The development and evaluation of peer-facilitated practice-based dementia workshops for GPs
Dementia is a topic of increasing concern internationally because of increasing prevalence rates, rising costs to healthcare systems and because of the impact dementia has on patients and on their families. The Irish National Dementia Strategy highlights the pivotal role played by GPs in the care of of people with dementia, in particular emphasising GPs’ central position in making a timely diagnosis and activating supports and recommends that GPs receive further dementia-care training.However, educational interventions have had largely disappointing results in improving dementia care in general practice. Aspects of interventions that were most effective in changing GPs practice included interactive small group work, facilitated by fellow GPs and the use of computerised decision support software.Here, we describe the development and evaluation of peer-faciltated practice-based dementia workshops for GPs.
Workshop participants (GPs), (n=105) were recruited from a register of general practices throughout Ireland.Workshop facilitators (GPs), (n=6) were trained to facilitate two 1-hr workshops for their peers.Informed by an educational needs analysis, the themes for the two workshops were (1) dementia diagnosis and early intervention and (2) the management of the behavoural and psychological symptoms of dementia.In accordance with the key tenets of adult learning theory, the design and delivery of the workshops incorporated relevant, interactive case-based scenarios and included the development and demonstration of a dementia web resource for primary care, www.dementiapathways.ie.A mixed-methods evaluation approach was used including (1) participants' completion of questionnaires post workshops and (2) a focus group with workshop facilitators (n=5).
This evaluation demonstrated the value of small-group, peer-facilitated dementia workshops, tailored to meet GPs’ educational needs.From a participant perspective, the evaluation found that attendance at the dementia workshops considerably improved participants’ self-reported knowledge and confidence in aspects of dementia care. Regarding the learning environment, the participants appreciated the accessibility and feasibility of lunch-time workshops held in their own practices, perhaps to be expected for busy clinicians. The workshop delivery method of interactive, case-based discussions was also highly rated by participants. The most highly rated aspect of the delivery of the workshops was the peer-facilitation. Participants appreciated the approach of an experienced fellow GP, who they felt was well-prepared, guiding them through the discussions around the complexities of dementia care.GP workshop facilitators were enthused by their role as peer-support for their colleagues though acknowledged a potential tension between their position as facilitator and being regarded as a subject expert.
Short, practice-based and peer-facilitated dementia workshops are well received by GPs. To be effective and acceptable, the content, design and delivery of educational interventions for GPs should be relevant, accessible and interactive.