Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education  

作　　者：Belinda O’Hagan Julie White Ilana Hardesty Rachel Amgott Candice Bangham Xinyang Liu Alyson Codner Amy Ursitti Alana Chandler Sarah Foster Marilyn Augustyn Jacey Greece Belinda O’Hagan;Julie White;Ilana Hardesty;Rachel Amgott;Candice Bangham;Xinyang Liu;Alyson Codner;Amy Ursitti;Alana Chandler;Sarah Foster;Marilyn Augustyn;Jacey Greece(Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Boston Medical Center, Boston, United States of America;Boston University Chobanian & Avedisian School of Medicine, Boston, United States of America;Department of Community Health Sciences, Boston University School of Public Health, Boston, United States of America)

机构地区：[1]Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Boston Medical Center, Boston, United States of America [2]Boston University Chobanian & Avedisian School of Medicine, Boston, United States of America [3]Department of Community Health Sciences, Boston University School of Public Health, Boston, United States of America

出　　处：《Open Journal of Pediatrics》2024年第3期488-513,共26页儿科学期刊（英文）

摘　　要：Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO^®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO^®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

关 键 词：Autism Spectrum Disorder Program Evaluation Case-Based Training Provider Burnout Continuing Medical Education 

分 类 号：R73[医药卫生—肿瘤]