JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic necessitated healthcare professionals to transition to telehealth service delivery, often with little preparation or training. E-learning is an accessible and scalable method of delivering health professional education yet there is little data on effectiveness of e-learning for training in telehealth. The PEAK (Physiotherapy Exercise and physical Activity for Knee osteoarthritis) e-learning modules were developed to upskill physiotherapists in evidence-based management of knee osteoarthritis (OA) via telehealth and in-person consultations. In the research setting, the PEAK e-learning modules are perceived by physiotherapists as effective when part of a comprehensive training program for a clinical trial. However, effectiveness of the PEAK e-learning modules on their own, in a ‘real-world’ setting, is unknown.

Objective:

Evaluate the uptake, effectiveness and implementation of the PEAK e-learning modules during the COVID-19 pandemic.

Methods:

This is a longitudinal study. Participants were clinicians, researchers, educators and healthcare students who registered for access to the e-learning modules between April 1st and November 30th 2020. Uptake was evaluated by outcomes (reach across countries; referral sources; attrition) extracted from registration data and embedded within pre-training surveys in the Learning Management System. Effectiveness was evaluated by outcomes (confidence with video-conferencing; likelihood to use education, strengthening exercise and physical activity in a treatment plan for knee OA; usefulness of modules) in pre- and post-training (immediately upon completion) surveys in the Learning Management System. Implementation was evaluated by outcomes related to use of learnings, and usefulness of program elements, in an electronic survey administered four months after completion of modules.

Results:

Broad uptake was evident, with 6741 people from 97 countries registering for access. Amongst registrants, there were high levels of attrition, with 2463 (37%) commencing the e-learning program and pre-training survey and 1318 (20%) completing all modules and post-training survey. The e-learning program was effective, with learners who completed the modules demonstrating increased confidence with video-conferencing (mean change (95% CI) 3.1 (3.0, 3.3) numerical rating scale units), as well as increased likelihood to use education, strengthening exercise and physical activity in a treatment plan for people with knee OA, compared to pre-training. Implementation of learnings was evident at 4 months with almost all respondents indicating that the modules had changed/informed their usual practice in some way, and 90% of respondents recommending the e-learning modules and/or downloadable resources to others. More than half used their learnings to structure in-person consultations with patients (56%) and the patient information booklets in their clinical practice (53%).

Conclusions:

This study provides evidence of uptake, effectiveness and implementation of learnings into clinical practice of an asynchronous self-directed e-learning program provided globally free-of-charge in a real-world setting. The PEAK e-learning modules offer clinicians an accessible educational course to learn about best-practice knee OA management, including telehealth delivery via video-conferencing.