2026 • 8(2) • DOI: 10.30542/JCEMS.2026.08.02.12
Poster Presentation Abstract
Accurate pain assessment is a critical skill for EMS providers, yet traditional training paradigms emphasize verbal self-report, which may be unreliable in patients who are nonverbal, cognitively impaired, or emotionally distressed. Provider biases related to gender and race may further complicate recognition and interpretation of pain, possibly resulting in underestimation or delayed intervention.
The Facial Action Coding System (FACS) is recognized as a valid and reliable method in objectively describing facial expressions, as well as monitoring pain-related facial expressions in various populations. Fifty New York State EMTs were randomly assigned to participate in one hour of didactic instruction in either standard patient assessment or FACE-IT. The FACE-IT training included (1) foundations in FACS and pain-related action units and (2) image-based exercises using the SynPAIN dataset, which provides synthetic and demographically balanced facial images annotated for pain expression. Then, trainees were randomly assigned to two adult simulation scenarios varied by pain expression, gender, and race.
Cohort outcomes were compared for absolute differences in trainee and standardized pain labels, demographic effects, and self-reported confidence. Trainees who received the FACE-IT training demonstrated higher accuracy in identifying pain expressions across all demographic categories and reported increased confidence in assessing nonverbal pain compared to the standard training group.
These findings support the integration of facial action recognition into EMS assessment training to improve accuracy, equity, and confidence in pain evaluation. Further research is needed to assess the generalizability of the program to non-adult patients and the extent of longitudinal retention.
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Author and Article Information
Address for Correspondence: Elisabeth Chai | Email: elisabeth.chai@stonybrook.edu
Conflicts of Interest/Funding Sources: By the JCEMS Submission Declaration Form, all authors are required to disclose all potential conflicts of interest and funding sources. The authors declared that they have no conflicts of interest. The authors declared that they did not receive funding to conduct the program or research associated with this work.
Ethical Compliance: The authors attest that the research associated with this abstract was conducted in accordance with the JCEMS Ethics Guidelines.
Submission History: Received January 16, 2026; accepted for presentation and publication January 27, 2026.
Poster Presentation: This abstract was presented as a poster at the Academic Poster Session of the 34th Annual Conference of the National Collegiate Emergency Medical Services Foundation; February 20-22, 2026; Arlington, VA, USA. The authors received the First Place Award in the Poster Presentation Competition for Original Research.
Published Online: February 19, 2026
Published in Print: September 01, 2026 (Volume 8: Issue 2)
Reviewer Information: In accordance with JCEMS editorial policy, poster presentation abstracts undergo double-blind peer-review by at least two reviewers (JCEMS Editorial Board members and/or independent reviewers) prior to acceptance for presentation and publication. JCEMS thanks the anonymous reviewers who contributed to the review of this work.
Copyright: © 2026 Chai. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The full license is available at: https://creativecommons.org/licenses/by/4.0/
Electronic Link: https://doi.org/10.30542/JCEMS.2026.08.02.12
