The impact of using pain scales by untrained students on the decision to provide analgesia to multiple species.

Overview

• This study investigated how untrained students assess pain in different animal species compared to an expert, and how the use of validated pain scales influences their decisions to provide analgesia.

Study Objectives

• To determine whether students without formal pain assessment training evaluate animal pain similarly to a board-certified anesthesiologist (expert).
• To compare students’ decisions to provide analgesia based solely on their opinion versus decisions based on scores from species-specific validated pain scales.

Methodology

• Study design: Prospective, blind, randomized, cross-sectional study.
• Subjects: Video recordings of five different species: bull, horse, cat, pig, and sheep.
• Participants:
  • First-year veterinary medicine students (44 for horse videos, 39 for bull videos)
  • Third-year veterinary medicine students (23 for cat videos, 21 for pig videos)
  • Fourth-year animal science students (16 for sheep videos)
• Each student was randomly assigned videos of specific species to assess and was blinded to the animals’ history or prior pain scores.
• Students first decided whether they would provide analgesia based on their opinion.
• Then, students used species-specific validated pain scales to score the pain seen in the videos.
• Scores from students were compared with those from a board-certified anesthesiologist considered the expert evaluator.
• Statistical tests including Chi-square were used to compare analgesic decisions between groups.

Key Findings

• Students generally underestimated the expert’s pain scores by 8-20%, except when assessing horses where the difference was not significant.
• Despite underestimating pain, nearly all students recommended analgesia at the same threshold as the expert:
  • Expert indicated analgesic intervention in 143 out of 143 evaluations (100%).
  • Students indicated analgesic intervention in 141 out of 143 evaluations (98.6%), which was not a statistically significant difference (p = 0.478).
• When deciding based on their own opinion without using pain scales, students recommended analgesics less frequently (81.1%) than when using the scale-derived scores (98.6%), a significant difference (p < 0.0001).

Conclusions

• Untrained students tend to underestimate the intensity of pain animals experience but are still capable of recognizing when animals require analgesic treatment similarly to an expert evaluator.
• The use of validated pain scales significantly improves students’ accuracy in recommending analgesia, optimizing pain management decisions compared to relying on subjective opinion alone.
• Incorporating pain scales in veterinary education could enhance early recognition and treatment of pain in multiple animal species.