Entanglements of Pediatric Pain Practices in an Acute Care Setting: Critical Participatory Action Research with Student Co-Researchers in an Interprofessional Education Context

Abstract

Children’s pain continues to be undertreated despite extensive research over the past five decades and this has ethical implications for practice. In this inquiry, I examine pediatric pain practices in my local health region through critical participatory action research (CPAR) with eight student co-researchers. CPAR is aligned with a clinical interprofessional education (IPE) experience in pediatric pain where students from medicine, nursing and psychology had varying degrees of involvement. As a facultystudent research team we explored the perspectives of 226 participants (children, parents, students, and health care professionals) on pediatric pain management. Data was gathered through interviews, focus groups and questionnaires. All participant groups identified the need for improvement in pediatric pain management. Several barriers were identified and suggestions were made for change. In the presentation of findings, data are entangled with critical theory, post-structuralism (genealogy) and post qualitative concepts (diffraction, rhizoanalysis). Vignettes of children in pain are presented using long quotes and raw data. This inquiry demonstrates the benefits of CPAR in creating awareness about pediatric pain and seeking local recommendations for change, as well as the benefits of combining CPAR with a student clinical IPE experience. Co-researcher discussions illuminate emotions experienced when witnessing the undertreatment of children’s pain and struggles with power when attempting to advocate. Co-researchers describe the benefits of participating in CPAR including learning about pediatric pain, opportunities for interprofessional collaboration (IPC) and implementation of action items. Identified challenges include blurring of student-researcher roles, student power imbalances and ethical issues with participation. Recommendations include further examination of student-faculty research partnerships, examination of student ethical distress in pediatric clinical settings, exploration of opportunities for patient-studentfaculty research partnerships, and engagement with the realism of post qualitative inquiry.