t miss this excellent report from NPR: How To Teach Future Doctors About Pain In The Midst Of The Opiod Crisis “Pain Rounds” creator and host Dr. Shravani Durbhakula directs an introductory course on pain management for medical students at Johns Hopkins University as communities throughout the country grapple with the opioid crisis. Medical students learn […]Read More
WHY “PAIN ROUNDS”?
In pain medicine, gaps in provider education across specialties and levels of training are linked to the opioid crisis as well as complications and the inappropriate utilization of therapies. Several such gaps were documented by the United States Department of Health and Human Services in their Pain Management Best Practices Inter-Agency Taskforce Report in 2019. “Pain Rounds” is a novel educational tool that seeks to reduce variabilities in pain education, foster appropriate therapy utilization and improve patient outcomes. It is analogous to a video textbook and is intended to be used as such.
At the graduate medical education level, literature confirmed that approximately half of pain medicine fellows left fellowship training feeling unprepared in spinal cord stimulation (SCS) procedures which are used for various pain indications and have the potential to be opioid sparing. The fellows cited a lack of structured SCS curriculum as a contributor to their under-preparation. The topics included in Pain Rounds were determined by a needs assessment of program directors, fellows, and professional medical societies to fill this need for a comprehensive curriculum.
Historically, pain fellowships accredited by the Accreditation Council for Graduate Medical Education (ACGME) required that learners participate in five neuromodulation cases and five neuromodulation lectures to graduate. In 2019, the ACGME requirements removed any firm case numbers. Further, non-ACGME-accredited pain programs, such as the rehabilitation-based spine fellowships, were never required to adhere to these standards. The range of expertise required to maximize appropriate use of the two most common neuromodulation procedures (SCS and IT pumps) is quite broad. Expertise in SCS requires knowledge of patient selection, mechanism of action, anatomy, placement of epidural electrodes, surgical implantation of hardware, complications, device programming, and infection prevention. Expertise in IT pumps requires additional knowledge such as intrathecal medication dosing, catheter and single-shot trialing, pump refilling, and granuloma recognition. With unclear markers of proficiency, it is possible for a fellow to fulfill the ACGME criteria without mastering the competencies needed to manage any single device, let alone multiple types.
Meet Dr. D
Dr. Shravani Durbhakula, M.D., M.P.H., M.B.A. is a double board-certified interventional pain physician and anesthesiologist with a national reputation as a clinician-educator and innovator focused on safe, effective, and individualized pain treatment. She is experienced in creating novel educational products and technological tools to reduce the impacts of educational gaps on medical, educational, and public health outcomes. In 2022, Dr. Durbhakula received the Clinician-Educator of the Year award from the American Society of Pain and Neuroscience and a Presidential Commendation from the American Academy of Pain Medicine for her work in education and curriculum design. She is the National Director of Media for the American Academy of Pain Medicine and host of the society’s official podcast, “Pain Matters, a Healthcare Innovation Podcast.” Furthermore, National Public Radio featured Dr. Durbhakula for her educational innovation and its value to public health. At the Johns Hopkins School of Medicine, Dr. Durbhakula serves as the Course Director of the School of Medicine's first-of-class Pain & Opioids Curriculum for all medical students. She has additionally served as the Director of Medical Education for Pain and the Program Director of the Multi-disciplinary Pain Fellowship. Dr. Durbhakula created and produced "Pain Rounds" with funding from public and private partners. Dr. Durbhakula takes a scientific and evidence-based approach to innovation. This is reflected in her NIH-funded research training, multiple research projects, collaborations with esteemed federal partners, and three advanced degrees.