Online osteoarthritis training programme for community-based clinicians: Mixed methods cohort study

Abstract

Background

Core osteoarthritis interventions are ideally delivered in community-based settings. However, many community-based clinicians lack confidence and/or competence to effectively deliver high-quality, culturally-safe, evidence-based osteoarthritis care.

Objective

Assess changes in community-based dietitians', pharmacists', and physiotherapists’ knowledge and confidence to treat people with knee osteoarthritis after completing online KneeCAPS training, and explore perceptions of usefulness, what clinicians learned, and how this influenced their ability to provide osteoarthritis care.

Design

Mixed methods cohort study with quantitative measures and qualitative free-text and focus group interviews.

Results

158 clinicians completed baseline measures, of which 121 completed all required training modules and 68 provided 3-month follow-up; 17 participated in focus groups. Osteoarthritis Knowledge Scale scores (mean change 6.7; 95 % CI 5.1, 8.3) and Confidence in Osteoarthritis Skills scores (mean change 11.8; 95 % CI 9.4, 14.3) increased across the cohort. Clinicians considered the training was thorough, helpful, and clinically applicable. Clinicians reported increased confidence to manage osteoarthritis, and gaining knowledge and skills to help patients. Three themes reflected areas of learning or professional growth: the importance of culturally-safe relationship-building to engage all patients in care; helpful ways to think about osteoarthritis based on best evidence; and the focus and structure of consultations to support sustainable health behaviours. An integrative theme reflected new awareness of the impact of language and communication on patient relationships and outcomes.

Conclusion

KneeCAPS osteoarthritis training improved knowledge about and confidence in skills to manage knee osteoarthritis, particularly regarding culturally-safe relationships, paradigms for making sense of OA, supporting behaviour change, and communication to support participation.