Evaluation of a novel e-learning program for physiotherapists to manage knee osteoarthritis via telehealth: A qualitative study nested in the PEAK randomised controlled trial (Preprint)

BACKGROUND The delivery of physiotherapy via telehealth could provide more equitable access to services for patients. Video conference based telehealth has been shown to be an effective and acceptable mode of service delivery for exercise-based interventions for chronic knee pain, however specific training in telehealth is required for physiotherapists to effectively and consistently deliver care using Telehealth. The development and evaluation of training programs to upskill healthcare professionals in the management of osteoarthritis (OA) has also been identified as an important priority to improve OA care delivery. OBJECTIVE To explore physiotherapist’s experiences with, and perceptions of, an e-learning program about best-practice knee osteoarthritis (OA) management (focussed on a structured program of education, exercise and physical activity), including telehealth delivery via video conferencing. METHODS A qualitative study using semi-structured individual telephone interviews, nested within a randomised controlled trial (RCT). Fifteen Australian physiotherapists from metropolitan and regional private practices were interviewed following completion of an e-learning program. The e-learning program involved self-directed learning modules, a mock video consultation with a researcher (simulated patient), and four audited practice video consultations with pilot patients with chronic knee pain. Interviews were audio-recorded and transcribed verbatim. Data were thematically analysed. RESULTS Five themes (with associated subthemes) arose: i) the experience of self-directed e-learning (physiotherapists were more familiar with in-person learning, however they valued the comprehensive self-paced online modules. Unwieldly technological features could be frustrating); ii) practice makes perfect (physiotherapists benefited from the mock consultation with the researcher and practice sessions with pilot patients alongside individualized performance feedback, resulting in confidence and preparedness to implement new skills); iii) the telehealth journey (although inexperienced with telehealth prior to training, physiotherapists were confident and able to deliver remote care following training but they still experienced some technological challenges); iv) the ‘whole package’ (the combination of self-directed learning modules, mock consultation and practice consultations with pilot patients) was felt to be an effective learning approach, and patient information booklets supported the training package); and v) impact on broader clinical practice (training consolidated and refined existing OA management skills, and enabled a switch to telehealth when the COVID-19 pandemic impacted in-person clinical care). CONCLUSIONS Findings provide evidence for the perceived effectiveness and acceptability of an e-learning program to train physiotherapists (in the context of a clinical trial) about best-practice knee OA management, including telehealth delivery via video conferencing. Implementation of e-learning programs to upskill physiotherapists in telehealth appears warranted, given the increasing adoption of telehealth service models for the delivery of clinical care. CLINICALTRIAL n/a