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Pain Puzzles: A Virtual, Guided Clinical Simulation in Effective, Individualized Pain Management Approaches

Patient Simulation

Interact with virtual patients and clinicians as you practice pain management with expert clinical mentoring.

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Nurses: 0.50 Nursing contact hour

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Optometrists: 0.50 COPE CE credit 

Pharmacists: 0.50 contact hour (0.05 CEUs)

Psychologists: 0.50 APA CE Credit

Social Workers: 0.50 ASWB ACE CE Credit

Released: December 07, 2023

Expiration: December 06, 2024



Andrew Friedman

Andrew Friedman, MD

Section Head
Virginia Mason Medical Center
Medical Director
Virginia Mason Franciscan Health
Clinical Assistant Professor
University of Washington
Seattle, Washington

Amanda Zimmerman

Amanda Zimmerman, PA-C

West Forsyth Pain Management
Winston Salem, North Carolina

Provided by

Provided by Clinical Care Options, LLC, and in partnership with Alliance to Advance Comprehensive Integrative Pain Management, American Academy of Physical Medicine and Rehabilitation and Practicing Clinicians Exchange, and ProCE.

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This activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies. Please see this link for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the U.S. Food and Drug Administration (FDA).

Opioid Analgesic REMS Program Companies


Alliance to Advance Comprehensive Integrative Pain Management

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American Academy of Physical Medicine and Rehabilitation

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Practicing Clinicians Exchange

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Target Audience

Through the collective effort by the collaborators, the Opioid REMS Interactive Curriculum is intended to reach the entire healthcare team including physicians, advanced practice nurses, physician associates/physician assistants, pharmacists, nurses, psychologists, and social workers. Specialty areas include, but are not limited to, physiatry, psychiatry, neurology, family medicine, internal medicine, pain management, and surgery. This includes HCPs who are involved with direct patient care, including HCPs registered with the DEA and eligible to prescribe all opioid analgesics, as well as non-prescribers involved in the care of patients receiving opioid analgesic therapy, nonpharmacologic therapies, and nonopioid analgesic therapies.  

Program Learning Goal

The goal of this program is to improve the knowledge, competence, and performance of learners in effort to optimize treatment for patients with Pain Management

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Create an individualized pain treatment plan considering patient-specific characteristics, needs, and preferences.


Clinical Care Options, LLC (CCO) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose all financial conflicts of interest (COI) they may have with ineligible companies. All relevant COI are thoroughly vetted and mitigated according to CCO policy. CCO is committed to providing its learners with high-quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The faculty reported the following relevant financial relationships or relationships to products or devices they have with ineligible companies related to the content of this educational activity:

Primary Author

Andrew Friedman, MD

Section Head
Virginia Mason Medical Center
Medical Director
Virginia Mason Franciscan Health
Clinical Assistant Professor
University of Washington
Seattle, Washington

Andrew Friedman, MD, has no relevant financial relationships to disclose.

Amanda Zimmerman, PA-C

West Forsyth Pain Management
Winston Salem, North Carolina

Amanda Zimmerman, PA-C: consultant/advisor/speaker: Averitas, Collegium.

The planners and content peer reviewers from Clinical Care Options, LLC do not have any relevant financial relationships to disclose, except Ameet Nagpal, MD, MS, MEd, MBATheresa Mallick-Searle, MS, PMGT-BC, ANP-BC and Gabrielle Giacona, as noted below.

Ameet Nagpal, MD, MS, MEd, MBA: consultant/advisor/speaker: Averitas; researcher: Saol Therapeutics.

Theresa Mallick-Searle, MS, PMGT-BC, ANP-BC: consultant/advisor/speaker: Salix.

Gabrielle Giacona: individual publicly traded stocks/stock options: AstraZeneca, Moderna.

Instructions for Credit

Participation in this self-study activity should be completed in approximately 0.5 hour. To successfully complete this activity and receive credit, learners must follow these steps during the period from December 07, 2023, through December 06, 2024:

  1. Login or Sign Up for an account by clicking at the top of this page
  2. Read the target audience, learning objectives, and faculty disclosures
  3. View and study the content in its entirety
  4. Submit answers to the post-test questions and evaluation questions online

You must receive a test score of 65% or better and respond to all evaluation questions to receive a certificate. After submitting the evaluation, you may access your online certificate by selecting the certificate link on the confirmation page. Records of all CME/CE activities completed can be found on the "My Certificates" page. There are no costs/fees for this activity.


This program has been made available online.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Copyright Statement

This CME simulation activity is licensed to Clinical Care Options. Copyright © 2023 Syandus Inc and Clinical Care Options. All rights reserved. No part of this simulation activity may be reproduced without written permission from Clinical Care Options and Syandus Inc.


Joint Accreditation Statement
Joint AccreditationIn support of improving patient care, Clinical Care Options, LLC (CCO) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Physician Continuing Medical Education

CCO designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Professional Development

The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 0.5 contact hour including 0.5 hour of pharmacotherapy credit.

Continuing Pharmacy Education

CCO designates this continuing education activity for 0.5 contact hour (0.1 CEUs) of the Accreditation Council for Pharmacy Education.

Universal Activity Number -  JA4008176-0000-23-308-H08-P
Type of Activity: Application

Upon successfully completing the post-test with a score of 65% or better and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 60 days.

Physician Associate Continuing Medical Education
Joint AccreditationClinical Care Options has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.5 AAPA Category 1 CME credit. Approval is valid until December 06, 2024. PAs should only claim credit commensurate with the extent of their participation.

Psychologist Continuing Education

Continuing education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.

This activity offers 0.5 continuing education credits for psychologists. 

Social Work Continuing Education

As a Jointly Accredited Organization, Clinical Care Options, LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 0.5 clinical continuing education credits.

Optometrist Continuing Education

Clinical Care Options, LLC designates this asynchronous enduring activity for a maximum of 0.5 COPE credit hours.