The scientific literature reveals a surprising lack of knowledge of chronic pain mechanisms and its management amongst health care professionals, including physicians and physiotherapists. There is little information directly related to a comparison between medical and physiotherapy students' knowledge of chronic pain. This study aimed to determine and compare the level of knowledge of chronic pain and its management between final year medical (n=126) and physiotherapy students (n=62). A chronic pain questionnaire which included two sections on knowledge and one section on management was used to gather quantitative and qualitative data. Final year physiotherapy students were found to have statistically greater knowledge of chronic pain than final year medical students (p=0.01 and p=0.002). In contrast, medical students were found to have statistically significantly greater understanding of the management of patients with chronic pain (p=0.001). Male students from both groups scored significantly higher in the management section (p=0.008) as did older students (p=0.01). There was a lack of understanding, in varying degrees, of central sensitization, opioid addition, fear-avoidance and a number of students from both cohorts appeared to bring a curative focus to the treatment of chronic pain. One way forward could be found in the interprofessional agenda. This will offer students from different disciplines opportunities to understand their different roles and enhance each others' learning base so that a biopsychosocial framework of care can be implemented. In this way, physiotherapists could learn more about the drug management of chronic pain and medical students could explore more collaborative patient-centred paradigms that address issues such as self-efficacy, self-management and patient empowerment. More focus needs to be paid to the education of the health professionals regarding their assumptions and understanding what 'vulnerable' means in a tissue in comparison to a person.

This programme appeared to be integral to the students' development as future physiotherapists.

This ethnographic study was undertaken to build a picture of physiotherapy practice through prolonged observation. Several building blocks of the therapists' culture were created one of which was the negotiation and meaning of food rituals in the practice of a team of physiotherapists in a UK National Health Service hospital. Interviews were carried out following the observations to gain the therapists' perspectives in an open critical exploration of assumptions and ideas. The analysis was iterative and followed a systematic recognized ethnographic approach. The findings revealed explicit and implicit meanings of the food rituals. Explicitly they were instrumental in sustaining continuity and a strong sense of harmony. They were seen as a morale-booster, a key ingredient to mark departures and a powerful component of the therapists' break time. They underpinned a need for cohesion within an environment of constant change. Implicitly, they were a vehicle to expose tensions and a catalyst for isolation. Food rituals, for this team, reduced the anxiety and stress, which unpredictability, a hallmark of clinical practice can engender. By hiding their concerns in rituals, the team members were able to avoid a real confrontation with issues of authority and hierarchy that underscored these activities. They also maintained the continuity of a professional tradition and contributed to a strong sense of professional autonomy which can smooth the pathway to inter-professional collaboration.