• Naileshni Singh, Alison A Nielsen, David J Copenhaver, Samir J Sheth, Chin-Shang Li, and Scott M Fishman.
• Education Program, Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, School of Medicine, University of California, Davis, Sacramento, California.
• Pain Med. 2018 Sep 1; 19 (9): 1725-1736.

BackgroundThe Accreditation Council for Graduate Medical Education (ACGME) has recently implemented milestones and competencies as a framework for training fellows in Pain Medicine, but individual programs are left to create educational platforms and assessment tools that meet ACGME standards.ObjectivesIn this article, we discuss the concept of milestone-based competencies and the inherent challenges for implementation in pain medicine. We consider simulation-based education (SBE) as a potential tool for the field to meet ACGME goals through advancing novel learning opportunities, engaging in clinically relevant scenarios, and mastering technical and nontechnical skills.ResultsThe sparse literature on SBE in pain medicine is highlighted, and we describe our pilot experience, which exemplifies a nascent effort that encountered early difficulties in implementing and refining an SBE program.ConclusionsThe many complexities in offering a sophisticated simulated pain curriculum that is valid, reliable, feasible, and acceptable to learners and teachers may only be overcome with coordinated and collaborative efforts among pain medicine training programs and governing institutions.

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