Pain-Me-Free: A Video Game to Improve Geriatric Pain Management Using a Multi-Discipline Approach

Friday, 28 July 2017

Martha Martinez, MN
Geriatric Research Education Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA
Sandra Sanchez-Reilly, MD
GEC/GRECC, South Texas Veterans Health Care system, San Antonio, TX, USA
Jeanette Ross, MD
School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA


In response to the IOM report the Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME) and American Association of Colleges of Nursing (AACN) recognized the importance adequately preparing healthcare professionals to care for elders and developed minimum geriatrics competency guidelines grounded in evidence-based principles of quality care for older adults. Despite its prevalence, evidence suggests that pain is often poorly assessed/managed, especially in the elderly. The PAIN-ME-FREE (Pain Activity for Inter-professional Nursing and Medical Student Education Focusing on Response, Effectiveness and decreasing side Effects among elders) educational intervention aims to promote collaboration and patient-centered best practices by educating health care trainees in the assessment, diagnosis, and safe treatment of total pain for elders, as an integral part of an inter-professional team.


This interactive game includes video, audio, and text to gain a general history of the patient the learner will be caring for. Intervention targeted nursing (NL) and medical learners (medical students: MS and fellows: F) at a teaching institution. Pain Game had 3 pain-related scenarios (Older Adult (OA) at home, hospitalized OA after fall and OA at rehabilitation facility). Pain Game has questions related to pain assessment, management and opioid side effects. Scores were compared between learners’ groups.

Aim 1. To evaluate the educational effectiveness of a geriatric chronic interactive pain video-game comparing different types of learners from different disciplines and educational levels.

Aim 2. To evaluate the effectiveness of this teaching tool by the learners.


Current data presents: N: 77, 78% female, Ethnicity: 36% Hispanic, 33% Caucasian, 4% African American. When comparing NL vs. MS/F; there were no significant differences related to rating or classifying pain. When asking about naming physical, emotional, social and spiritual factors influencing “total pain” when a patient was suffering, 89.5%F were knowledgeable as compared with 77.8%MS and 47%NL (p=0.02). When deciding on a specific pharmacological pain regimen, 100% MS/F had accurate recommendations vs. only 54% NL (p=0.03). When discussing side effects, 100% MS knew opioids caused constipation and how to treat it vs. only 60% NL (p=0.04).


Incorporating chronic pain education into clinician’s curriculum will greatly improve the management of chronic pain for Older Adults. An innovative intervention such as the Pain Game could be ideal to gain such expertise, and is much needed for all learners, including nursing: the forefront of patient care. Reaching to MS and NL early in their education and providing them with the skills and specialized training to treat chronic pain in Older Adults will improve patient satisfaction and overall quality of care.