Pediatric Project ECHO® for Pain: implementation and mixed methods evaluation of a virtual medical education program to support interprofessional pain management in children and youth

Abstract

Background Pediatric pain is a complex health challenge requiring a multi-modal management approach. It is critical that healthcare providers (HCPs) have access to ongoing, flexible education and mentorship specific to pediatric pain. However, there are significant gaps in available pain education and a need for more opportunities to support interprofessional training. Project Extension for Community Healthcare Outcomes (Project ECHO®) is a model for delivering online HCP education and cultivating a virtual community of practice. Within the pediatric pain setting, ECHO® has potential to improve local access to specialized pain knowledge, particularly among the physicians, nurses, and allied health providers who primarily manage these cases in community and hospital settings across rural and urban environments. The purpose of this study was three-fold. First, to evaluate the feasibility (participation levels, acceptability) of implementing Project ECHO® in the context of pediatric pain. Second, to measure preliminary program impacts on HCP knowledge, self-efficacy, and clinical practice. Third, to characterize HCP program engagement levels before and after onset of the COVID-19 pandemic. Methods A needs assessment was conducted to identify interprofessional education gaps and inform the program curriculum. The no-cost Pediatric ECHO® for Pain program offered TeleECHO sessions (didactic and case-based learning) as well as foundational education. Surveys were distributed at baseline and 6 months to assess outcomes using 7-point Likert scales. Participant engagement was assessed for periods prior to and during the COVID-19 pandemic. Descriptive and inferential statistical analyses were conducted. Results Eighty-five TeleECHO sessions were hosted, with a mean attendance of 34.1 ± 23.4 HCPs. Acceptability scores at 6 months (n = 33) ranged from 5.0 ± 1.4 to 6.5 ± 0.5. Participants reported statistically significant (p < 0.05) improvements in knowledge (7 out of 7 topics) and self-efficacy (8 out of 9 skills). Most participants reported positive practice impacts, including improved satisfaction with managing children with pain. Exploratory analyses showed a trend of greater engagement from ECHO® learners after onset of the COVID-19 pandemic. Conclusions Project ECHO® is a feasible and impactful model for virtual education of interprofessional HCPs in managing pediatric pain.

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Organisational challenges of pain management in neonatal intensive care unit: a qualitative study

“…Nurses in particular play a significant role in pain management due to spending more time at the patient's bedside. 10 According to previous studies, the lack of knowledge in care providers is the significant barrier to optimal pain management. 11 12 The evidence shows…”

“…Nurses in particular play a significant role in pain management due to spending more time at the patient’s bedside. 10 According to previous studies, the lack of knowledge in care providers is the significant barrier to optimal pain management. 11 12 The evidence shows that care providers’ knowledge of pain management and their perceived responsibility are significantly related to the organisation’s policies.…”

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“…Pediatric ECHO® For Pain , based in Ontario Canada, is one of the largest pediatric pain-focused ECHO® programs in the world ( 26 ). Program scope is inclusive of multimodal, evidence-based approaches to support interdisciplinary management of pediatric acute, chronic, and transitional pain.…”

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