The community fracture capture (CFC) learning hub: implementation and evaluation.

Abstract

Primary care physicians (PCP) play a key role at the community level in the primary and secondary prevention of fragility fractures. It is critical that they have appropriate opportunities to acquire and maintain the necessary knowledge, confidence and experience to fulfill this role. However, such opportunities are commonly limited for PCPs, given the paucity of suitable learning resources and the extent of other demands on their time and attention. Therefore, our multidisciplinary team has devised an online platform to address these needs. The CFC Learning Hub is characterised by easy online interaction with PCP facilitators and with topic experts, flexibility in the timing and amount of interaction, a small group format, and imparting information that is contextualised by reference to PCP participants' own (anonymised) patients. There is an associated knowledge hub where participants can explore topics in more depth. The program was promoted via an online medical education provider and through professional bodies relevant to PCPs. The CFC Learning Hub program was implemented and evaluated in four 6-week cycles, each with 11 to 19 PCP participants; 35 PCPs completed a post-participation evaluation survey. Based on the overall evaluation, the primary reason for participating given by 91% of respondents was either to improve patient care or to learn from experts; 82% were satisfied with the program content and 96% considered that their training needs had been entirely or partly met. At week 1 of the program, <50% were confident in applying published guidelines to investigate and manage osteoporosis; this increased to >97% at the end. The confidence in managing treatment failure rose from <10% at week 1 to 69% at the end and 89% were likely to recommend the program to others. Some participants provided suggestions for program improvements, including to increase the number of webinars/interactive sessions with specialists: these were found to be very engaging. Responses to additional questions asked in cycle 4 showed that 90% will change their practice as a result of the program. We conclude that this model for PCP learning has the potential to contribute significantly to the care of patients in our communities who are at high risk for fragility fractures. It might also be applied in other common conditions mainly managed in the general community. The Learning Hub model warrants further application with PCPs and other health professionals, and trialling in other professional fields.