General Practitioner Blended Learning Solution - Quality Use of Pathology in Practice (QUPP)

Introduction

General practitioners (GPs) in Australia play a crucial role in screening for chronic diseases, managing predispositions, and providing ongoing patient care. Over the past decade, there has been a significant increase in GP visits and managed problems, resulting in an estimated 24.2 million additional laboratory tests and increased expenditure on testing. This trend has led to GPs prescribing a high number of low-value pathology tests, which increases healthcare costs and risks patient harm. To address this issue, a comprehensive educational intervention was needed to improve GPs' referral practices and enhance their decision-making processes.

Objectives

The primary goal of this project was to deliver an online multifaceted educational intervention aimed at improving the quality of care for patients while reducing costs from low-value test ordering. The project aimed to educate 1,000 GPs over the intervention period, support informed and evidence-based referral practices, and enhance consumer information to facilitate informed choices. Additionally, it sought to implement strategies to minimize risks of harm to patients.

Solutions

To achieve these objectives, Medcast partnered with Emergent Learning to design, develop, and host the online learning for health professionals.

The program began with pre and post-course multiple-choice quizzes and self-assessed knowledge and confidence ratings. These quizzes were centered around a case study, with questions mapped to the defined competencies, skills, attitudes, and behaviors targeted by the learning.

The educational content included pre and post-course interactive online case scenarios. Four eLearning modules were developed in Articulate Storyline, each featuring a case scenario with two presentations—diagnosis and monitoring—totalling eight cases. The case studies were selected in collaboration with an expert GP educator based on the top 20 common presentations. The eLearning modules considered factors influencing GP decisions, personal biases, patient harm likelihood and consequences, pre-test probability, sensitivity and specificity, and the concept of cognitive pause.

Live webinars were also an integral part of the intervention. Three 60-minute webinars were run three times over the intervention period, involving case studies similar to those in the eLearning modules but featuring different cases.

Additionally, four podcasts were developed in a Q&A format, covering core topics such as lived experience/personal bias, patient harm, test sensitivity/specificity, and strategies for rational decision-making.

Practice-based education activities involved small group learning on specific topics. These activities included extracting data from practice versus norms, and activities for reflection and/or reporting.

Supporting reference material was developed in the form of a page hosted on the Medcast LMS, ensuring that participants had access to essential resources.

Finally, a community of practice and discussion forum was hosted on the Medcast LMS to facilitate ongoing engagement and support among participants.

Outcome

The educational intervention had a substantial impact on improving general practitioners' (GPs) decision-making processes regarding pathology test referrals. By engaging over 1,000 GPs through a comprehensive and multifaceted online learning program, the initiative successfully enhanced the quality of patient care while reducing the prevalence of low-value test ordering. GPs reported improved knowledge and confidence in their referral practices, as evidenced by the significant knowledge gains between pre- and post-course assessments. The case-based learning approach, combined with interactive eLearning modules, live webinars, and podcasts, provided participants with the tools to critically assess their biases, improve their understanding of test sensitivity and specificity, and implement rational decision-making strategies in their daily practice.

Furthermore, the practice-based education activities and access to supporting materials fostered a deeper level of engagement, enabling GPs to reflect on their practices and benchmark their performance against industry norms. The community of practice, hosted on the Medcast LMS, further supported sustained learning and collaboration among participants, ensuring the long-term application of skills and knowledge. This intervention not only contributed to better patient outcomes but also helped reduce healthcare costs by minimising unnecessary testing, making it a valuable initiative in the healthcare landscape.