MSN Project

My project’s purpose is to help nursing students understand the effects of bias and assumptions on wound care-associated pain management. This presentation was given during the undergraduate nursing J1 assessment lecture.

The slide show includes two case studies for nursing students to observe and analyze. Each case study video includes a pause point where students can discuss with one another which statements or behaviors observed in the video are examples of bias or assumptions that could affect patient care. The conclusion of each video presents a solution that recognizes the bias/assumption and offers an appropriate approach/intervention to address the patient’s pain.

There are three pre-presentation quiz questions at the start of the lecture, followed by the lecture and case studies, and then three post-presentation quiz questions. Comparing pre- and post-presentation quiz question results helped me determine if my presentation and case studies were effective in helping students identify bias and assumptions and understand their effects on patient care. For my project, quiz scores did not affect students’ grades. The students were not informed of this until after the test to help protect the integrity of the evaluation.

The goal of my presentation is to help develop a workforce that understands how failing to identify and mitigate bias and assumptions can negatively affect outcomes for wound care patients. This stage of the project was aimed at nursing students. The results showed students’ understanding of the concepts taught, so after graduation, I will further develop the lesson and eventually market it to other healthcare-related educational programs.

Project Description
This educational module assists nursing students in identifying their biases and assumptions regarding pain management during the adult wound care process. The purpose of this project is to have nursing students examine their own biases when assessing a patient’s pain before, during, and after wound care.

I will present an approximately 30-minute lecture and slide show, along with two case studies in video format for nursing students to watch and analyze. The students will learn to identify bias and assumptions by observing multiple wound care encounters. After a vigorous discussion with other students about what was observed and how to address the situation, the students will resume the case study videos with the correct behaviors presented. The students will have a 3–question quiz before and after the presentation to assess for gained knowledge. This comparison will allow us to see if the students gained an overall understanding of the effects of bias and assumptions on pain management, regardless of the clinical setting.

This project is vital for improving patient care and outcomes. The audience will be future working professionals, namely nursing students. The case studies occur during wound care encounters, but their value remains applicable across all health care settings. Students who enter the workforce prepared to identify bias and assumptions and to advocate for equity in patient pain management will be an essential asset in improving all patient outcomes (Bahari et al., 2024).

Student nurses still need to understand that patients with chronic wounds hesitate to return for ongoing care if they perceive that healthcare professionals disregard or minimize their pain during wound care encounters (Zhou et al., 2025). Student nurses will also see and understand that pain, if disregarded, can result in poor outcomes and diminished trust in the health care system (Bahari et al., 2024).

Examination of the Problem
This project is essential to patients who frequently feel they must choose between enduring unmanaged pain during their care or foregoing treatment to avoid pain (Chitambira, 2019). Even with earlier design changes to this project, the affected parties have not changed. Patients who frequently experience this situation are persons of color (POC) (predominantly women), persons of lower socio-economic status, and persons with comorbidities such as paralysis or developmental disabilities, regardless of the setting (Guzikevits et al., 2024; Lee et al., 2019; Sabin, 2022; Varghese et al., 2020).

Literature Review
My research used the following terms: bias in pain management, pain, chronic wounds, debridement, bias, amputation, neurogenic pain, clinical medicine, wound care, empathy, nurses, doctors, compliance, and non-compliance. I used the TWU library and searched all available databases, including CINAHL, PubMed, Cochrane Library, and MEDLINE database. While I found many pieces of literature discussing elements of my project (bias, pain, empathy, compliance, patient satisfaction, etc.), I was unable to find a current article specifically addressing the effects of bias on pain in the management of the chronic wound care patient population. All but two of the pieces are from within the last 5 years. The two references I included from 2019 were included because their topics were particular and relevant, and I found no more recent published pieces covering those topics. None of this has changed since my last update.
This project will enhance nursing education by educating and encouraging a more empathetic nursing workforce to more honestly address all patients’ pain issues, regardless of cause or setting, thereby increasing compliance, patient satisfaction, and more successful patient outcomes (Wu et al., 2023). Upon completion of this project, the collected data can be used to improve educational materials provided to future nursing students and, perhaps, even to experienced health care professionals (Centers for Disease Control and Prevention [CDC], 2024).

Framework
By utilizing the Universal Design for Learning framework, I intend to reach a broader student audience. Nursing student cohorts have become a multinational mosaic of learners, and I have designed my presentation with this in mind (Howard, 2021). The presentation will be delivered in both written and video formats within a slide deck. The video format will allow students to see how a patient is treated in both functional and dysfunctional situations, while the written information will briefly explain the differences. Not only will the information be presented in multiple ways to facilitate comfortable learning for a variety of audience members, but there will be multiple opportunities for the presentation to be paused so the audience can interact and work to analyze what they are seeing in the videos in conjunction with the information presented in the slides (DePaul University, n.d.). The audience’s interaction with each other and the presenter is intended to allow students to clarify their understanding of the information and how it should be used (DePaul University, n.d.). The end-goal of the presentation is to shape students who will understand the challenges biases and assumptions pose to effectively managing patient pain, and how to identify when they occur in self- and other health care workers. 

References

Bahari, Z., Vosoghi, N., Ramazanzadeh, N., Moshfeghi, S., & Aghamohammadi, M. (2024). Patient trust in nurses: Exploring the relationship with care quality and communication skills in emergency departments. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02241-z

Centers for Disease Control and Prevention. (2024, October 28). Evaluate training: Measuring effectiveness. https://www.cdc.gov/training-development/php/about/evaluate-training-measuring-effectiveness.html#:~:text=The%20best%20way%20to%20evaluate,addition%20to%20knowledge%2C%20if%20needed.

Chitambira, F. (2019). Patient perspectives: Explaining low rates of compliance to compression therapy. Wound Practice and Research, 27(4). https://doi.org/10.33235/wpr.27.4.168-174

DePaul University. (n.d.). Frameworks & taxonomies of learning. https://resources.depaul.edu/teaching-commons/teaching-guides/course-design/Pages/teaching-learning-frameworks.aspx

Guzikevits, M., Gordon-Hecker, T., Rekhtman, D., Salameh, S., Israel, S., Shayo, M., Gozal, D., Perry, A., Gileles-Hillel, A., & Choshen-Hillel, S. (2024). Sex bias in pain management decisions. Proceedings of the National Academy of Sciences, 121(33). https://doi.org/10.1073/pnas.2401331121

Howard, S. (2021, February 26). Foreign-educated nurses in Texas – Texas Nurses Association. Texas Nurses Association. https://www.texasnurses.org/news/553875/Foreign-Educated-Nurses-in-Texas.htm

Lee, P., Le Saux, M., Siegel, R., Goyal, M., Chen, C., Ma, Y., & Meltzer, A. C. (2019). Racial and ethnic disparities in the management of acute pain in US emergency departments: Meta-analysis and systematic review. The American Journal of Emergency Medicine, 37(9), 1770–1777. https://doi.org/10.1016/j.ajem.2019.06.014

Sabin, J. A. (2022). Tackling implicit bias in health care. New England Journal of Medicine, 387(2), 105–107. https://doi.org/10.1056/nejmp2201180

Varghese, J., Anderson, K. D., Widerström-Noga, E., & Mehan, U. (2020). A primary care provider’s guide to pain after spinal cord injury: Screening and management. Topics in Spinal Cord Injury Rehabilitation, 26(3), 133–143. https://doi.org/10.46292/sci2603-133

Wu, L., Chen, X., Jia, S., Yan, L., Li, J., Zhang, L., Guo, Y., Lu, J., & Li, W. (2023). Evaluating the relationship between pain empathy, knowledge and attitudes among nurses in North China: A cross-sectional study. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01577-2

Zhou, W.-Q., Gao, Y.-T., Zhang, C.-R., Xing, Y., Zhou, L.-S., & Luan, W. (2025). Exploring pain empathy among doctors, nurses and patients: A scoping review. Journal of Multidisciplinary Healthcare, Volume 18, 2565–2580. https://doi.org/10.2147/jmdh.s519647