Pain Knowledge and Attitudes of Health Professional Undergraduate Students in Spain: A Cross‐Sectional Observational Study

Abstract

BACKGROUND: A solid foundation in pain science and evidence-based biopsychosocial approaches is essential for quality pain management. Understanding how health professional students' pain knowledge and attitudes evolve during their studies can guide curriculum development. This study compared pain knowledge and attitudes (a) between first- and final-year undergraduate students in Medicine, Nursing, Pharmacy and Physiotherapy, and (b) among final-year students across these disciplines. METHODS: This cross-sectional, observational study recruited students from six Spanish universities. An online survey, which included the Revised Neurophysiology of Pain Questionnaire (RNPQ) to assess pain knowledge and the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) to assess pain attitudes and beliefs, was completed by first- and final-year students. RESULTS: Seven hundred and fifteen students (527 female, 188 male) completed the survey. Comparisons between first and final year students in each discipline showed that Medical and Physiotherapy students improved their scores in both RNPQ (p < 0.001) and HC-PAIRS (p = 0.026 and p < 0.001 respectively). Pharmacy students only showed improvements in RNPQ (RPNQ: p < 0.001; HC-PAIRS: p = 0.313), while Nursing students showed no differences (RPNQ: p = 0.711; HC-PAIRS: p = 0.875). Comparisons between disciplines at final year showed that Physiotherapy and Medicine students scored better than Pharmacy and Nursing students in both RNPQ (p < 0.05) and HC-PAIRS (p < 0.05). CONCLUSIONS: Medical and Physiotherapy students seem to achieve higher pain knowledge and more favourable pain attitudes when compared to Pharmacy and Nursing students. Nursing students did not show improvements in either measure. Our findings highlight the need for longitudinal, interprofessional pain education in Spain. SIGNIFICANCE STATEMENT: This multi-center, cross-sectional observational study with a sample of more than 700 students provides important insight into the level of pain knowledge and attitudes among Medicine, Nursing, Pharmacy and Physiotherapy undergraduate students in Spain. Utilizing validated assessment instruments, it identifies significant discipline-specific and year-level differences, offers meaningful findings on gaps in pain education and implications for curriculum development. The observed discipline-specific disparities underscore the need for longitudinal, interprofessional pain education to equip future health professionals for evidence-based pain management.

The authors' abstract, as published at the source. European Journal of Pain, 2026 · DOI ↗