Building an AODA-Compliant, Evidence-Based Training Program for Pain Management in Dementia Care

Training healthcare teams to assess and manage pain in elderly patients with dementia is uniquely challenging. These residents often struggle to communicate discomfort, leaving caregivers to rely on non-verbal cues and behavioural changes to recognize distress. Without a structured approach, pain can go unrecognized or misattributed, leading to unnecessary suffering and potentially escalating behaviours.

To address this, I developed a five-day, AODA-compliant training program designed for mixed-level learners (novice nursing students and experienced practitioners). The curriculum integrates RNAO Best Practice Guidelines (BPG) on Pain Assessment and Management, the PAINAD (Pain Assessment in Advanced Dementia) tool, and leading instructional design frameworks like CSAM (Context, Scaffolding, Assessment, Motivation), TPACK (Technological Pedagogical Content Knowledge), and the Community of Inquiry (CoI) framework.

What Makes This Program Different?

  1. Accessibility First:
    The entire package, including instructor blueprints, learner handouts, evaluations, and microlearning tools, is built to meet AODA standards. Content is presented in screen-reader-friendly, high-contrast formats with no inaccessible tables or untagged visuals, ensuring equitable access for all learners.

  2. Evidence-Based Tools:
    The PAINAD scale is central to the training, helping learners recognize non-verbal pain cues through structured practice, including video case reviews, role-play, AI-driven branching scenarios, and VR simulations. Every stage references RNAO’s Pain Assessment and Management BPG, reinforcing best practices for both assessment and intervention (RNAO, 2021).

  3. Progressive, Active Learning:
    Guided by the CSAM framework (Power, 2023), the unit scaffolds from foundational knowledge to high-stakes, high-fidelity simulation. Learners begin by mastering core tools, progress to collaborative case work, and conclude with OSCE assessments and immersive simulations that demand both clinical reasoning and teamwork.

  4. Flexible Delivery:
    The kit includes instructor scripts, learner checklists, evaluation tools, and quick-reference sheets, enabling consistent delivery across organizations. Facilitators also receive accessible slides, cue sheets, and debrief guides, ensuring the program can be adapted for classroom, online, or blended settings.

Why This Matters

Research shows that structured, accessible training programs improve not only learner confidence but also clinical outcomes when implemented in long-term care settings (RNAO, 2021). By combining evidence-based clinical tools with research-backed instructional design, this program equips healthcare teams to better recognize and manage pain, improve resident quality of life, and reduce the likelihood of behavioural escalations.

References

Registered Nurses’ Association of Ontario (RNAO). (2021). Assessment and management of pain (3rd ed.). Toronto, ON: RNAO. Retrieved from https://rnao.ca/bpg/guidelines/pain
Power, M. (2023). Instructional design frameworks for scaffolding and engagement: Applying CSAM in healthcare education. Journal of Continuing Education in Nursing, 54(4), 162–170.

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