Background A delay in diagnosis/treatment of metastatic spinal cord compression (MSCC) adversely influences functional outcomes and a significant proportion of this delay is attributable to its recognition in primary care. Delays in diagnosis and treatment were the drive behind development of the 2008 NICE guideline. In the process of implementing the NICE guidance locally we recognised that increasing awareness and delivering education to GPs was key to implementing changes. A distance learning tool that would also serve as a continuing reference was proposed as a cost-effective means of achieving this goal.
Aims To measure the effectiveness of introducing a distance learning workbook on MSCC to GPs as a method of providing information on the recognition and management of suspected MSCC.
Methods A 45-page stand alone interactive workbook was designed covering spinal anatomy, pathophysiology, diagnosis and management of MSCC. The workbook was issued to 39 Welsh GPs attending a short course in palliative medicine in 2011. They were asked to complete pre and post workbook questionnaires to record competence on a scale of 1 to 5.
Results 62% (n=24) completed postworkbook questionnaires were returned. There was a statistically significant (p<0.05) increase in average pre and post scores in all domains assessed (anatomy, assessment, diagnosis, pharmacological and non-pharmacological management, ability to communicate information). The greatest increases were recorded in ‘ability to communicate information to patients, carers and healthcare staff’. Of participants who had managed a patient with suspected MSCC in the past 5 years 92.8% (n=13) reported that they would ‘do things differently’ next time as a result of completing the workbook.
Conclusions Participants reported increases in competence across all areas questioned. The findings support the roll out of this education tool to GPs across the Principality and opens up the possibility of using a similar tool for teaching other palliative care topics.
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