The “ABCs of AD”: A pilot test of an online educational module to increase use of the autonomic dysreflexia clinical practice guidelines among paramedic and nurse trainees

Abstract

Context/Objective

Despite availability of clinical practice guidelines (CPGs), gaps in autonomic dysreflexia (AD) knowledge and practice persist. A free, online educational module, the “ABCs of AD”, was developed to improve knowledge of the AD-CPGs among emergency healthcare personnel. We examine short-term changes in paramedic and nurse trainees’ knowledge of, and social cognitions towards using, the AD-CPGs following module completion.

Design

Pre–post.

Methods

Thirty-four paramedic and nurse trainees from two training programs in Canada completed measures immediately before and after viewing the online “ABCs of AD” module.

Outcome measures

AD knowledge test; Theory of Planned Behavior social cognition questionnaire; module feedback survey.

Results

Paired samples t-tests revealed significant increases in participants’ AD knowledge test scores (M ± SDpre = 9.00 ± 2.46, M ± SDpost = 12.03 ± 4.07, P < 0.001; d = 0.84). Prior to viewing the module, participants reported positive social cognitions for using the AD-CPGs (all Ms ≥ 4.84 out of 7). From pre- to post-module, no significant changes were seen in participants’ social cognitions for using the AD-CPGs. Participants’ average module viewing time was 36.73 ± 24.17 minutes (range 8–90 minutes). There was a decline in viewing from the first to the last module sections, with only half of participants viewing all six sections.

Conclusion

Knowledge alone is insufficient for clinical behavior change; as such, social cognitive determinants of behavior should be explicitly targeted in future iterations of the module to increase the likelihood of increased use of the AD-CPGs. To engage viewers across all module sections, the “ABCs of AD” module should include supplementary learning strategies, such as interactive quizzes and peer-to-peer interaction.

Keywords:

• Autonomic dysreflexia
• Clinical practice guideline
• Knowledge translation
• Psychological theory
• Spinal cord injuries

Acknowledgment

The authors would like to acknowledge Melanie Meyers for connecting the research team with trainees at the Justice Institute of British Columbia, Catherine Yang for assistance with data collection in British Columbia, and Krystn Orr for assistance with data collection in Ontario and for management of the online data.