Please accept this document of a summary of my learning and activities to date. I began my fellowship with the overarching goal to acquire extensive, comprehensive knowledge and skill in the design, implementation and evaluation of an Acute Pain Service and its use as a pain management strategy for postoperative surgical patients. I have structured this summary in a format that mirrors the objectives of my learning plan which accompanies this document as an appendix.

My first objective was to improve knowledge and understanding of acute pain management as it relates to perception of pain, addiction/dependency/tolerance, modes of analgesia and pharmacological and non-pharmacological measures. Prior to my fellowship I attended an 8 hour pain course offered by my clinical educator and fellowship mentor, Sarah Canning. During my fellowship I attended a two day pain conference in Toronto on “Advancing Pain Assessment and Management across the Life Span”. Various speakers came and spoke on topics such as pharmacological management, non-pharmacological management, acute pain, chronic pain, assessment of pain on different patient populations, and advanced practice roles for pain management. I spent part of a day in the Ambulatory Care department at Bluewater Health in the chronic pain clinic with Dr. Lena, an anesthesiologist. I was able to observe the process of assessing patients and determining treatment. I made a reflective journal from the visit, as I was able to observe various treatments such as blocks and IV lidocaine infusions. I conducted literature reviews as recommended by my mentor. I reviewed the Best Practice Guideline for Pain and reviewed it again once the updated version was available, and I am a champion for the Assessment and Management of Pain Best Practice Guideline at Bluewater Health. Based on various literature reviewed, I made posters regarding various aspects of pain such as addiction, tolerance, dependence, facts on pain, side effects and around the clock analgesia. I used these posters to provide in-servicing to staff for a two-week period. I also made a poster on epidural analgesia discussing motor and sensory block, frequency of monitoring and complications. I had sent out a survey to staff requesting input on what they would like to see, and based on their feedback I developed education sheets on various epidural complications, Patient Controlled Analgesia, pharmacokinetics chart of analgesia, physiology of pain and the WHO ladder. I placed these resources in a folder online for staff access and also developed a pain resource binder that has a hard copy of various resources including learning packages.

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