TABLE 1.

Dimensions included in the Epstein and Hundert (10) model of professional development, and applications to teaching clinical pain care (in this example, applications are described that might pertain to a student learning about assessment, diagnosis and management of persistent headache)

Dimension	Application
Cognitive	Name five antidepressants that are effective against persistent pain. Describe the pain processing system (nociceptive pathways) that signals pain in this region
Emotional	Recognize that pain can impact mood and acknowledge the medical student’s or physician’s role in addressing depressed mood. Accept that you may feel sad or have other feelings after encountering a patient with depressed mood related to pain
Reflective	Consider how your particular approach to a patient in pain may have impacted the patient: did they feel comforted or did they perceive that their concerns were disregarded?
Technical skills	Query patients about the impact of pain on sleep, function, enjoyment of life. Know how to gauge the severity of effects in various domains and apply appropriate instruments
Values formation	Adopt a nonjudgmental stance toward patients who report severe pain even though acute trauma is not apparent, and seek to restore function while obtaining adequate analgesia
Communication	Ask a patient about the cardinal characteristics of their pain, but also provide support and counseling where appropriate. Exchange informational details as well as conveying empathy and acting with compassion
Clinical reasoning	Formulate a differential diagnosis, identifying more and less catastrophic diagnoses. Plan a diagnostic work-up based on the history and physical examination