An interdisciplinary e-learning intervention for professionals working with breast cancer survivors and chronic pain: a realist evaluation

Abstract

Purpose: Chronic pain is prevalent among breast cancer survivors. Bio-psychosocial factors interplay in its exacerbation and maintenance. Therefore, prevention and treatment require an interdisciplinary response and the integration of various approaches. To deliver this way of working, healthcare professionals may need training. We developed an e-learning intervention, aimed at increasing awareness and interdisciplinary collaboration in response to pain after cancer. We aimed to gain insight into the intervention's implementation, mechanisms, and outcomes through a realist evaluation.

Methods: A mixed-methods pre- and post-test design with follow-up was used. Via questionnaires, professionals reported on the feasibility of the e-learning and their knowledge, beliefs, confidence, and professional role in pain prevention and treatment. Six-month post-intervention, interviews were conducted to explore transferability in practice.

Results: An interdisciplinary group of 22 professionals completed the intervention. Overall, e-learning was deemed a feasible format for training. An increase in confidence was found, whereas no changes were detected in knowledge and professional role. Configurations were outlined between these mechanisms and behaviors in practice, influenced by implementation processes and context-related factors.

Conclusions: E-learning holds promise in stimulating knowledge, beliefs, confidence, and professional role. In this, the value of asynchronous discussion forums, case-based exercises, practical tools, and models were emphasized.

Keywords: Continuous professional development; cancer survivorship; chronic pain management; e-learning; interdisciplinary; realist evaluation.