Experiences and perceptions of nurses participating in an interprofessional, videoconference-based educational programme on concurrent mental health and substance use disorders: a qualitative study

Abstract

Background Individuals with co-occurring mental health and substance use disorders (i.e., concurrent disorders) have complex healthcare needs, which can be challenging for nurses to manage. Providing optimal care for this subpopulation requires nurses to develop high-level competencies despite limited resources at their disposal and the isolated settings in which many of them work. The Extension for Healthcare Community Outcomes (ECHO®) is a promising collaborative learning and capacity building model that uses videoconference technology to support and train healthcare professionals in the management of complex and chronic health conditions. The aim of this study was to explore the experiences and perceptions of nurses participating in a Canadian ECHO programme on concurrent disorders about the competencies they developed and used in their clinical practice, and which factors have influenced this process. Methods The study was qualitative, guided by an interpretive description approach. Individual semi-structured interviews were held with ten nurses who had participated in the programme between 2018 and 2020. A thematic analysis was conducted iteratively using an inductive approach to progressive data coding and organization. Results Four themes and eighteen sub-themes were identified. During their participation in ECHO, the nurses perceived as having further developed eight clinical nursing competencies. Nurses viewed ECHO as a unique opportunity to open themselves to their peers’ experiences and reflect on their own knowledge. Learning from experts in the field of concurrent disorders helped them to build their confidence in managing complex clinical situations. The nurses’ sense of belonging to a community further enhanced their engagement in the programme, and learning was facilitated through the programme’s interprofessional environment. Nevertheless, the lack of contextualized educative content linked to local realities, the limited resources in concurrent disorders, and time constraints were experienced as factors limiting competency development. Conclusions ECHO is a promising alternative to conventional, in-person continuing education programmes to improve the development of advanced competencies among nurses providing care to individuals with chronic and complex health conditions. These findings can inform clinicians, educators, researchers, and decision makers who are developing, implementing, evaluating, and escalating future educational interventions in the field of CDs.

Key conditions for the successful implementation of evidence-based practice in concurrent disorder nursing care with the ECHO® model: Insights from a mixed-methods study

“…In this study, we lay bare a large number of cultural, contextual, and organizational factors that negatively affected the nurses’ consistent participation in ECHO Concurrent Disorders (time constraints, limited access to technology, or lack of contextualized educative content) as well as their capacity to implement the competencies they developed in their clinical practice (limited concurrent disorder-specialized resources, high job turnover, or lack of employer support toward practice changes) ( Chicoine et al., 2022a ). Such barriers have also been uncovered in other ECHO programs addressing complex and chronic health topics within the constraints of resource-scarce healthcare settings ( McBain et al., 2019 ; Zhou et al., 2016 ).…”

“…A detailed description of the educational program—including adaptations made for the learners and their local context, and unplanned modifications that took place in delivering the program's 2019–2020 curriculum due to the COVID-19 pandemic—was previously reported ( Chicoine et al., 2022a ), in accordance with the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) ( Phillips et al., 2016 ). More information is also publicly available online ( https://ruisss.umontreal.ca/cectc/services/echo-troubles-concomitants/ ).…”

“…Ten nurses volunteered to participate in the interviews (see Table 1 ). Detailed methods and results from the qualitative component of the mixed-methods study have been previously reported ( Chicoine et al., 2022a ).…”

“…Together, these themes reflected the progress made by the nurses on some clinical nursing competencies and how these competencies were implemented into their clinical practice (theme 1). The themes also illuminated how this learning process took place during ECHO Concurrent Disorders (theme 2), and they depicted the factors that facilitated (theme 3) or limited (theme 4) the nurses’ competency development and practice changes ( Chicoine et al., 2022a ).…”

Physics vlogs learning videos on parabolic motion on youtube channels based on scientific approach

“…so that it can support the edited learning video. Technology-based education makes it easier to deliver material and minimizes costs because it can be implemented flexibly (Chicoine et al, 2022), such as through learning videos on YouTube channels.…”