title: Evaluating the role of key learning theories in ECHO: a telehealth educational program for primary care providers.
abstract: BACKGROUND
  ECHO (Extension for Community Healthcare Outcomes) is a telehealth educational program that uses videoconference technology to train community-based primary care providers (PCP's) on the management of complex, chronic diseases. The main components of ECHO are didactics, case presentations, and case-based learning. ECHO was developed using the key principles of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory.
  
  
  OBJECTIVE
  In a prior study, we implemented an ECHO curriculum to improve management of resistant hypertension. The goals of the current study were to determine the extent to which the learning theories served as the foundation of the ECHO curriculum and identify opportunities to more effectively incorporate key principles of these theories into the ECHO program.
  
  
  METHODS
  We conducted semi-structured interviews with the nine clinicians who participated in the pilot curriculum. A community-based PCP assisted with question development, analysis, and manuscript preparation. We analyzed the interview transcripts using Directed Content Analysis.
  
  
  RESULTS
  Transcript analysis supported the contention that ECHO is based upon Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Comments from study participants highlighted benefits of each theory's principles. Conversely, they also suggested we could improve our implementation of ECHO by adhering more closely to specific learning theory strategies.
  
  
  CONCLUSIONS
  Our results indicate that ECHO indeed reflects the key tenants of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Several aspects of our ECHO curriculum can be improved by more complete application of these learning theories.
authors.forename: Carmela
authors.initials: C
authors.lastname: Socolovsky
authors.forename: Christopher
authors.initials: C
authors.lastname: Masi
authors.forename: Tamara
authors.initials: T
authors.lastname: Hamlish
authors.forename: Glen
authors.initials: G
authors.lastname: Aduana
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Arora
authors.forename: George
authors.initials: G
authors.lastname: Bakris
authors.forename: Daniel
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000328:Adult; D002641:Chicago; D055812:Community-Based Participatory Research; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D004521:Educational Measurement; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007407:Interviews as Topic; D008297:Male; D017145:Models, Educational; D010865:Pilot Projects; D011320:Primary Health Care; D016730:Program Development; D015397:Program Evaluation; D014504:Urban Health; D049269:Videoconferencing