Effectiveness of the Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education and influence of key learning conditions on the development of competencies in healthcare professionals: Protocol for a mixed methods systematic review

Abstract BackgroundThe Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education is an innovative guided-practice model aiming at amplifying healthcare professionals’ competencies in the management of chronic and complex health conditions. While data on the effectiveness of the ECHO Model is increasingly available in the literature, the influence of key learning conditions on the model effectiveness remains unclear. Therefore, the overarching aim of this systematic review is to identify, appraise and synthesize the available quantitative (QUAN) and qualitative (QUAL) evidence regarding the effectiveness of the ECHO Model and the influence of key learning conditions on the development of competencies in healthcare professionals.MethodsThis proposed systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for Mixed Methods Systematic Reviews (MMSR) and will follow a convergent segregated approach. A systematic search will be undertaken using QUAN, QUAL and mixed methods (MM) studies of ECHO-affiliated programs identified in five databases. A publication date filter will be applied to find the articles published from 2003 onwards. Sources of unpublished studies and grey literature will be searched as well. Retrieved citations will be screened by two review authors independently. Disagreements will be resolved through discussion until a consensus is reached, or by including a third reviewer. Studies meeting the predefined inclusion criteria will be assessed on methodological quality and the data will be extracted using standardized data extraction forms. Separate QUAN and QUAL synthesis will be performed, and findings will be integrated using a matrix approach for the purpose of comparison and complementarity.DiscussionThis MMSR will fulfill important gaps in the current literature on the ECHO Model, as the first to provide estimates on its effectiveness and consider simultaneously the influence of key learning conditions on the development of competencies in healthcare professionals. As implementations of the ECHO Model greatly vary depending on the context, topic and targeted professional group, a better understanding of the conditions that contribute to competencies’ development in healthcare professionals is crucial to inform the design and implementation of the model.Systematic review registration:This MMSR protocol is pending registration in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (submitted October 21, 2020; ID Number: 197579).