Brazilian physical therapy educators' perspectives on pain education and pain curriculum implementation: A mixed-methods study.
Abstract
Background
Pain is a leading cause of disability worldwide, yet its integration into undergraduate physical therapy education remains inconsistently implemented. Despite the availability of international curricular frameworks, gaps persist between pain science and educational practice.
Objectives
To investigate physical therapy educators' self-perceived adequacy of knowledge and perspectives regarding the International Association for the Study of Pain (IASP) pain curriculum and to explore how pain education is understood and implemented in undergraduate training in Brazil.
Methods
We conducted a mixed-methods study combining a cross-sectional survey (n = 89) and semi-structured interviews (n = 23). The survey assessed perceived knowledge across domains of the IASP curriculum, while qualitative data were analyzed using reflexive thematic analysis to explore educators' experiences and perspectives.
Results
The proportion of educators rating their knowledge as adequate varied across domains, with higher proportions for clinically familiar topics (e.g., multidimensional pain, communication, and exercise-based management) and lower proportions for more complex or less emphasized areas (e.g., neurophysiology, psychophysical assessment, digital health, and at-risk populations). Qualitative findings revealed that pain is considered central to clinical practice but remains marginal within curricula, often lacking dedicated space. Barriers included limited faculty training, curricular rigidity, and reliance on individual educators rather than institutional structures. Interview participants also described difficulties translating conceptual knowledge into clinical application.
Conclusion
Among participating Brazilian physical therapy educators, pain education was described as fragmented and inconsistently aligned with international standards. The main challenge appeared to involve translating existing curricular frameworks into structured, competency-oriented teaching and clinical training.