Description

The Mayo Clinic comprehensive Pain Rehabilitation Center (PRC), established in 1974, is a hospital-based outpatient group treatment rehabilitation program aimed at helping patients with chronic pain experience functional restoration and enhanced quality of life. This is achieved through learning self-management of their symptoms and decreased use of medications and reliance on health care utilization.

You work directly with an interdisciplinary treatment team, including a consulting psychologist or psychiatrist, in the case conceptualization and evidence-based cognitive behavioral treatment of pediatric or adult patients with chronic pain and other somatic symptoms.

Specific goals

1. Develop an understanding of the biopsychosocial theories of acute versus chronic pain and reduced function associated with chronic pain in pediatric or adult populations
2. Develop an understanding of the concept of functional restoration to regain or maintain age-appropriate functioning
3. Develop experience in the case conceptualization of medical, psychiatric or psychological, and psychosocial factors impacting the experience of chronic pain
4. Gain exposure to a comprehensive pain rehabilitation curriculum for patients and their families through observation of group-based psychoeducation classes
5. Gain experience in patient group facilitation to deliver evidence-based cognitive behavioral psychoeducation under the supervision of a consulting psychologist
6. Gain experience in working with an interdisciplinary pain rehabilitation team
7. Develop an understanding of the literature of pain and pain rehabilitation that influences clinical practice, including the rationale for tapering opioid medications and the effective use of behavioral strategies to enhance function despite chronic symptoms
8. Verbalize how the functional restoration and self-management approach to pain rehabilitation will influence ongoing case conceptualization and medical practice, regardless of your chosen area of medical specialty

Activity outline

You begin your rotation with observation of a group-based pain rehabilitation curriculum delivered to patients with chronic pain symptoms. You participate in morning interdisciplinary rounds with the clinical team designed to track patients' progress with medication tapering, self-identified functional goals and implementation of program concepts.

As you progress through the rotation, you are expected to verbalize pertinent patient observations in interdisciplinary rounds. Case conceptualization is discussed and you select specific patients to follow through the patient's course of treatment in order to be able to verbalize a comprehensive conceptualization of medical, psychiatric or psychological, and psychosocial factors that impact the patient's experience of chronic pain and symptoms.

Toward the end of the rotation, you gain experience in the facilitation of patient group treatment, as supervised by a consulting psychologist. You also are expected to reflect on and verbalize how the functional restoration and self-management approach to pain rehabilitation will influence their ongoing case conceptualization and future medical practice, regardless of their chosen area of medical specialty.

Throughout the rotation, you have a series of individual supervisory sessions with the consulting psychologist to discuss your clinical observations, group facilitation, case conceptualization and reflection on your medical practice.

Method of evaluation

A general performance review is provided verbally and formally (in writing) at the end of the elective.

Per Mayo Clinic institutional policy, faculty and residents/fellows will not complete any outside evaluations. You will be provided with an electronic performance evaluation via Mayo Clinic’s MedHub portal. A final summative evaluation will be sent to you and your school official upon completion of your clerkship.