Building paediatric eyecare capability via Project ECHO tele-mentoring in Australia

Effective paediatric eyecare requires up-to-date knowledge and skills. Effective tele-mentoring and continuous education can significantly improve clinical confidence and ensure comprehensive care for paediatric patients.

Project ECHO (Extension for Community Healthcare Outcomes) is a proven interactive case-based tele-mentoring for medical practitioners. A Paediatric Eyecare ECHO was implemented with Australian optometrists to evaluate its acceptability as an education modality and impact on self-reported confidence in clinical knowledge and competency.

Eight weekly, hour-long ECHO sessions on paediatric eyecare topics, informed by a learning needs assessment survey, were conducted. Each session included a brief didactic lecture by an expert, case presentations by participating optometrists and interactive discussions. Participant engagement, satisfaction, likeliness to implement knowledge, and competence were evaluated. Online questionnaires (5-point scale) with open-ended questions were administered before, during, and after the programme. Quantitative data were analysed descriptively and inferentially, while qualitative data were thematically analysed.

Fifty-four optometrists registered for the ECHO with 98.1% attending at least one ECHO session. Forty-four of 54 ECHO programme registrants participated in the programme evaluation. Initial self-reported competencies showed knowledge deficits (score <3) in assessing and managing strabismus (72.1%), amblyopia (64.4%), and children with developmental delays (81.8%) and assessing and triaging paediatric ocular emergencies (63.6%). Most optometrists were satisfied with the ECHO format (>85%) and were likely to implement knowledge gained (>88.6%). Competence ratings increased significantly by +0.51 (Z = 4.3, p < .001). Qualitative feedback highlighted an appreciation for case-based presentations but a desire for more detailed clinical management and vision therapy information.

The Paediatric Eyecare ECHO showed positive outcomes for optometrists in respect of engagement, satisfaction, likeliness to implement knowledge and self-assessed competency in treating paediatric patients. In addition to paediatric eye care case management, this model holds promise for interactive education in other ocular conditions managed by optometrists.