Moving from theory to practice: Barriers and facilitators to physiotherapy students’ use of the biopsychosocial approach in the management of chronic pain

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Abstract Background: Chronic pain poses a challenge to the health and well-being of people globally. A biopsychosocial approach is recommended for the management of chronic pain. Little is known about how the curriculum prepares students to apply this approach in practice. The aim of this study was to explore the facilitators and barriers for the use of the biopsychosocial approach, as experienced by physiotherapy students. Methods: The study utilised a case study approach located within an interpretive paradigm. Purposive and snowball sampling were used to select physiotherapy students in their clinical years. In-depth interviews were conducted over Microsoft Teams using a semi-structured interview guide. The interviews were recorded, transcribed and coded after which thematic analysis was conducted. Results: The study found that students were aware of the biopsychosocial approach and understood its importance in theory but had difficulty translating their theoretical understanding to practice. Facilitators to the use of the approach included positive attitudes towards patients with chronic pain, good interpersonal skills, emotional awareness, effective clinical supervision, guidance from supervisors and personal experience with pain. Barriers to the use of this approach included negative attitudes towards patients with chronic pain, clinical supervision and minimal interaction with members of the interdisciplinary team. Conclusion: The study highlights the gap between theoretical training and practice when using the biopsychosocial model when treating patients with chronic pain. The importance of supporting and guiding students when treating patients with chronic pain is emphasised. The use of a biopsychosocial approach and an interdisciplinary team must be encouraged in practice.

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