Learning needs analysis of spinal specialist triage practitioners

Purpose

The South East London and Kent Regional Spinal Network (RSN) aims to provide evidenced-based pathways for management of musculoskeletal spinal conditions from first point of contact through to tertiary care. From 1st April 2018 all non-emergency referrals to secondary care (Pain and Spinal Surgery) must be referred by Spinal Specialist Triage Practitioners (SSTP). GP referrals will not be accepted. This aligns with the National Back Pain Pathway (NBPP) and NICE CG59 guidelines towards improving spinal care, equity of services and commissioning of spine care across the region. SSTPs, predominantly physiotherapists by background, are multidisciplinary (e.g. osteopaths, nurses) and work in primary or secondary care or in interface services run by NHS and Any Qualified Providers (AQP).

There have been calls for the development of a regional training programme and in the long-term, a nationally recognised qualification, to support SSTPs and promote excellent patient care. Current provision of training is fragmented and learning needs unknown. A learning needs analysis is required to allow for development of future training and development.

There are no validated learning needs questionnaires suitable for the specific purpose therefore a comprehensive tool was required.

Approach

An electronic questionnaire was informed, developed and refined in a process of reviewing validated learning needs analysis questionnaires, incorporating standards and competencies defined in the National Low Back Pain and Radicular Pain Pathway 2017, discussion with stakeholders (e.g. Advanced Practice Physiotherapists, Pain Consultants, Consultant Spinal Surgeons) and professional networks (e.g. National Back Pain Clinical Network) and piloted by SSTPs from two services.

In April 2018 the questionnaire was sent to all managers of spinal triage services within the South East London and Kent RSN (n=14) for dissemination to SSTPs (n=50-60). Two reminders will be sent and the survey will be closed three weeks after initial circulation. Expected response rate is 60%.

Descriptive (e.g. mean, interquartile range) analysis of results will be conducted as well as qualitative review of additional narrative responses submitted.

Outcomes

The developed questionnaire requests participants to rate on a 5-point Likert scale 'How important is this activity to the successful performance of your job?' and 'How well do you consider you perform the following activity' in relation to 41 activities; how they would like to receive future training; if competency frameworks and in-service-training programmes are available locally and if so, would they be willing to share with the network. Demographic data (e.g. professional background, qualifications) are also collected.

Implications

A comprehensive learning needs analysis has been developed for SSTPs. Strengths include it's suitability for multidisciplinary use within NHS and AQPs, simplicity of delivery and initial analysis using online software. A weakness is the lack of psychometric validation however expert opinion has been sought and the questionnaire has been well piloted.

The questionnaire is available for use by other RSNs. The results of the learning needs analysis will inform the content, format and future development of training for SSTPs within the South East London and Kent RSN. It has the potential to be used to inform the development of nationally recognised training programmes.

Fund acknowledgements

This work was not funded

Additional notes

This work was presented at Physiotherapy UK 2018.