• Christopher P Dwyer, Pádraig MacNeela, Hannah Durand, Laura L O'Connor, Chris J Main, Phoebe E McKenna-Plumley, Robert M Hamm, Bronagh Reynolds, Sinéad Conneely, Brian W Slattery, Darragh Taheny, Saoirse NicGabhainn, Andrew W Murphy, Thomas Kropmans, and Brian E McGuire.
• Centre for Pain Research, National University of Ireland, Galway, Ireland.
• Pain Med. 2020 May 1; 21 (5): 939-950.

BackgroundChronic lower back pain (CLBP) is a major health care burden and often results in workplace absenteeism. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions informed by the flags approach, which integrates cognitive and behavioral approaches via identification of biopsychosocial barriers to recovery, have resulted in reduced pain-related work absences and increased return to work for individuals with CLBP. However, research indicates that physicians' adherence to biopsychosocial guidelines is low.ObjectiveThe current study examined the effects of a flags approach-based educational intervention on clinical judgments of medical students and general practitioner (GP) trainees regarding the risk of future disability of CLBP patients.DesignRandomized controlled trial (trial registration number: ISRCTN53670726).SettingUniversity classroom.SubjectsMedical students and GP trainees.MethodsUsing 40 fictional CLBP cases, differences in clinical judgment accuracy, weighting, and speed (experimental N = 32) were examined pre- and postintervention, as were flags approach knowledge, pain attitudes and beliefs, and empathy, in comparison with a no-intervention control group (control N = 31).ResultsResults revealed positive effects of the educational intervention on flags approach knowledge, pain-related attitudes and beliefs, and judgment weighting of psychologically based cues; results are discussed in light of existing theory and research.ConclusionsShort flags approach-based educational video interventions on clinical judgment-making regarding the risk of future disability of CLBP patients may provide opportunities to gain biopsychosocial knowledge, overcome associated attitude barriers, and facilitate development of clinical judgment-making more aligned with psychological cues.© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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