Background & Aims

Healthcare professionals attend Continuing Professional Education (CPE) programs to maintain their competence and learn about new and developing areas in their field. We offer a virtual, synchronous CPE program to increase competence in managing chronic pain Ontario: Project ECHO (Extensions for Community Healthcare Outcomes) which uses a hub-and-spoke design to connect interprofessional primary care practitioners (PCPs) with a team of interprofessional experts (1-6). The teleclinics involve both a didactic component delivered by a member of the expert hub and a case presentation by one of the PCP ‘spokes’, followed by discussion. For the past year, our expert hub included a person with lived experience of chronic pain as a member of the expert team. Our aim was to evaluate the engagement and feedback of participants in relation to the person with lived experience in the expert hub.

Methods

We conducted two focus group discussions (FGDs) with ECHO participants who attended the annual in-person event in November 2023 in Toronto, Ontario. Participants were compensated with C$50.00. Two facilitators with two note-takers ran the sessions using an agreed question guide; the FGDs were recorded and transcribed with permission from participants. Participant professions include nursing, pharmacy, kinesiology, social work, and physiotherapy.

Results

The FGDs lasted approximately one hour and included 9 people (n = 4 in FGD 1, n = 5 in FGD 2). The results presented here refer to one question in particular about the inclusion of a person with lived experience as part of the hub?
The majority of responses expressed appreciation of L’s presence on the hub. One respondent referred to patients as “good teacher[s]”; the patient perspective also may remind practitioners of the patient as a whole person” Yet another appreciated having L’s experience to share in conversations with their patients.
Several participants referred to the presence of L as “powerful” and L’s own progress in managing their pain as encouraging. Two participants mentioned empathy as a factor.
Several individuals mused on how their case presentation or discussion might alter due to knowing that a patient was there in the group, and worried about the possibility of using “some language” that might be “triggering” to the patient.

Conclusions

The inclusion of a person with lived experience in an education program to improve chronic pain management in PCPs in Ontario has, over the year that L has been involved, evoked thoughtfulness around the use of language and attitude toward patients amongst these interprofessional representatives of Project ECHO participants. While the overall valence of comments tends toward the positive, some reservations can also be discerned. Further investigation is warranted.

References

(1) Zhao, J., Salemohamed, N., Stinson, J., Carlin, L., Seto, E., Webster, F., & Furlan, A. D. (2020). Health care providers’ experiences and perceptions participating in a chronic pain telementoring education program: A qualitative study. Canadian journal of pain = Revue canadienne de la douleur, 4(1), 111–121. https://doi.org/10.1080/24740527.2020.1749003

(2) Hassan, S., Carlin, L., Zhao, J., Taenzer, P., & Furlan, A. D. (2021). Promoting an interprofessional approach to chronic pain management in primary care using Project ECHO. Journal of interprofessional care, 35(3), 464–467. https://doi.org/10.1080/13561820.2020.1733502

(3) Furlan, A. D., Pajer, K. A., Gardner, W., & MacLeod, B. (2019). Project ECHO: Building capacity to manage complex conditions in rural, remote and underserved areas. Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada, 24(4), 115–120. https://doi.org/10.4103/CJRM.CJRM_20_18

(4) Furlan, A. D., Zhao, J., Voth, J., Hassan, S., Dubin, R., Stinson, J. N., Jaglal, S., Fabico, R., Smith, A. J., Taenzer, P., & Flannery, J. F. (2019). Evaluation of an innovative tele-education intervention in chronic pain management for primary care clinicians practicing in underserved areas. Journal of telemedicine and telecare, 25(8), 484–492. https://doi.org/10.1177/1357633X18782090

(5) Carlin, L., Zhao, J., Dubin, R., Taenzer, P., Sidrak, H., & Furlan, A. (2018). Project ECHO Telementoring Intervention for Managing Chronic Pain in Primary Care: Insights from a Qualitative Study. Pain medicine (Malden, Mass.), 19(6), 1140–1146. https://doi.org/10.1093/pm/pnx233

(6) Dubin, R. E., Flannery, J., Taenzer, P., Smith, A., Smith, K., Fabico, R., Zhao, J., Cameron, L., Chmelnitsky, D., Williams, R., Carlin, L., Sidrak, H., Arora, S., & Furlan, A. D. (2015). ECHO Ontario Chronic Pain & Opioid Stewardship: Providing Access and Building Capacity for Primary Care Providers in Underserviced, Rural, and Remote Communities. Studies in health technology and informatics, 209, 15–22.

Presenting Author

Andrea Furlan

Poster Authors

Andrea Furlan

MD, PhD

IWH

Lead Author

E-mail

Lynn Cooper

ECHO Ontario Chronic Pain and Opioid Stewardship

Lead Author

E-mail

Jane Zhao

MSc

Toronto Rehab, University Health Network (UHN)

Lead Author

E-mail

Leslie Carlin

PhD

University of Toronto

Lead Author

E-mail

Paulo Taenzer

PhD

Toronto Rehab, University Health Network (UHN)

Lead Author

E-mail

Andrew Smith

MD

Centre for Addiction and Mental Health (CAMH)

Lead Author

E-mail

John Flannery

MD

Toronto Rehabilitation Institute-University Health Network

Lead Author

E-mail

Topics

  • Patient Engagement and Co-Creation in Research and Education