International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students

Jagjit Mankelow, Cormac Ryan, Paul Taylor, Marie-Brid Casey, Jenni Naisby, Kate Thompson, Joseph McVeigh, Chris Seenan, Kay Cooper, Paul Hendrick, Donna Brown, William Gibson, Mervyn Travers, Norelee Kennedy, Cliona O'Riordan, Denis Martin

Research output: Contribution to journalArticlepeer-review

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Background: Persistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students’ pain related knowledge and attitudes. The secondary aim was to explore what factors influence students’ pain related knowledge and attitudes. Methods: In this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes]. Results: Physiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01) and attitudes (-17.2, -19.2 to 15.2, p = 0.01) between first and final year. Pain education teaching varied considerably from course to course (0 to 40 h), with greater levels of pain related knowledge and attitudes associated with higher volumes of pain specific teaching. Conclusions: There was little difference in pain knowledge and attitudes between all first and final year NMAHP students other than physiotherapy. This suggests that for most NMAHP disciplines, undergraduate teaching has little or no impact on students’ understanding of pain. There is an urgent need to enhance pain education provision at the undergraduate level in NMAHPs. Trial Registration: The study protocol was prospectively registered at ClinicalTrials.Gov NCT03522857.

Original languageEnglish
Article number547
Pages (from-to)1-11
Number of pages11
JournalBMC Medicine
Issue number1
Early online date15 Jul 2022
Publication statusPublished online - 15 Jul 2022

Bibliographical note

The Musculoskeletal Association for Chartered Physiotherapists has permitted funding to be used for dissemination of this study.

Funding Information:
The authors acknowledge the contribution of colleagues at each university who assisted data collection.

Publisher Copyright:
© 2022, The Author(s).


  • Pain education
  • Attitude
  • Midwifery
  • Humans
  • Students, Health Occupations
  • Students, Nursing
  • Surveys and Questionnaires
  • Healthcare students
  • Cross-section
  • Pain
  • Pregnancy
  • Health Kno0wledge, Attitudes, Practice
  • Female
  • Cross-Sectional Studies
  • Health Knowledge, Attitudes, Practice


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