The acceptability to primary care staff of a multidisciplinary training package on acute back pain guidelines

Implementing clinical guidelines is more likely to be successful when the whole practice team is committed to the process. Practices from the MRC General Practice Research Framework in two distinct geographical centres in the UK (West Yorkshire and Greater Manchester) participated in the feasibility study for the UK Back pain Exercise And Manipulation (UK BEAM) trial. Practice teams were randomized to continue with their usual care for back pain patients, or to be trained in managing back pain in line with national guidelines. Those randomized to the intervention arm of the trial were invited to attend training, delivered by either a generic trainer or a back pain expert.

Our aims were to assess the general acceptability of the training package to staff, to assess the acceptability of the multidisciplinary approach and to determine if a generic primary care educator could deliver the training as effectively as a clinical back pain expert.

All staff (clinical and non-clinical) from intervention practices were invited to attend multidisciplinary training sessions on the active management of back pain. Practice staff in West Yorkshire were trained by a generic primary care educator and practice staff in Greater Manchester were trained by a clinical back pain expert. The content of sessions was standardized for both trainers and included didactic and interactive components and small group, case study discussions. Detailed notes were taken of observations made of participants during sessions, and evaluation forms were completed by all those who attended.

The majority of participants found the training useful and said that the session had lived up to their expectations. Most found that the session was well planned and that they had sufficient opportunity to participate in learning. The training package was well received by clinical staff, but was less acceptable to non-clinical staff. GPs dominated the small group work discussions. No differences were found between the preferences of participants for the two different trainers.

The training package was appropriate for clinical staff, but did not always meet the needs of non-clinical staff and may require modification for this group. A generic educator can successfully lead multidisciplinary educational sessions addressing clinical issues.