De Morgan Simone, Walker Pippy, Blyth Fiona M, Daly Anne, Burke Anne L J, Nicholas Michael K
Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Charles Perkins Centre D17, Camperdown, NSW 2006, Australia.
School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building A27, Camperdown, NSW 2006, Australia.
Aust J Prim Health. 2024 Dec;30. doi: 10.1071/PY24035.
Background The South Australian (SA) Chronic Pain Extension for Community Healthcare Outcomes (ECHO) Network was established to upskill primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach using didactic and case-based virtual mentoring sessions. The aims of this study were to assess: (a) participation, satisfaction (relevance, satisfaction with format and content, perceptions of the mentorship environment), learning (perceived knowledge gain, change in attitudes), competence (self-confidence) and performance (intention to change practice, perceived practice change) of the ECHO Network clinician participants; and (b) self-perceived barriers at the clinical, service and system level to applying the learnings. Methods A mixed methods, participatory evaluation approach was undertaken. Data sources included analysis of program records (learning needs assessment, enrolment survey data, program participation data and online surveys of healthcare professionals including a satisfaction survey after each ECHO session (n=106 across the ECHO series of 10 sessions; average response rate=46%), a case presenters survey (n=7, response rate=78%) and an outcome survey after all 10 ECHO sessions (n=11, response rate=25%). Results Forty-four healthcare professionals participated in the ECHO Network from a range of career stages and professional disciplines (half were general practitioners). One-third of participants practised in regional SA. Participants reported that the ECHO sessions met their learning needs (average=99% across the series), were relevant to practice (average=99% across the series), enabled them to learn about the multidisciplinary and biopsychosocial approach to pain care (a verage=97% across the series) and provided positive mentorship (average=96% across the series). Key learnings for participants were the importance of validating the patient experience and incorporating psychological and social approaches into pain care. More than one-third of participants (average=42% across the series) identified barriers to applying the learnings such as limited time during a consultation and difficulty in forming a multidisciplinary team. Conclusions The ECHO Network model was found to be an acceptable and effective interdisciplinary education model for upskilling primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach to pain managment. However, participants perceived barriers to translating this knowledge into practice at the clinical, service and system levels.
背景 南澳大利亚州社区医疗保健成果慢性疼痛扩展（ECHO）网络的建立，旨在通过教学式和基于案例的虚拟指导课程，提升初级保健提供者在以患者为中心的生物心理社会方法框架下的最佳实践疼痛护理技能。本研究的目的是评估：（a）ECHO网络临床医生参与者的参与度、满意度（相关性、对形式和内容的满意度、对指导环境的看法）、学习情况（感知到的知识收获、态度变化）、能力（自信心）和表现（改变实践的意愿、感知到的实践变化）；以及（b）在临床、服务和系统层面应用所学知识的自我感知障碍。方法 采用混合方法参与式评估方法。数据来源包括项目记录分析（学习需求评估、入学调查数据、项目参与数据以及对医疗保健专业人员的在线调查，包括每次ECHO课程后的满意度调查（在10次ECHO课程系列中，共106份；平均回复率 = 46%）、病例展示者调查（n = 7，回复率 = 78%）以及所有10次ECHO课程后的结果调查（n = 11，回复率 = 25%）。结果 44名医疗保健专业人员从不同职业阶段和专业学科参与了ECHO网络（其中一半是全科医生）。三分之一的参与者在南澳大利亚州的地区执业。参与者报告称，ECHO课程满足了他们的学习需求（系列课程平均 = 99%），与实践相关（系列课程平均 = 99%），使他们能够了解疼痛护理的多学科和生物心理社会方法（系列课程平均 = 97%），并提供了积极的指导（系列课程平均 = 96%）。参与者的关键学习收获是验证患者体验以及将心理和社会方法纳入疼痛护理的重要性。超过三分之一的参与者（系列课程平均 = 42%）指出了应用所学知识的障碍，如会诊期间时间有限以及难以组建多学科团队。结论 发现ECHO网络模式是一种可接受且有效的跨学科教育模式，可提升初级保健提供者在以患者为中心的生物心理社会疼痛管理最佳实践疼痛护理方面的技能。然而，参与者在临床、服务和系统层面感知到将这些知识转化为实践存在障碍。
