Description

The Mayo Clinic comprehensive Pain Rehabilitation Center (PRC) was established in 1974, and is a hospital-based outpatient program. The program helps patients with chronic pain achieve functional restoration and an 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. The team focuses on case conceptualization and evidence-based cognitive behavioral treatment. Training includes pediatric and adult patients with chronic pain and other somatic symptoms.

Specific goals

1. Develop an understanding of biopsychosocial theories of acute and chronic pain. Training explores reduced function associated with chronic pain in pediatric and 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 pain and pain rehabilitation literature that influences clinical practice. You learn the rationale for tapering opioid medications and the effective use of behavioral strategies. These strategies help enhance function despite chronic symptoms
8. Verbalize how the functional restoration and self-management approach influences ongoing case conceptualization. You also discuss how these principles affect medical practice, regardless of your chosen 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. The rounds are designed to track progress with medication tapering, functional goals, and program concepts.

As you progress through the rotation, you are expected to verbalize pertinent patient observations in interdisciplinary rounds. Case conceptualization is discussed throughout training, and you follow selected patients through treatment. This experience helps you understand the medical, psychiatric, psychological, and psychosocial factors affecting chronic pain. You learn how these factors influence patient symptoms and experiences.

Toward the end of the rotation, you gain experience in facilitating patient group treatment. This work is supervised by a consulting psychologist. You are expected to reflect on and discuss the functional restoration and self-management approach to pain rehabilitation. You also consider how these principles influence ongoing case conceptualization and future medical practice. This applies regardless of your chosen medical specialty.

Throughout the rotation, you participate in individual supervisory sessions with the consulting psychologist. These sessions focus on clinical observations, group facilitation, case conceptualization, and reflection on 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.