OPEN ACCESSAugust 22, 2012

Management of Nociceptive Pain for Third-Year Medical Students-Team Based Learning (TBL) Format


    This team-based learning (TBL) module covers the use of nonsteroidal anti-inflammatory drugs (NSAIDs), nonopioid, and opioid analgesics in the treatment of nociceptive pain. Students will be required to establish a treatment plan for cases of nociceptive pain and apply multimodal analgesia when appropriate. This TBL case is one of seven bimonthly TBL modules used in the clinical pharmacology course that is offered to third-year medical students at the American University of Beirut Faculty of Medicine. This individual case has so far been used more than six times. We did not evaluate outcomes of each individual module, so the positive outcomes we observed are for the course as a whole. Nevertheless, we have been observing a very high level of student-to-student interaction during all modules in general. Furthermore, as expected with TBL performance on the group readiness assurance test has always been significantly better than performance on the individual readiness assurance test.

    Educational Objectives

    By the end of this resource, learners will be able to:

    1. Work effectively in small groups to solve a clinical therapeutic case scenario.

    2. Differentiate the signs and symptoms of nociceptive and neuropathic pain.

    3. Discuss the treatment of both types of pain.

    4. Differentiate nonopioid analgesics from opioid analgesics.

    5. Classify opioid analgesics by potency.

    6. Choose a proper analgesic regimen for the initial treatment of two cases of nociceptive pain: pain from a bone fracture treated surgically and bone pain in a cancer patient.

    7. Choose a proper add-on analgesic regimen to patients with unsatisfactory nociceptive pain relief.

    8. Explain the major adverse effects of analgesic regimens.

    9. Develop a monitoring plan for the efficacy and toxicity of the chosen analgesic therapy.

    10. Practice good prescribing.


    • Zgheib N.K, Simaan J.A, and R Sabra. Using Team Based Learning to Teach Clinical Pharmacology in Medical School: Student Satisfaction and Improved Performance. Journal of Clinical Pharmacology. 2011 Jul; 51(7):1101–11.MedlineGoogle Scholar
    • Bou Akl I, Ghaddar F, Sabra R, Simaan J, Parmelee D, Zgheib NTeaching Clinical Pharmacology Using Team Based Learning: A Comparison Between Third and Fourth Year Medical Students. Journal of Clinical Pharmacology. 2011 Dec 15. [Epub ahead of print].Google Scholar