• Effects of an e-learning programme on osteopaths’ back pain attitudes: a mixed methods feasibility study

      Draper-Rodi, Jerry (University of BedfordshireUniversity of Bedfordshire, 2016-07)
      i. Background Guidelines recommend the biopsychosocial (BPS) model for managing non-specific low back pain (NSLBP) but the best method for teaching this model is unclear. Printed material and face-to-face learning have limited effects on practitioners’ attitudes to back pain. An alternative way is needed and e-learning is a promising option. E-learning is becoming an important part of teaching, but little guidance is available to the osteopathic profession. ii. Purpose This study had four aims. First to assess the feasibility of running a main trial to test the effectiveness of an e-learning programme on the BPS model for NSLBP on experienced practitioners’ attitudes to back pain; secondly, to assess the acceptability of the e-learning programme and the use of the internet as a mode of CPD; thirdly to provide an effect size estimate; and finally to explore the participants’ views on the e-learning programme and its possible impact on their reported behaviour. iii. Methods First a scoping review of the BPS factors and assessment methods for NSLBP was conducted. It informed the content of an e-learning programme that was designed and developed, and informed by a behaviour change model and an e-learning developmental model. An explanatory mixed methods feasibility study was conducted: first, a pilot Randomised Controlled Trial (RCT) assessed experienced osteopaths’ attitudes before and after the intervention, using the Pain Attitudes and Beliefs Scale (PABS) and the Attitudes to Back Pain Scale for musculoskeletal practitioners (ABS-mp); then semi-structured interviews explored participants’ views on the e-learning programme and its possible impact on their reported practice behaviours. ii iv. Results 45 osteopaths, each with at least 15 years of experience consented to, and took part in, the study. The two trial arms were: a 6-week e-learning programme (intervention group) and a waiting-list group (control group). 9 participants were interviewed for the qualitative strand. The feasibility of conducting a main trial was good, the intervention was well accepted and the adherence to the intervention was good. An effect size estimate was calculated to inform sample size for a main trial. In the qualitative strand, participants’ views on the BPS model fell in with the themes of being Not structural enough, being Part of existing practice and being Transformative. v. Conclusion(s) This study provided new knowledge that had not been reported before in several areas:  how an e-learning programme for experienced manual practitioners should be developed,  a new intervention was reported (e-learning programme), including its design and acceptability,  osteopaths’ views on using the internet as a form of CPD,  information on the challenges faced in implementing a BPS approach.