A technology-enabled collaborative learning model (Project ECHO) to upskill primary care providers in best practice pain care

Abstract

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 (average = 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.