Multimodal EEG and explainable machine learning characterize neuroticism-related neurodynamic heterogeneity in mild cognitive impairment during visuospatial working memory.

Chronic pain is among the most prevalent and costly health conditions in the United States. In 2023, an estimated 24.3% of U.S. adults (approximately 60 million people) reported chronic pain in the prior 3 months, and 8.5% reported high-impact chronic pain (HICP) — pain that limits life or work activities on most or every day (). Chronic pain is one of the most common reasons adults seek medical care and is associated with reduced quality of life, lost productivity, increased anxiety and depression, harmful opioid use, and unmet mental health needs (). By definition, HICP meets the Americans with Disabilities Act () criterion of “a physical or mental impairment that substantially limits one or more major life activities,” including walking, standing, lifting, sleeping, concentrating, and working. In healthcare, estimates of pain and work-related musculoskeletal disorders vary widely: 61% of healthcare workers report low back pain and 64% report hip pain (); 77.2% of nurses report pain in various regions (); 40.1% of physical therapists report low back pain (); and 77% of orthopedic surgeons report low back pain and 74% report neck pain (). Pain and HICP thus carry significant population-level relevance for the health professions workforce, with implications for how clinicians are trained and prepared to deliver equitable care. Use of the biopsychosocial (BPS) model () has been emphasized in the examination and treatment of people with pain (). The BPS model of pain conceptualizes pain as a multidimensional experience shaped by the dynamic interaction of biological (e.g., tissue pathology, nociception, genetics), psychological (e.g., cognitions, emotions, behaviors), and social (e.g., relationships, culture, environment, socioeconomic context) factors (, ). While biological aspects of pain have historically been the predominant focus, health professions education (HPE) programs now integrate more psychosocial content within formal coursework (). Similarly, clinical care for pain reflects improvements in taking an integrative approach (). In this manuscript, integrative pain management refers to a coordinated, person-centered approach that combines multiple evidence-informed strategies to address biopsychosocial contributors to a person’s pain (). Despite advances, barriers to BPS implementation have been identified. A scoping review by van Dijk et al. () identified categories of barriers including: (1) clinician: inclination toward biomedical contributions, negatively framing the presence of psychological and social factors, and lack of mentoring in BPS; (2) patient: treatment expectations; and (3) system: inadequate time and decreased knowledge of referral sources. Elements within training environments of HCP create additional barriers to acceptance and integration of psychosocial management of pain in clinical practice (). The “hidden curriculum” has been identified as a contributing factor to the delay in the translation of the BPS to clinical practice (). Hidden curricula are those aspects of an educational program that are implicit within attitudes of educators and policies of a program () (). The learning effects from hidden curricula are often longer lasting than aspects of the formal or explicit curricula in HPE ().