Training family doctors and primary care nurses in evidence-based prevention, screening and management of cardiovascular risks in western Ukraine: A longitudinal study

Abstract

Introduction: The Ukrainian primary healthcare programme of preventive and screening recommendations has not been evidence-based. The traditional system of continuous medical education in Ukraine places participants in the role of passive listeners. This study explored the effects of an interactive training course on evidence-based prevention and screening of cardiovascular risks, on changes in Ukrainian family doctors’ (FDs) and primary care nurses’ (PCNs) knowledge and readiness to change practice over time. Methods: Three hundred and seven FDs and PCNs participated in the study. Changes in participants’ knowledge were assessed with 20 multiple choice questions, and their readiness to change practice with a five-item questionnaire. These were administered before, immediately after, three and twelve months after training. Results: The mean pre-course knowledge score was 6.1 (SD 1.8) out of 20, increasing to 14.9 (SD 2.3) immediately afterwards (p<0.001). Three months later it was 10.2 (SD 3.2) and at one year it was 10.4 (SD 3.3), both of which were significantly higher than the pre-training level (p<0.005). The percentage of participants that were highly motivated to change their practice increased from 18.4% before the training to 62.3% immediately afterwards (p<0.001). Three months later, this fell to 40.4%. At 12 months it further reduced to 27.4%, but was still significantly higher than the baseline level (p<0.001). Conclusions: The interactive training was effective in increasing both participants’ knowledge and their readiness to change their clinical practice. The impact of the training diminished over time, but was still evident a year later.