Presenters
- Sanjeev Sockalingam, MD, MHPE, Vice-President Education & Clinician Scientist, Centre for Addiction and Mental Health, Professor of Psychiatry, University of Toronto
Summary
Background/Rationale: Project Extension for Community Healthcare Outcomes (Project ECHO©) is an established hub-and-spoke tele-education model to bridge knowledge gaps between academic specialists and remote primary care providers (PCPs). Little is known about the mechanisms of learning in this model. This project aimed to identify how ECHO supports learning through analyzing recorded tele-video-education data from Project ECHO Ontario Mental Health (ECHO-ONMH). Study Design: A qualitative thematic analysis was conducted by sampling sessions across an ECHO-ONMH 34 week cycle and utilized the conceptual framework of adaptive expertise to under learning experiences. Two individuals coded participant interactions during 2-hour recorded sessions using an iterative, constant comparative methodology until thematic saturation was achieved. Results: The authors identified four key mechanisms of learning in ECHO: (i) productive struggle with cases, (ii) integrated understanding, (iii) collaborative reformulation of cases, and (iv) generation of conceptual solutions based on a new understanding. Quotes from the sessions illustrated these four key learning mechanisms during the virtual education program. Learning was observed to be bidirectional from both the hub to spoke as well as between spoke sites throughout the ECHO sessions. Conclusion: Despite the widespread implementation of Project ECHO, a paucity of research has focused on how PCP spokes learn within this capacity building model. Our study demonstrated a bidirectional exchange of knowledge between hub specialist teams and PCP spokes that aligned with the development of adaptive expertise. These findings support the role of ECHO in supporting providers in their capability to manage new and complex mental health needs in their practice. Key Words: adaptive expertise, continuing professional development, instructional methods, tele-education, capacity building, mental health
Objectives
- Describe Project ECHO© and the need in specialized care it aims to address
- Discuss how ECHO supports the learning, adapting and solving of complex clinical problems
- Apply an approach to foster the development of adaptive expertise within ECHO sessions and other capacity building models
