Socolovsky Carmela, Masi Christopher, Hamlish Tamara, Aduana Glen, Arora Sanjeev, Bakris George, Johnson Daniel
Prog Community Health Partnersh. 2013 Winter;7(4):361-8. doi: 10.1353/cpr.2013.0043.
ECHO (Extension for Community Healthcare Outcomes) is a telehealth educational program that uses videoconference technology to train community-based primary care providers (PCP's) on the management of complex, chronic diseases. The main components of ECHO are didactics, case presentations, and case-based learning. ECHO was developed using the key principles of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory.
In a prior study, we implemented an ECHO curriculum to improve management of resistant hypertension. The goals of the current study were to determine the extent to which the learning theories served as the foundation of the ECHO curriculum and identify opportunities to more effectively incorporate key principles of these theories into the ECHO program.
We conducted semi-structured interviews with the nine clinicians who participated in the pilot curriculum. A community-based PCP assisted with question development, analysis, and manuscript preparation. We analyzed the interview transcripts using Directed Content Analysis.
Transcript analysis supported the contention that ECHO is based upon Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Comments from study participants highlighted benefits of each theory's principles. Conversely, they also suggested we could improve our implementation of ECHO by adhering more closely to specific learning theory strategies.
Our results indicate that ECHO indeed reflects the key tenants of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Several aspects of our ECHO curriculum can be improved by more complete application of these learning theories.
社区医疗成果拓展项目（ECHO）是一项远程医疗教育项目，利用视频会议技术对社区基层医疗服务提供者（PCP）进行复杂慢性病管理方面的培训。ECHO的主要组成部分包括教学、病例展示和基于病例的学习。ECHO是依据社会认知理论、情境学习理论和实践共同体理论的关键原则开发的。
在之前的一项研究中，我们实施了ECHO课程以改善顽固性高血压的管理。本研究的目的是确定学习理论在多大程度上作为ECHO课程的基础，并找出将这些理论的关键原则更有效地纳入ECHO项目的机会。
我们对参与试点课程的九名临床医生进行了半结构化访谈。一名社区基层医疗服务提供者协助问题开发、分析和稿件准备。我们使用定向内容分析法对访谈记录进行了分析。
记录分析支持了ECHO基于社会认知理论、情境学习理论和实践共同体理论这一论点。研究参与者的评论突出了每种理论原则的益处。相反，他们也建议我们可以通过更严格地遵循特定学习理论策略来改进ECHO的实施。
我们的结果表明，ECHO确实反映了社会认知理论、情境学习理论和实践共同体理论的关键原则。通过更全面地应用这些学习理论，我们的ECHO课程的几个方面可以得到改进。
