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The Effects of Medical Evidence and Pain Intensity on Medical Student Judgments of Chronic Pain Patients
Authors:John T. Chibnall  Raymond C. Tait  Lisa R. Ross
Affiliation:(1) Department of Psychiatry, Saint Louis University School of Medicine, 1221 South Grand Boulevard, St. Louis, Missouri, 63104;(2) SSM Rehabilitation Institute, Hazelwood, Missouri, 63042;(3) Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, 63110
Abstract:This study examined symptom judgments made by medical students of hypothetical chronic low back pain patients. Eight vignettes were varied as to the pain intensity reported by the hypothetical patient (low vs. moderate vs. high vs. very high) and the availability of medical evidence supportive of the pain report (present vs. absent). Ninety-five subjects read vignettes and made judgments of patient emotional distress, pain intensity, and pain-related disability. Subjects significantly discounted pain level when intensity was high but slightly augmented pain level when intensity was low. Judgments of pain and disability were higher for patients for whom medical evidence was present compared to those for whom it was absent. The results support and extend previous research on the effects of situational and patient variables on observer pain judgments. Future research should examine the influence of these biasing variables on the assessment and treatment of chronic pain patients.
Keywords:chronic pain  symptom judgments  medical students
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