ArticleImpact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: A randomised clinical trialDomenech, J.a,*; Sánchez-Zuriaga, D.b; Segura-Ortí, E.a; Espejo-Tort, B.c; Lisón, J. F.aAuthor Information Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. aDepartment of Physiotherapy, Faculty of Health Sciences. University CEU—Cardenal Herrera, Moncada, Valencia, Spain bDepartment of Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain cDepartment of Methodology and Behavioural Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain *Corresponding author. Address: Facultad Ciencias de la Salud, Departamento de Fisioterapia, Universidad CEU—Cardenal Herrera, Edificio Seminario, s/n 46.113 Moncada, Valencia, Spain. Tel.: +34 96 136 90 00x1370; fax: +34 96 139 52 72. E-mail address:[email protected] Submitted January 24, 2011; revised July 12, 2011; accepted July 26, 2011. Pain: November 2011 - Volume 152 - Issue 11 - p 2557-2563 doi: 10.1016/j.pain.2011.07.023 Buy Metrics Abstract Summary A brief educational module following a biopsychosocial model can positively modify the behaviour of physical therapy students, in contrast to the effects of a strict biomedical approach. The beliefs and attitudes of health care providers may contribute to chronic low back pain (LBP) disability, influencing the recommendations that they provide to their patients. An excessively biomedical style of undergraduate training can increase negative beliefs and attitudes about LBP, whereas instruction following a biopsychosocial model could possibly lessen these negative beliefs in health care professionals. The objectives of this study were to determine the effectiveness of 2 brief educational modules with different orientations (biomedical or biopsychosocial) on changing the beliefs and attitudes of physical therapy students and the recommendations that they give to patients. The intervention in the experimental group was based on the general biopsychosocial model, whereas the sessions in the control group dealt with the basics of the biomechanics of back pain. The participants completed the Fear-Avoidance Beliefs Questionnaire (FABQ), Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS), and Rainville et al. Clinical Cases questionnaire before and after the interventions. The participants attending the biopsychosocial session displayed a reduction in fear-avoidance beliefs (P < .001) and Pain-Impairement beliefs (P < .001), which was strongly correlated with an improvement in clinicians’ activity and work recommendations. However, the students assigned to the biomechanics sessions increased their fear-avoidance scores (P < .01), and their recommendations for activity levels worsened significantly (P < .001). Our results confirm the possibility of modifying the behaviour of students through the modification of their beliefs and attitudes. We also conclude that a strictly biomedical education exacerbates maladaptive beliefs, and consequently results in inadequate activity recommendations. The implications of this study are important for both the development of continuing medical education and the design of the training curriculum for undergraduate students. © 2011 Lippincott Williams & Wilkins, Inc.