An evaluation of an Extension for Community Healthcare Outcomes (ECHO) intervention in cancer prevention and survivorship care

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Abstract

To improve cancer care in Indiana, a telementoring program using the Extension for Community Healthcare Outcomes (ECHO) model was introduced in September 2019 to promote best-practice cancer prevention, screening, and survivorship care by primary care providers (PCPs). The aim of this study was to evaluate the program’s educational outcomes in its pilot year, using Moore’s Evaluation Framework for Continuing Medical Education and focusing on the program’s impact on participants’ knowledge, confidence, and professional practice. We collected data in 22 semi-structured interviews (13 PCPs and 9 non-PCPs) and 30 anonymous one-time surveys (14 PCPs and 16 non-PCPs) from the program participants (hub and spoke site members), as well as from members of the target audience who did not participate. In the first year, average attendance at each session was 2.5 PCPs and 12 non-PCP professionals. In spite of a relatively low PCP participation, the program received very positive satisfaction scores, and participants reported improvements in knowledge, confidence, and practice. Both program participants and target audience respondents particularly valued three features of the program: its conversational format, the real-life experiences gained, and the support received from a professional interdisciplinary community. PCPs reported preferring case discussions over didactics . Our results suggest that the Cancer ECHO program has benefits over other PCP-targetted cancer control interventions and could be an effective educational means of improving cancer control capacity among PCPs and others. Further study is warranted to explain the discrepancies among study participants’ perceptions of the program’s strengths and the relatively low PCP participation before undertaking a full-scale effectiveness study.

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The online version contains supplementary material available at 10.1186/s12911-022-01874-x.

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Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment.

Liselotte Dyrbye, C. West, Daniel Satele … (2012)

Burnout is a common problem among physicians and physicians-in-training. The Maslach Burnout Inventory (MBI) is the gold standard for burnout assessment, but the length of this well-validated 22-item instrument can limit its feasibility for survey research. To evaluate the concurrent validity of two questions relative to the full MBI for measuring the association of burnout with published outcomes. DESIGN, PARTICIPANTS, AND MAIN MEASURES: The single questions "I feel burned out from my work" and "I have become more callous toward people since I took this job," representing the emotional exhaustion and depersonalization domains of burnout, respectively, were evaluated in published studies of medical students, internal medicine residents, and practicing surgeons. We compared predictive models for the association of each question, versus the full MBI, using longitudinal data on burnout and suicidality from 2006 and 2007 for 858 medical students at five United States medical schools, cross-sectional data on burnout and serious thoughts of dropping out of medical school from 2007 for 2222 medical students at seven United States medical schools, and cross-sectional data on burnout and unprofessional attitudes and behaviors from 2009 for 2566 medical students at seven United States medical schools. We also assessed results for longitudinal data on burnout and perceived major medical errors from 2003 to 2009 for 321 Mayo Clinic Rochester internal medicine residents and cross-sectional data on burnout and both perceived major medical errors and suicidality from 2008 for 7,905 respondents to a national survey of members of the American College of Surgeons. Point estimates of effect for models based on the single-item measures were uniformly consistent with those reported for models based on the full MBI. The single-item measures of emotional exhaustion and depersonalization exhibited strong associations with each published outcome (all p ≤ 0.008). No conclusion regarding the relationship between burnout and any outcome variable was altered by the use of the single-item measures rather than the full MBI. Relative to the full MBI, single-item measures of emotional exhaustion and depersonalization exhibit strong and consistent associations with key outcomes in medical students, internal medicine residents, and practicing surgeons.

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The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review.

Carrol Zhou, Allison M. Crawford, Eva Serhal … (2016)

Project Extension for Community Healthcare Outcomes (ECHO) uses tele-education to bridge knowledge gaps between specialists at academic health centers and primary care providers from remote areas. It has been implemented to address multiple medical conditions. The authors examined evidence of the impact of all Project ECHO programs on participant and patient outcomes.

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Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.

Donald E. Moore, Joseph Green, Harry Gallis (2009)

Most physicians believe that to provide the best possible care to their patients, they must commit to continuous learning. For the most part, it appears the learning activities currently available to physicians do not provide opportunities for meaningful continuous learning. At the same time there have been increasing concerns about the quality of health care, and a variety of groups within organized medicine have proposed approaches to address issues of physician competence and performance. The authors question whether CME will be accepted as a full partner in these new approaches if providers continue to use current approaches to planning and assessing CME. A conceptual model is proposed for planning and assessing continuous learning for physicians that the authors believe will help CME planners address issues of physician competence, physician performance, and patient health status.

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Author and article information

Contributors

Eneida A. Mendonca: emendonc@iu.edu

Journal

Journal ID (nlm-ta): BMC Med Inform Decis Mak

Journal ID (iso-abbrev): BMC Med Inform Decis Mak

Title: BMC Medical Informatics and Decision Making

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6947

Publication date (Electronic): 17 May 2022

Publication date PMC-release: 17 May 2022

Publication date Collection: 2022

Volume: 22

Electronic Location Identifier: 135

Affiliations

[1 ]GRID grid.448342.d, ISNI 0000 0001 2287 2027, Center for Biomedical Informatics, , Regenstrief Institute, ; 1101 West Tenth Street, Indianapolis, IN 46202 USA

[2 ]GRID grid.257413.6, ISNI 0000 0001 2287 3919, Richard M. Fairbanks School of Public Health, , Indiana University, ; 1050 Wishard Boulevard, Indianapolis, IN 46202 USA

[3 ]GRID grid.414923.9, ISNI 0000 0000 9682 4709, Riley Hospital for Children, ; 705 Riley Hospital Drive, Indianapolis, IN 46202 USA

[4 ]GRID grid.257413.6, ISNI 0000 0001 2287 3919, Indiana University School of Medicine, ; 340 West Tenth Street, Fairbanks Hall, Suite 6200, Indianapolis, IN 46202 USA

[5 ]GRID grid.280429.5, ISNI 0000 0004 0509 7737, Kansas Department of Health and Environment, , Curtis State Office Building, ; 1000 SW Jackson St, Topeka, KS 66612 USA

Article

Publisher ID: 1874

DOI: 10.1186/s12911-022-01874-x

PMC ID: 9112252

PubMed ID: 35581580

SO-VID: 124b0ba3-2722-4071-8b3e-7c79b253a458

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 9 November 2021

Date accepted : 4 May 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000092, U.S. National Library of Medicine;

Award ID: T15LM012502

Award Recipient : Zheng Z. Milgrom

Funded by: Indiana Cancer Consortium

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ScienceOpen disciplines: Bioinformatics & Computational biology

Keywords: telemedicine,education,continuing,population health,cancer control,evaluation

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ScienceOpen disciplines: Bioinformatics & Computational biology

Keywords: telemedicine, education, continuing, population health, cancer control, evaluation

An evaluation of an Extension for Community Healthcare Outcomes (ECHO) intervention in cancer prevention and survivorship care

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Most cited references 18

Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment.

The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review.

Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.

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