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Thakur A, Bobbette N, Bond V, Gonzales A, Lake J, Lefkowitz G, Mia N, Niel U, Sockalingam S, Streisslberger E, Thomson K, Volpe T, Lunsky Y. Bridging the gap: national virtual education programme for professionals caring for adults with intellectual and developmental disabilities at the time of COVID-19. BJPsych Open 2024; 10:e130. [PMID: 39051453 DOI: 10.1192/bjo.2024.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly impacted the mental health of adults with intellectual and developmental disabilities (IDD). During this period of uncertainty and need for up-to-date information, various virtual training programmes demonstrated the role of tele-mentoring programmes. AIM The aim of this paper is to describe the educational evaluation of the National Extension for Community Healthcare Outcomes - Adults with Intellectual and Developmental Disabilities (ECHO-AIDD), a programme for service providers working with adults with IDD during COVID-19. METHOD The programme consisted of six sessions, conducted weekly, over two cycles. Each session included didactic teaching by hub team members, COVID-19 news updates, wellness check-ins and a brief mindfulness activity, followed by a 30 to 45 min case-based discussion. The hub structure had an inter-professional approach to team expertise. Those with lived experience were an integral part of the content experts' hub. Pre-, post- and follow-up evaluation data were collected. RESULTS Care providers from health and social care sectors (n = 230) participated in the programme. High levels of engagement and satisfaction were reported. Self-efficacy ratings improved from pre- to post-, and were maintained at 8-week follow-up; improvement from pre- to post- was significant (P < 0.0001). CONCLUSION Exposure to National ECHO-AIDD educational intervention led to improvement in perceived competencies. This study also shows the valuable role of people with lived experience in fostering adaptive expertise in learners. The outreach and scalability support the feasibility of building a national virtual community of practice for IDD service providers. Future studies should focus on studying the impact of these programmes on the health outcomes of people with IDD.
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Affiliation(s)
- Anupam Thakur
- Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Victoria Bond
- Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Johanna Lake
- Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, Canada
| | - Gill Lefkowitz
- Azrieli Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | | | | | | | - Erica Streisslberger
- Azrieli Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Tiziana Volpe
- Azrieli Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Yona Lunsky
- Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, Canada
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Ramos A, Pujol R, Palma C. Reducing patients' rate of frequent attendance through a training intervention for physicians. BMC MEDICAL EDUCATION 2024; 24:758. [PMID: 39004704 PMCID: PMC11247833 DOI: 10.1186/s12909-024-05748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Frequent attendance is a common issue for primary care health centres. The phenomenon affects the quality of care, increases doctors' workloads and can lead to burnout.This study presents the results of an educational intervention for primary care physicians, aimed at helping them to decrease the prevalence rate of excessive attendance by patients at their centres. METHODS A training programme was carried out for 11 primary care doctors in Barcelona who had patient lists totalling 20,064 patients. The goal of the training was to provide the participating physicians with techniques to curb frequent attendance. Additionally, the programme sought to offer them strategies to prevent professional burnout and tools to better organize their everyday medical practice. The study used a quasi-experimental design for an evaluation of an educational intervention, featuring a pre-test assessment (before the training programme) and a post-test assessment (after the training programme), as well as comparison with a control group that did not undergo the training. The study assessed the effects of the programme on the rates of frequent attendance of patients served by the participating physicians. These rates were compared with those registered by the patients seen by the control group physicians over the same period. RESULTS Among the group of physicians who received the training, the mean prevalence of patients who qualified as frequent attenders decreased from 22% prior to the training programme to 8% after completion of the programme. In other words, 14% of patients (2,809) limited the frequency of their visits to primary care physicians after their physicians had completed the training programme. Meanwhile, the study recorded an average decrease of 3.1 visits per year by the patients of the physicians who had undergone the training. Statistically significant differences between this group and the control group were observed. CONCLUSIONS The educational intervention proved effective at helping primary care physicians to decrease their patients' rates of frequent attendance. It also contributes to the impact research of continuing education on doctors and their patients. We need to increase primary care spending from the current 14% to the 25%, to address this problem, among others.
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Affiliation(s)
- Alex Ramos
- Postgraduate and Continuing Education in Health Sciences, Faculty of Life Sciences,, Universidad Nebrija, Madrid, Spain.
- Continuing Medical Education Centre of the Official Medical College of Barcelona, Barcelona, Spain.
| | - Ramon Pujol
- Internal Medicine, Faculty of Medicine of the University of Vic-Central Catalonia, Barcelona, Spain
- Board of Directors of the Official Medical College of Barcelona, Barcelona, Spain
| | - Carol Palma
- Psychology at Blanquerna Faculty, Universitat Ramon Llull, Barcelona, Spain
- Psychologist at the Mental Health Center of the Mataró Hospital, Barcelona, Spain
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Nevin SM, Le Marne FA, Beavis E, Macintosh R, Palmer EE, Sachdev R, Nunn K, Bye A. Psychosocial experiences of clinicians providing care for children with severe neurological impairment. Dev Med Child Neurol 2024. [PMID: 38837791 DOI: 10.1111/dmcn.15987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate clinicians' psychosocial experiences navigating interdisciplinary care for children with severe neurological impairment (SNI), for example children with a developmental epileptic encephalopathy; secondarily, to identify preferences for future interventions to support clinicians caring for children with SNI. METHOD We conducted a qualitative descriptive study with interdisciplinary clinicians by using a purposeful sampling recruitment strategy. Twenty-four participants with expertise caring for children with SNI completed in-depth, semi-structured interviews. We transcribed the interviews, de-identified them, and performed inductive thematic analysis. RESULTS Thematic analysis elicited interrelated themes. Clinicians experienced immense professional barriers providing patient-centred care across fragmented healthcare contexts. Physical, emotional, and psychological impacts were attributed to inadequate reflective practice training and a paucity of integrated resources to support clinicians over time. Multipronged strategies were prioritized by clinicians, incorporating psychoeducation, interdisciplinary peer mentorship, and psychological resources to build reflective practice skills for clinicians providing complex care in an advancing era of medicine. INTERPRETATION This study provides novel and in-depth insight into clinicians' experiences navigating care for children with SNI. The results will be used to inform future integrated and multipronged co-developed resources tailored for clinicians, on the basis of their recommendations.
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Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Fleur A Le Marne
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rani Sachdev
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine Sydney, Children's Hospital Network, Sydney, NSW, Australia
| | - Ann Bye
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
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Adams MS, Sokoloff LG, Checkland C, Sodums DJ, Santiago AT, Feldman S, Seitz D, Ewa V, Grief C, Mackay I, Conn DK. Evaluating the impact of a national geriatric mental health ECHO educational program on healthcare providers' practice. GERONTOLOGY & GERIATRICS EDUCATION 2024:1-15. [PMID: 38646956 DOI: 10.1080/02701960.2024.2344680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Project Extension for Community Healthcare Outcomes (ECHO) enables healthcare providers to share knowledge and best practices via telementoring. The ECHO model builds provider capacity and improves care for patients with a variety of health conditions. This study describes a Canada-wide National ECHO pilot project in the area of geriatric mental health and reports on the program's impact on providers' care practices. A mixed-methods approach was used to analyze surveys completed by participating healthcare providers. Program evaluation measured satisfaction, achievement of learning objectives, awareness of issues related to geriatric mental health, and comfort and self-efficacy working with older adults. The program led to a statistically significant increase in participants' awareness of issues related to support for older adults with mental illness and comfort and self-efficacy in managing these patients in their own practice. The National ECHO pilot project was successful in building healthcare providers' capacity to care for older adults with mental health issues and positively impacting their practice. These findings support using the ECHO model to provide ongoing geriatric mental health education for clinicians from across Canada and beyond.
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Affiliation(s)
- Meaghan S Adams
- Baycrest Academy for Research & Education, Baycrest, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lisa Guttman Sokoloff
- Baycrest Academy for Research & Education, Baycrest, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Claire Checkland
- Canadian Coalition for Seniors' Mental Health, Markham, ON, Canada
| | - Devin J Sodums
- Baycrest Academy for Research & Education, Baycrest, Toronto, ON, Canada
| | - Anna T Santiago
- Baycrest Academy for Research & Education, Baycrest, Toronto, ON, Canada
| | - Sid Feldman
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Baycrest Centre for Geriatric Care, Baycrest, Toronto, ON, Canada
| | - Dallas Seitz
- Department of Psychiatry and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Vivian Ewa
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Cindy Grief
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Baycrest Centre for Geriatric Care, Baycrest, Toronto, ON, Canada
| | - Ian Mackay
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - David K Conn
- Baycrest Academy for Research & Education, Baycrest, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Baycrest Centre for Geriatric Care, Baycrest, Toronto, ON, Canada
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de la Garza Iga FJ, Mejía Alvarez M, Cockroft JD, Rabin J, Cordón A, Elias Rodas DM, Grazioso MDP, Espinola M, O'Dea C, Schubert C, Stryker SD. Using the project ECHO™ model to teach mental health topics in rural Guatemala: An implementation science-guided evaluation. Int J Soc Psychiatry 2023; 69:2031-2041. [PMID: 37477264 DOI: 10.1177/00207640231188038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Mental health (MH) disorders are major causes of disability in Guatemala. Unfortunately, limited academic training and funding resources make MH care inaccessible to most people in rural Guatemala. These disparities leave many indigenous populations without care. Project ECHO™ is an educational model used globally to deliver virtual training for providers in rural/ underserved communities. The aim of this project was to implement and evaluate a Project ECHO™ program bridging MH training gaps for providers who serve rural communities in Guatemala. METHODS The Project ECHO™ curriculum was implemented through a partnership between educational and nonprofit institutions in Guatemala City and the United States. Participants were primary care physicians and nurses working in rural Guatemala as well as medical/nursing/psychology students. Evaluation of its implementation was guided by a RE-AIM framework. Reach, effectiveness, adoption, fidelity, sustainability, acceptability, feasibility, and appropriateness were evaluated using a mixed-methods approach, using a pre-post survey and semi-structured focus groups. RESULTS Forty unique participants attended the five sessions. Attitudes about mental health did not change quantitatively but self-efficacy improved in four of five modules. High quality fidelity scores were noted in two of five sessions. Sustainability scores across multiple domains were highly rated. Scores on instruments measuring acceptability, feasibility, and appropriateness were high. Focus groups showed two main themes: the curriculum filled a gap in education and further adaptation of the model might help improve the experience. CONCLUSION Implementation of the Project ECHO™ educational model appeared to have good reach/adoption, showed improvements in self-efficacy, illuminated facilitators and barriers to sustainability, and was felt to be acceptable, feasible, and appropriate. Qualitative analysis supported these conclusions. Future directions would include ongoing evaluation and monitoring of further Project ECHO™ curricular experiences through this partnership and adaptation of this project to other learners and settings in Latin America.
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Affiliation(s)
| | | | - Joshua D Cockroft
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Julia Rabin
- Department of Psychology, College of Arts & Sciences, University of Cincinnati, OH, USA
| | - Ana Cordón
- Wuqu' Kawoq / Maya Health Alliance, Tecpan, Guatemala
| | | | | | - Maria Espinola
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Christine O'Dea
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Charles Schubert
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Shanna D Stryker
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
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Chan CT, Dommert-Breckler B, Cannon J, Cassidy R, Crampton K, Concepcion D, Hutchinson S, Joseph J, Mehrotra R, Moore G, Pierce N, Rivara MB, Wilkens K. Home Dialysis Curriculum Implementation for Health Care Workers Using Project ECHO Principles: A Feasibility Report From NKF-KDOQI. Kidney Med 2023; 5:100735. [PMID: 38116166 PMCID: PMC10728695 DOI: 10.1016/j.xkme.2023.100735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Affiliation(s)
- Christopher T. Chan
- Division of Nephrology at University Health Network, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | - Rajnish Mehrotra
- Division of Nephrology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | | | - Nancy Pierce
- Network 16 Medical Review Board, St Peter’s Health, Helena, MN
| | - Matthew B. Rivara
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA
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