Course Descriptions

Core Courses

PREP 230 Neuroscience of Pain:  From Society to Synapse

(Fall - 1.0 cr)
This course presents theory and research on the anatomical structures and physiological processes involved in the transmission and modulation of pain. Peripheral mechanisms, central mechanisms of nociceptive transmission, and the involvement of higher centers (thalamic nuclei and cortical areas) involved in pain are differentiated. In addition, the course presents information on the brain stem regions involved in modulation of nociceptive transmission, their interconnections, their spinal projections, and the effects of electrical or chemical stimulation. Opioid analgesia is distinguished from nonopioid forms of analgesia. In addition, the course presents the pharmacology of pain transmission and its modulation focusing on peripheral mechanisms; synaptic transmission in the dorsal horn; central sensitization; and the role of neurotransmitters in pain.

PREP 232 Ethical and Sociocultural Aspects of Pain

(even years Fall, odd years Summer - 1.0 cr)
Pain is a ubiquitous experience transcending space and time. The ways in which individuals experience pain, express pain, respond to pain and treatments prescribed for pain varies across these dimensions. In addition, public and institutional policies designed, proposed and implemented to relieve pain vary by time and geography. Pain is an individual as well as a group phenomenon. There is an uneven distribution of pain, and its associated chronic diseases in the US, and access to appropriate pain care appears to be is inequitably distributed in the US as well. This course will present theory and research concerning factors (cultural, social, psychological, political, ethical and economic) related to pain assessment, pain treatment, receptivity to treatment and treatment outcomes. It will provide an overview of the epidemiology of pain as well as the clinical, societal and institutional policies to alleviate it. The importance of the patient/clinician relationship and the many factors that influence it will be emphasized throughout the course.

PREP 233 Palliative Care and End of Life Issues

(odd years Fall, even years Summer - 1.0 cr)
Palliative care has emerged as a significant and legitimate interdisciplinary care model under strong medical leadership with a growing research and outcomes-based foundation. Palliative care and hospice services are generally underutilized and undervalued by healthcare professionals and the public, requiring a new approach to integration. This course provides a broad overview of palliative medicine practices, potential for integration into traditional medicine, with detailed attention to skills development in pain, symptom management, and communication as well as illumination of ethical, legal, public policy, and regulatory issues.

PREP 234 Introduction to Clinical Pain Problems

(Spring - 1.0 cr)
This course will introduce the general principles of biomedical evaluation and management of common clinical pain problems. It will present ways to evaluate the biomedical characteristics of the pain experience (temporal pattern, severity, location, quality, intensity and exacerbating and relieving factors). Students will become familiar with common standardized instruments to assess pain and pain-related outcomes. Students will learn to recognize the mechanisms of pain present in common clinical pain syndromes, to understand the rationale for current-day assessment and treatment of these problems by multiple healthcare disciplines, and to evaluate the impact of concurrent medical disease upon pain symptoms. Throughout the course, emphasis will be placed upon viewing superficially diverse pain syndromes as part of a fundamentally unified group of processes.

PREP 235 Public Policy, Legislative and Forensic Issues

(Fall - 1.0 cr)
This course explores medico-legal issues affecting the way pain is managed. Individual practice issues that expose professionals to litigation, workplace policies and standards, and regulatory issues are covered. Emphasis is placed on what individuals can do to advocate for better pain control in local, regional, national and international arenas.

PREP 236 Principles of Change and Education Applied to Pain Management

(Spring - 0.5 cr)
Despite numerous efforts to improve pain management over the last 30 years, many clinical and institutional practices remain unchanged. Multiple barriers have been identified such as low patient expectations, clinicians' lack of pain management knowledge, opioid-phobia at the patient, clinician, and systems levels, failure to make pain management an institutional priority, and outdated or inappropriate health policies. The purpose of this course is to address this pervasive resistance to change by training students to become outspoken "pain management champions" in a variety of clinical and organizational settings. Students learn about the principles of needs assessment, change, leadership, and education at all levels of health care delivery, enabling them to develop workable strategies to comprehensively improve the management of pain.

PREP 238 Evaluation and Treatment of Pain: Psychological Approaches

(Spring - 0.5 cr)
This course is intended to illustrate the role of psychology in the assessment and treatment of pain. Topics covered include the biopsychosocial model of pain, co-morbid psychiatric conditions often accompanying pain, identification of patients would benefit from psychosocial evaluation, standard psychological testing utilized in chronic pain, motivation and stages of change in treatment planning, opioids and addiction in chronic pain, and multiple psychological treatment strategies.

PREP 240 Complementary Medicine

(Spring - 0.5 cr)
Contemporary medicine finds itself in a curious situation. Even with an unending succession of spectacular biomedical achievements, one after the next, the American public's interest and enthusiasm for medical alternatives remains high. This course takes a critical look at complementary and alternative medicine (CAM) from various perspectives: historical, philosophical, scientific, and clinical. We will also examine its effects on the health of the public. Our main objectives will be to (1) explore CAM in the context of an allopathic medical system under increasing economic and social pressure, (2) evaluate the clinical effectiveness of some of the most popular CAM therapies and explore plausible mechanisms to explain their alleged health effects, (3) consider how the use of CAM and its widespread adoption could affect the health of individuals and populations, and (4) observe how actual healers practice their trade. The management of chronic pain will be the main focus of the course.

PREP 241 Medical Acupuncture*

(Summer - 0.5 cr)
(Required course for New England School of Acupuncture joint degree program students only)
As acupuncture has grown in popularity in the West, biomedical researchers have been eager to understand how the precise placement of needles superficially in the skin could produce measurable clinical effects. An impressive accumulation of research already demonstrates acupunctures ability to predictably stimulate neuroendocrine responses in humans, even in the absence of a clear correlation between acupuncture points and major neurovascular pathways. The most convincing findings to date have been in area of pain physiology. This course will explore in detail the current scientific inquiry devoted to uncovering a western-oriented explanation for the analgesic effects of acupuncture, and the clinical applications of this provocative work.

PREP 251 Capstone Project Planning Phase

(Fall, Spring, Summer (1 & 2) - 0.5 cr)
All students in the PREP program are required to complete a two-semester Capstone Project prior to graduation. The purpose of the Capstone Project is to offer students the opportunity to integrate and apply the knowledge and skills they have learned in the classroom to comprehensively address a clinical, public health and/or social problem pertaining to pain. The Project occurs over two adjacent semesters during the final year of the program. PREP 251 is devoted to the planning phase of the capstone project.

PREP 252 Capstone Project Implementation Phase

(Fall, Spring, Summer (1&2) - 0.5 cr)
(pre-req. PREP0251) All students in the PREP program are required to complete a two-semester Capstone Project prior to graduation. The purpose of the Capstone Project is to offer students the opportunity to integrate and apply the knowledge and skills they have learned in the classroom to comprehensively address a clinical, public health and/or social problem pertaining to pain. The Project occurs over two adjacent semesters during the final year of the program. PREP 252 is devoted to the implementation phase of the capstone project.

HCOM 502 Epidemiology - Biostatistics: Reading and Interpreting the Medical Literature

(Spring - 1.0 cr)
Lectures and small group exercises introduce students to the concepts and methods of epidemiology and biostatistics. The course is divided into two components. The initial component presents basic methods for measuring disease frequency and for quantifying relationships between determinants of health and medical and/or public health outcomes. Students are also provided with fundamental skills for the critical evaluation of biomedical and epidemiological literature. The second part of the course explores in detail the principles of epidemiological research design and their application to a critical evaluation of the literature.

HCOM 504 Introduction to Medicine**

(Fall - 1.0 cr)
This course is an introduction to biomedical science and its application to clinical medicine. It explores how doctors think about their patients, make decisions on their behalf, and gauge the success of their interventions. The objective of the course is to critically examine the connection between health outcomes and the clinical application of biomedicine. Students take an evidence-based approach in their assessment of the technology physicians routinely use to diagnosis and treat their patients; the physical, emotional and economic effects of this technology; and the use and effectiveness of its alternatives. Students "practice" clinical medicine by obtaining medical histories from each other, developing a differential diagnosis, and planning a course of treatment. They also investigate alternatives to the conventional treatment of a specific medical problem, appraise the evidence supporting the effectiveness of these interventions, and develop a management strategy that comprehensively incorporates both conventional and unconventional approaches. * For students without health science experience.

Electives

PREP 231 Pharmacoeconomics

(Every other year - 0.5 cr)
This class consists of a mix of lectures and discussions, split evenly between the methodology of pharmacoeconomics and the practical application of this discipline. The course is conducted as a series of lectures and seminars, and students are expected to contribute to the discussion in class. This course is taught at an introductory level, and prior knowledge of economics is not required. Students are introduced to key concepts in health economics, such as health care as an economic commodity, competition in the pharmaceutical and medical device industry, drug pricing and economic evaluations. The course also covers key areas of study design and data collection, both prospective and retrospective. Students learn to design and evaluate outcomes studies and assess the impact that these studies have on health care delivery.

PREP 243 Clinical Perspectives in Pain Management

(Spring - 0.5 cr)
The purpose of this course is to introduce students to pain medicine as it's practiced at the point of care. It combines in class discussion and patient interviews with visits to area pain care facilities. At those visits, students accompany pain practitioners from various disciplines as they see patients suffering from a variety of painful conditions. During intervening classroom sessions, students present the most interesting cases they encountered the previous week for discussion with faculty and fellow students. Live patient interviews supplement these student presentations. During the final classroom session, students present an in-depth, evidence-based case study on one of the patients they encountered during their clinical sessions.

PREP 244  Interprofessional Team Management of Pain

(Summer 1 – 0.5 cr)
Today’s health care is increasingly delivered by groups of health care providers with diverse professional training, roles and identities. Lack of coordination and communication between health professionals frequently leads to suboptimal or adverse patient outcomes and lower patient satisfaction, carries risk management challenges, and provokes provider dissatisfaction and burnout. This course provides tools to analyze and if needed repair group dynamics within interprofessional teams such as the medical home. Attendees will acquire knowledge and skills for achieving real-world outcomes crucial to patient-centered care, with an emphasis upon pain and its treatment.

PREP 245  Controlled Substances and their Alternatives for Pain: Inter-Professional Context and Controversies

(even years, Spring - 0.5 cr)
Evidence-based practice guidelines typically support interdisciplinary approaches for the most complex pain patients, yet, clinician time constraints, patient demand for pharmaceutical interventions and more passive strategies, along with possible influence from industry, can result in more narrowly focused pharmaceutical management approaches. In some cases, these approaches have involved chronic opioid management for treatment of resistant pain conditions. Medical and nonmedical use of opioids has been more recently recognized as resulting in significant morbidity and mortality and led scientific and regulatory initiatives to modify guidelines for prescribing opioids for chronic, non-cancer pain. Nonetheless, adherence to a best practice approach likely remains poor, e.g., a review of practices from a similar state revealed 100% non-compliance with respect to a legally mandated chronic opioid therapy guideline. This course examines the epidemiology and public policy, cautions and best practices for prescribing controlled substances in pain management, along with recent controversies, particularly for opioids and marijuana.

PREP 246  Public Health Applications of Mindfulness to the Experience of Pain and Chronic Illness

(Spring - 0.5 cr)
The application of mindfulness to the experiences of pain, chronic illness and health behavior in general has grown, yet it remains underutilized and often undervalued by healthcare clinicians, public health professionals and the general public. Students in this course will be introduced to the concept of mindfulness.  The will explore its historical development from its early roots in Eastern meditative practice through significant Western cultural trends to its current focus in evidence-based research in medical centers, universities and health behavior change initiatives. From the individual to the society, mindfulness is now playing a larger role in the understanding of complex biopsychosocial phenomena.

PREP 247 Design and Appraisal of Analgesic Trials

(Spring - 0.5 cr)
Enrollees in this course will review selected classic and recent publications in pain research.  In conjunction with the Course Director, enrollees will critically evaluate these publications in similar detail as might be undertaken by a referee for a peer-reviewed journal.  The readings will be arrived at by consensus at the beginning of the course, and might range from clinical analgesic trials to systematic reviews of effects and side effects of a specific health-related intervention.   Student assessments for this course will reflect the depth and breadth of enrollees’ preparation each week, their discussions of the strengths and weaknesses of the literature reviewed, and an oral presentation formally evaluating the hypothesis, methodology, strengths and weaknesses of a publication selected by prior mutual agreement with the Course Director.  Wherever possible, the weekly teleconference will involve one or more investigators (denoted by an asterisk in the reading list below) directly involved in the published research reports.  The first-hand accounts of the latter may include what led them to undertake the trial, why they designed it as they did, key and/or surprising results, and their impressions of the strengths and weaknesses of the trial (both anticipated and
unanticipated).

PH 215  Public Health & Health Care: Politics, Policies & Programs

(Fall, Spring, Summer - 1.0 cr)
This course is an overview of the theory, organization, policies, politics, and practices that have shaped public health and health care services in the United States. Students learn about the forces that influence the substance and process of public health and health care delivery. They are also challenged to think about ways in which various stakeholders, including health professionals (clinical and administrative), commercial interests, governmental officials, and the public have come to interact in the evolution of public health and health care delivery systems. The issues of access, cost, quality and health disparities are used to frame aspects of theory, policy, and practice as well as to provide evidence of the opportunities and challenges in the integration of public health and health care services. Finally, students are exposed to some quantitative and qualitative tools and methods used by practitioners in public health planning and in fostering community involvement.

PH 222  Survey Research & Data Management

(Fall, Spring - 1.0 cr)
In this course, real world examples are used to introduce students to basic survey methodology and data management. Students have the opportunity to practice the fundamentals of good survey design and how to enter, code and clean collected data. Topics include formulating research questions, sampling, sample size determination, linking instruments to conceptual frameworks, principles of item construction and scale development, modes of survey administration, and qualitative methods. The second part of the course provides hands-on experience in data coding, entry, and management. Prerequisite: core epidemiology and biostatistics.

PH 542  Race, Culture, and Ethnicity

(Spring - 1.0 cr)
This course examines the ideological, institutional, social, and professional dimensions of culture(including class, gender and sexual orientation as facets of group and personal identity), race and ethnicity, and their effects on health status, research, planning and service delivery. The course will also explore the role of history, power, and the economy as they relate to societal inequality among diverse cultural groups, and their influence on the current policies, institutional arrangements, service delivery models, and professional practices in health services. Cultural competency will be discussed, and more appropriate methods of practice will be analyzed.

HCOM 506 Online Consumer Health

(Fall - 0.5 cr)
The course teaches the skills to design health websites, and redesign existing ones, to provide sites that are appealing, usable, and effective at achieving their goals. You will learn how to meet the needs of your target user population through developing personas and scenarios, how to learn from and differentiate your site from competitors' sites through competitive analysis, and how to conduct formative and heuristic evaluations to improve site effectiveness. The course covers the different types of content, including how to create expert-generated content, how to solicit and manage user-generated content, how to select imagery, and how to select a site name, tagline, and logo. For the course project, you will design a new health website or redesign an existing one using the skills you learn in class.

HCOM 510  Patient Provider Interaction

(Summer - 1.0 cr)
This course provides an overview of patient-provider interactions, surveying the field from initial conceptual communication models to the current development of participatory decision-making, examining the significant public health and policy implications. Various providers and their inter-relationships are covered, and recent health care financing and regulatory influences explored. Differences in provider and patient goals are assessed; methods for analyzing patient-provider interactions, and measuring patient satisfaction and quality are reviewed. Health disparities, and the effects of age, gender, ethnicity, race, and class on interaction are examined; policy challenges are debated. Different types of encounters are illustrated, including health promotion and risk communication, issues around dying and death, acute pain and trauma, and chronic pain and other disabilities. The public health significance and adverse effects of patient-provider interactions are detailed and policy alternatives framed. Types of communication excellence are highlighted, and progressive improvements in interaction quality and effectiveness are examined.

HCOM 515  Mobile Health Design

(Summer Semester – 1.0 cr)
This online course examines the impact and potential of mobile devices for health, a growing area of importance since many health organizations have or are thinking about creating apps. Using design methodologies, students will conceptualize and design health apps that incorporate evidence-based guidelines and capitalize on the mobility, portability, and input and output capabilities of smartphones and tablets. We will consider the user experience: how healthcare consumers locate health apps and decide to download and try them; how they use health apps and why they sustain or abandon use; and studies of health benefits, focusing on how apps educate, connect, track, and remind. We will also examine global use of mobile devices. The course is a mixture of lecture and discussion, with guest lecturers bringing their expertise and perspectives, and work in teams to design health apps using the techniques covered in class. A final paper will be required as well. Course lecture and discussions will use Adobe Connect and Google+ Hangouts. 

HCOM 522  Changing Health Behaviors: Healthy People and Communities

(Fall, Spring, Summer - 1.0 cr)
This course provides an overview of the scientific basis for understanding human health behavior, the forces that shape and influence behavioral health policies, and the practical issues involved with implementing programs and policies to alter health behavior. The course makes extensive use of numerous faculty from the Boston area as well as media materials from current and past public health campaigns.

HCOM 544  Professional Communication

(Fall, Spring, 0.5 cr)
The course is designed to provide students with knowledge, experience, and practical skills in public presentations. Students will learn how to organize, research, support, and deliver impromptu, informative, and persuasive presentations, as well as manage a press conference in a simulated crisis situation. Through lectures, discussions, exercises, applications, and written assignments, students will increase their communication competence so that they can become more effective communicators in their field.

NUTR 220  Introduction to Writing About Nutrition and Health

(Fall - 1.0 cr)
This course reinforces the skills necessary to write nutrition, science, and health-related papers that are clear, accurate, and audience-appropriate. It is a practical review of writing and revision, enabling students to develop clear, fluent, and readable styles. It includes both individual and collaborative exercises and requires weekly writing assignments, rewrites, and a journal. Students in the MS-PREP program will be required to choose pain related topics for their written assignments.

CRES 545  Psychometrics and Outcomes Measurement

(Spring - 1.0 cr)
This course presents issues involved in the measurement of pain and analgesia. It critically examines assessment instruments specifically designed to measure pain, as well as pain measures in quality of life and health surveys. Students learn about research design as well as the conduct of clinical trials and the evaluation of their results. Special emphasis is given to clinical outcomes research. In addition, ethical issues involved in pain research are presented. Concepts covered in class are reinforced through concurrent projects employing computerized databases and statistical software packages.