EVALUATION OF AN E-LEARNING PROGRAMME FOR THE CHELSEA CRITICAL CARE PHYSICAL ASSESSMENT TOOL (CPAX): A CLINIMETRIC STUDY

S. Eggmann¹, A. Kindler¹, P. Nydahl², R. Hilfiker³

¹Inselspital, Bern University Hospital, Department of Physiotherapy, Bern, Switzerland, ²University Hospital of Schleswig-Holstein, Nursing Research, Working group Didactics of Nursing and Health Professions, Institute for General Medicine, Kiel, Germany, ³HES-SO Valais-Wallis, School of Health Sciences, Leukerbad, Switzerland

Background: The Chelsea Critical Care Physical Assessment tool (CPAx) is a performance-based measurement tool to evaluate physical function and activity in critically ill adults. In single-centre studies, the CPAx demonstrated excellent measurement properties following a 2-hour training session for assessors. We therefore developed a complimentary E-Learning programme to enhance training and implementation in clinical practice.

Purpose: This clinimetric study aimed to evaluate the CPAx E-Learning programme and to investigate the interrater reliability and practicability to assess the CPAx for the two video case examples that were shown within the CPAx E-Learning programme. We hypothesised that the CPAx would have an excellent interrater reliability (ICC>0.8) and good practicability (scoring duration of 5 minutes) in health-care professionals from different settings.

Methods: We designed a prospective, clinimetric study that was launched with the newly developed CPAx E-Learning programme in June 2022. The E-Learning was open to all health-care professionals who are involved in the rehabilitation of critically ill patients. Participants of the CPAx E-Learning were invited to voluntarily complete an a-priori piloted, online survey. Following informed consent, we obtained demographic data, feedback on the E-Learning as well as CPAx scoring and rating duration for the two video case examples. The survey was estimated to take between 15 to 20 minutes. We used descriptive statistics and calculated intraclass correlation coefficients (ICC) by absolute agreement with a two-way random, single measurement model.

Results: We recruited 25 participants (72% female) from June to August 2022. All participants were physiotherapists, except one respiratory therapist. They had a median age of 35 years [IQR 28-49] with 8 years [3-24] of professional experience. Three [12%] had an academic degree in critical care and 12 [48%] attended specialist courses. Participants’ workplaces ranged from an intensive care unit (ICU) at a university hospital (9 [36%]), ICU in large regional hospital (3 [12%]), ICU in small regional hospital (10 [40%]) to step down units (2 [8%]) and rehabilitation centres (1 [4%]). The E-Learning was predominantly considered as easy to access (n=23 [92%]) with a meaningful structure (n=24 [96%]), whereby the content on background, measurement properties, CPAx instructions, case examples and practical implementation were rated as just right by >91% of participants. The first video case received a median CPAx rating of 10 [IQR 10-12] and the second 26 [24-28] with a median rating duration of 5 minutes [IQR 5-7] per case. The ICC was 0.945 [95% CI 0.762 to 1.000].

Conclusions: The newly developed complimentary, E-Learning programme for the CPAx was well received by the majority of physiotherapists from various settings. Interrater reliability was excellent and the evaluation of the CPAx was also highly practical with a median duration of 5 minutes, even among newly educated health care professionals, thus supporting an online training.

Implications: The CPAx is a highly practical and reliable tool following a short, 2-hour online E-Learning. Accordingly, an online E-Learning programme seems to promote training among physiotherapists working with critically ill patients. Future studies should investigate translation into clinical practice.

Funding acknowledgements: Research award from physioswiss

Keywords:
Measurement instrument
Education
Reliability

Topics:
Critical care
Cardiorespiratory
Education: methods of teaching & learning

Did this work require ethics approval? Yes

Institution: Inselspital, Bern University Hospital, Bern, Switzerland

Committee: Ethics Committee of Bern, Switzerland

Ethics number: Req-2022-00114 (waived the need for ethics approval)