Evaluation of the impact of telementoring using ECHO© technology on healthcare professionals' knowledge and self-efficacy in assessing and managing pain for people with advanced dementia nearing the end of life

Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja McIlfatrick, Sharon Morgan, Max Watson, Carole Parsons

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Pain assessment and management in advanced and end-stage dementia are challenging; patients are at risk of under-diagnosis, under-assessment and under-treatment. Previous research has highlighted the importance of needs-driven training and development in this area for physicians, nurses and healthcare assistants (HCAs) across specialties, disciplines and care settings. This study used teleconferencing technology to connect healthcare professionals across multiple settings and disciplines in real-time clinics, based on the Project ECHO© model. This paper reports the evaluation of the clinics by physicians, nurses and HCAs, including their knowledge and self-efficacy in pain assessment and management for patients with advanced and end-stage dementia.Methods: A mixed method evaluation comprising quantitative survey of self-reported knowledge and self-efficacy pre- and post-ECHO clinic participation, and qualitative exploration of experiences of the clinics using focus group interviews. A census approach to sampling was undertaken. Pre- and post-ECHO evaluations were administered electronically using Survey Monkey software. Mann-Whitney U tests were used to explore differences in knowledge and self-efficacy scores pre- and post-ECHO clinic participation. Statistical significance was set a-priori at p=0.05. Focus groups were video- and audio-recorded, transcribed verbatim and analysed using Braun & Clarke’s model of thematic analysis.Results: Eighteen healthcare professionals [HCPs] (physicians [n=7], nurses [n=10], HCA [n=1]) and twenty HCPs (physicians [n=10], nurses [n=10]) completed pre- and post-ECHO evaluations respectively, reporting improvements in knowledge and self-efficacy on participation in ECHO clinics and perceived utility of the clinics. Seven HCPs (physicians [n=2], nurses [n=5]) participated in two focus groups. Four themes emerged: knowledge and skills development and dissemination; protected time; areas for improvement; and the future of ECHO.Conclusions: Telementoring clinics for HCP education and training in pain assessment and management in advanced and end-stage dementia demonstrate a positive impact on knowledge and self-efficacy of HCPs and highlight the value of a cross-specialty network of practice which spans across disciplines/HCP types, care settings and geographical areas. Further development of ECHO services in this and in other clinical areas, shows significant potential to support delivery of high-quality care to complex patient populations
LanguageEnglish
Pages0-0
JournalBMC Health Services Research
Volume18
Early online date2 Apr 2018
DOIs
Publication statusE-pub ahead of print - 2 Apr 2018

Fingerprint

Self Efficacy
Dementia
Technology
Delivery of Health Care
Pain
Allied Health Personnel
Nurses
Pain Measurement
Pain Management
Focus Groups
Physician Assistants
Physicians
Professional Education
Quality of Health Care
Censuses
Nonparametric Statistics
Haplorhini
Software
Interviews
Research

Keywords

  • dementia
  • palliative care
  • pain assessment
  • pain management
  • telementoring
  • ECHO©
  • knowledge
  • self-efficacy

Cite this

De Witt Jansen, Bannin ; Brazil, Kevin ; Passmore, Peter ; Buchanan, Hilary ; Maxwell, Doreen ; McIlfatrick, Sonja ; Morgan, Sharon ; Watson, Max ; Parsons, Carole. / Evaluation of the impact of telementoring using ECHO© technology on healthcare professionals' knowledge and self-efficacy in assessing and managing pain for people with advanced dementia nearing the end of life. In: BMC Health Services Research. 2018 ; Vol. 18. pp. 0-0.
@article{e8950e0b756f42bb8d73c8415fcb6958,
title = "Evaluation of the impact of telementoring using ECHO{\circledC} technology on healthcare professionals' knowledge and self-efficacy in assessing and managing pain for people with advanced dementia nearing the end of life",
abstract = "Background: Pain assessment and management in advanced and end-stage dementia are challenging; patients are at risk of under-diagnosis, under-assessment and under-treatment. Previous research has highlighted the importance of needs-driven training and development in this area for physicians, nurses and healthcare assistants (HCAs) across specialties, disciplines and care settings. This study used teleconferencing technology to connect healthcare professionals across multiple settings and disciplines in real-time clinics, based on the Project ECHO{\circledC} model. This paper reports the evaluation of the clinics by physicians, nurses and HCAs, including their knowledge and self-efficacy in pain assessment and management for patients with advanced and end-stage dementia.Methods: A mixed method evaluation comprising quantitative survey of self-reported knowledge and self-efficacy pre- and post-ECHO clinic participation, and qualitative exploration of experiences of the clinics using focus group interviews. A census approach to sampling was undertaken. Pre- and post-ECHO evaluations were administered electronically using Survey Monkey software. Mann-Whitney U tests were used to explore differences in knowledge and self-efficacy scores pre- and post-ECHO clinic participation. Statistical significance was set a-priori at p=0.05. Focus groups were video- and audio-recorded, transcribed verbatim and analysed using Braun & Clarke’s model of thematic analysis.Results: Eighteen healthcare professionals [HCPs] (physicians [n=7], nurses [n=10], HCA [n=1]) and twenty HCPs (physicians [n=10], nurses [n=10]) completed pre- and post-ECHO evaluations respectively, reporting improvements in knowledge and self-efficacy on participation in ECHO clinics and perceived utility of the clinics. Seven HCPs (physicians [n=2], nurses [n=5]) participated in two focus groups. Four themes emerged: knowledge and skills development and dissemination; protected time; areas for improvement; and the future of ECHO.Conclusions: Telementoring clinics for HCP education and training in pain assessment and management in advanced and end-stage dementia demonstrate a positive impact on knowledge and self-efficacy of HCPs and highlight the value of a cross-specialty network of practice which spans across disciplines/HCP types, care settings and geographical areas. Further development of ECHO services in this and in other clinical areas, shows significant potential to support delivery of high-quality care to complex patient populations",
keywords = "dementia, palliative care, pain assessment, pain management, telementoring, ECHO{\circledC}, knowledge, self-efficacy",
author = "{De Witt Jansen}, Bannin and Kevin Brazil and Peter Passmore and Hilary Buchanan and Doreen Maxwell and Sonja McIlfatrick and Sharon Morgan and Max Watson and Carole Parsons",
year = "2018",
month = "4",
day = "2",
doi = "10.1186/s12913-018-3032-y",
language = "English",
volume = "18",
pages = "0--0",
journal = "BMC Health Service Research",
issn = "1472-6963",
publisher = "BioMed Central",

}

Evaluation of the impact of telementoring using ECHO© technology on healthcare professionals' knowledge and self-efficacy in assessing and managing pain for people with advanced dementia nearing the end of life. / De Witt Jansen, Bannin; Brazil, Kevin; Passmore, Peter; Buchanan, Hilary; Maxwell, Doreen; McIlfatrick, Sonja; Morgan, Sharon; Watson, Max; Parsons, Carole.

In: BMC Health Services Research, Vol. 18, 02.04.2018, p. 0-0.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of the impact of telementoring using ECHO© technology on healthcare professionals' knowledge and self-efficacy in assessing and managing pain for people with advanced dementia nearing the end of life

AU - De Witt Jansen, Bannin

AU - Brazil, Kevin

AU - Passmore, Peter

AU - Buchanan, Hilary

AU - Maxwell, Doreen

AU - McIlfatrick, Sonja

AU - Morgan, Sharon

AU - Watson, Max

AU - Parsons, Carole

PY - 2018/4/2

Y1 - 2018/4/2

N2 - Background: Pain assessment and management in advanced and end-stage dementia are challenging; patients are at risk of under-diagnosis, under-assessment and under-treatment. Previous research has highlighted the importance of needs-driven training and development in this area for physicians, nurses and healthcare assistants (HCAs) across specialties, disciplines and care settings. This study used teleconferencing technology to connect healthcare professionals across multiple settings and disciplines in real-time clinics, based on the Project ECHO© model. This paper reports the evaluation of the clinics by physicians, nurses and HCAs, including their knowledge and self-efficacy in pain assessment and management for patients with advanced and end-stage dementia.Methods: A mixed method evaluation comprising quantitative survey of self-reported knowledge and self-efficacy pre- and post-ECHO clinic participation, and qualitative exploration of experiences of the clinics using focus group interviews. A census approach to sampling was undertaken. Pre- and post-ECHO evaluations were administered electronically using Survey Monkey software. Mann-Whitney U tests were used to explore differences in knowledge and self-efficacy scores pre- and post-ECHO clinic participation. Statistical significance was set a-priori at p=0.05. Focus groups were video- and audio-recorded, transcribed verbatim and analysed using Braun & Clarke’s model of thematic analysis.Results: Eighteen healthcare professionals [HCPs] (physicians [n=7], nurses [n=10], HCA [n=1]) and twenty HCPs (physicians [n=10], nurses [n=10]) completed pre- and post-ECHO evaluations respectively, reporting improvements in knowledge and self-efficacy on participation in ECHO clinics and perceived utility of the clinics. Seven HCPs (physicians [n=2], nurses [n=5]) participated in two focus groups. Four themes emerged: knowledge and skills development and dissemination; protected time; areas for improvement; and the future of ECHO.Conclusions: Telementoring clinics for HCP education and training in pain assessment and management in advanced and end-stage dementia demonstrate a positive impact on knowledge and self-efficacy of HCPs and highlight the value of a cross-specialty network of practice which spans across disciplines/HCP types, care settings and geographical areas. Further development of ECHO services in this and in other clinical areas, shows significant potential to support delivery of high-quality care to complex patient populations

AB - Background: Pain assessment and management in advanced and end-stage dementia are challenging; patients are at risk of under-diagnosis, under-assessment and under-treatment. Previous research has highlighted the importance of needs-driven training and development in this area for physicians, nurses and healthcare assistants (HCAs) across specialties, disciplines and care settings. This study used teleconferencing technology to connect healthcare professionals across multiple settings and disciplines in real-time clinics, based on the Project ECHO© model. This paper reports the evaluation of the clinics by physicians, nurses and HCAs, including their knowledge and self-efficacy in pain assessment and management for patients with advanced and end-stage dementia.Methods: A mixed method evaluation comprising quantitative survey of self-reported knowledge and self-efficacy pre- and post-ECHO clinic participation, and qualitative exploration of experiences of the clinics using focus group interviews. A census approach to sampling was undertaken. Pre- and post-ECHO evaluations were administered electronically using Survey Monkey software. Mann-Whitney U tests were used to explore differences in knowledge and self-efficacy scores pre- and post-ECHO clinic participation. Statistical significance was set a-priori at p=0.05. Focus groups were video- and audio-recorded, transcribed verbatim and analysed using Braun & Clarke’s model of thematic analysis.Results: Eighteen healthcare professionals [HCPs] (physicians [n=7], nurses [n=10], HCA [n=1]) and twenty HCPs (physicians [n=10], nurses [n=10]) completed pre- and post-ECHO evaluations respectively, reporting improvements in knowledge and self-efficacy on participation in ECHO clinics and perceived utility of the clinics. Seven HCPs (physicians [n=2], nurses [n=5]) participated in two focus groups. Four themes emerged: knowledge and skills development and dissemination; protected time; areas for improvement; and the future of ECHO.Conclusions: Telementoring clinics for HCP education and training in pain assessment and management in advanced and end-stage dementia demonstrate a positive impact on knowledge and self-efficacy of HCPs and highlight the value of a cross-specialty network of practice which spans across disciplines/HCP types, care settings and geographical areas. Further development of ECHO services in this and in other clinical areas, shows significant potential to support delivery of high-quality care to complex patient populations

KW - dementia

KW - palliative care

KW - pain assessment

KW - pain management

KW - telementoring

KW - ECHO©

KW - knowledge

KW - self-efficacy

U2 - 10.1186/s12913-018-3032-y

DO - 10.1186/s12913-018-3032-y

M3 - Article

VL - 18

SP - 0

EP - 0

JO - BMC Health Service Research

T2 - BMC Health Service Research

JF - BMC Health Service Research

SN - 1472-6963

ER -