title: Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.
abstract: OBJECTIVE
  To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study.
  
  
  METHODS
  Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT.
  
  
  RESULTS
  Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain.
  
  
  CONCLUSIONS
  RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term.
authors: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors: Robyn E
authors: RE
authors: Fary
authors: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors: Helen
authors: H
authors: Slater
authors: School of Physiotherapy and Exercise Science, Curtin University and Department of Health, Government of Western Australia, Perth, Australia.
authors: Jason
authors: J
authors: Chua
authors: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors: Sonia
authors: S
authors: Ranelli
authors: Tan Tock Seng Hospital, Singapore.
authors: Madelynn
authors: M
authors: Chan
authors: Curtin University and Department of Health, Government of Western Australia, Perth, and Arthritis and Osteoporosis Victoria, Elsternwick, Victoria, Australia.
authors: Andrew M
authors: AM
authors: Briggs
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000628:therapy*; D015331:Cohort Studies; D020375:Education, Distance / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D059825:Physical Therapists / Q000193:education* / Q000592:standards; D026741:Physical Therapy Modalities / Q000193:education* / Q000592:standards; D011446:Prospective Studies; D016037:Single-Blind Method