Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.
BMC Med Educ. 2023 Jan 28;23(1):71. doi: 10.1186/s12909-023-04023-8.
Pediatric pain is a complex health challenge requiring a multi-modal management approach. It is critical that healthcare providers (HCPs) have access to ongoing, flexible education and mentorship specific to pediatric pain. However, there are significant gaps in available pain education and a need for more opportunities to support interprofessional training. Project Extension for Community Healthcare Outcomes (Project ECHO®) is a model for delivering online HCP education and cultivating a virtual community of practice. Within the pediatric pain setting, ECHO® has potential to improve local access to specialized pain knowledge, particularly among the physicians, nurses, and allied health providers who primarily manage these cases in community and hospital settings across rural and urban environments. The purpose of this study was three-fold. First, to evaluate the feasibility (participation levels, acceptability) of implementing Project ECHO® in the context of pediatric pain. Second, to measure preliminary program impacts on HCP knowledge, self-efficacy, and clinical practice. Third, to characterize HCP program engagement levels before and after onset of the COVID-19 pandemic.
A needs assessment was conducted to identify interprofessional education gaps and inform the program curriculum. The no-cost Pediatric ECHO® for Pain program offered TeleECHO sessions (didactic and case-based learning) as well as foundational education. Surveys were distributed at baseline and 6 months to assess outcomes using 7-point Likert scales. Participant engagement was assessed for periods prior to and during the COVID-19 pandemic. Descriptive and inferential statistical analyses were conducted.
Eighty-five TeleECHO sessions were hosted, with a mean attendance of 34.1 ± 23.4 HCPs. Acceptability scores at 6 months (n = 33) ranged from 5.0 ± 1.4 to 6.5 ± 0.5. Participants reported statistically significant (p < 0.05) improvements in knowledge (7 out of 7 topics) and self-efficacy (8 out of 9 skills). Most participants reported positive practice impacts, including improved satisfaction with managing children with pain. Exploratory analyses showed a trend of greater engagement from ECHO® learners after onset of the COVID-19 pandemic.
Project ECHO® is a feasible and impactful model for virtual education of interprofessional HCPs in managing pediatric pain.
儿科疼痛是一个复杂的健康挑战，需要采用多模式管理方法。医疗保健提供者（HCP）获得持续、灵活的针对儿科疼痛的教育和指导至关重要。然而，现有的疼痛教育存在很大差距，需要更多机会来支持跨专业培训。社区医疗保健成果扩展项目（Project ECHO）是一种提供在线 HCP 教育和培养虚拟实践社区的模式。在儿科疼痛环境中，ECHO 有可能改善当地获得专门疼痛知识的机会，特别是在农村和城市环境中社区和医院环境中主要管理这些病例的医生、护士和联合保健提供者中。本研究的目的有三。首先，评估在儿科疼痛背景下实施 ECHO 的可行性（参与水平、可接受性）。其次，衡量初步方案对 HCP 知识、自我效能和临床实践的影响。第三，描述 COVID-19 大流行前后 HCP 计划参与水平。
进行需求评估以确定跨专业教育差距，并为课程提供信息。免费的儿科疼痛 ECHO 计划提供远程 ECHO 会议（理论和基于案例的学习）以及基础教育。在基线和 6 个月时使用 7 分李克特量表分发调查问卷以评估结果。在 COVID-19 大流行之前和期间评估参与者的参与度。进行描述性和推断性统计分析。
举办了 85 次远程 ECHO 会议，平均有 34.1±23.4 名 HCP 参加。6 个月时的可接受性评分（n=33）范围为 5.0±1.4 至 6.5±0.5。参与者报告说，在知识（7 个主题中的 7 个）和自我效能（9 项技能中的 8 项）方面均有统计学意义的（p<0.05）提高。大多数参与者报告说对实践产生了积极影响，包括提高了对管理疼痛儿童的满意度。探索性分析显示，COVID-19 大流行后，ECHO 学习者的参与度呈上升趋势。
Project ECHO 是一种可行且有影响力的虚拟教育模式，可用于管理儿科疼痛的跨专业 HCP 教育。
