1 Department of Psychology, Concordia University, Montréal, QC, Canada.
2 Department of Surgery, Université de Montréal, Montréal, QC, Canada.
3 Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada.
4 Division of Anesthesiology, St. Jude Children's Research Hospital, Memphis, TN, USA.
5 Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Introduction: Healthcare provider pain knowledge is critical in surgical settings, where effective pain management plays a key role in the prevention of chronic postsurgical pain. Despite this, little is known about the pain training and knowledge of surgical residents.

Objective: To comprehensively assess Canadian surgery residents' knowledge and attitudes toward pain - including associated factors, training sources, understanding of biopsychosocial and pediatric pain management, and perceived preparedness for managing pain.

Methods: General and orthopedic surgery residents (N = 110, median age = 29.9 years) recruited from 27 accredited residency programs across Canada completed measures of pain training, perceptions, and experience as well as the Knowledge and Attitudes Survey Regarding Pain (KASRP)-a validated 41-item measure of provider pain knowledge. Descriptive statistics examined overall pain knowledge (% correct on the KASRP), pain knowledge sources and training, perceived preparedness, personal pain experiences, and knowledge of the biopsychosocial model. Multiple linear regression examined resident factors (eg, sex, speciality) associated with increased pain knowledge.

Results: Residents scored 75.1% (SD = 8.6, range = 43.9-95.1) on average on the KASRP-which is below the 80% passing score. Three items pertaining to opioid tolerance and opioid administration were answered incorrectly by >70% of residents. In contrast, an average correct score of 86.5% was obtained on pediatric pain knowledge items. Personal experience with postsurgical pain was associated with greater overall pain knowledge (ß = 0.24, P = 0.01).

Conclusion: Canadian surgery residents demonstrated pain knowledge below the level generally considered adequate among health care providers, with areas of relative strength and gaps in knowledge identified. Collectively, these results underscore the importance of expanding both the breadth and depth of surgery residents' pain education and training.