Evaluation of the knowledge enhancement and impact of telementoring on liver care, using ECHO platform on nursing professionals in India

Document Type


Publication Date



Aims: The objective of the study was to assess the effectiveness of the one-day training program on liver care among nursing professionals using online training platform of ECHO (Extension for Community Healthcare Outcomes). The study also aimed to assess the impact of one-day training program on liver care on their attitude and practice at least after four months.

Study Design: Pre-post design

Place and Duration of Study: Institute of Liver and Biliary Sciences New Delhi and 26th March 2019 till 22nd February 2020.

Methodology: A one-day training program titled “Approach to patients with liver diseases” on management of liver infections for nursing professionals was conducted. An online link for KAP and Pre-post knowledge assessment questionnaire consisting 32 (KAP) questions was shared with all registered participants. Same Knowledge questionnaire consisting 19 questions was shared with the participants after training. Four months after training impact assessment was conducted by sharing the online link with the participants of the conducted program. The data was extracted in MS excel. The continuous variable was presented as mean and standard deviation (SD) or median and Inter quartile range (IQR) as appropriate. The categorical variable was presented as frequency and percentages. Paired t-test was used to assess the difference in pre and post knowledge assessment. For performing the requisite analysis, knowledge score was divided as poor-to-moderate (<66.67%) and Good (≥66.67%). The analysis was performed in IBM-SPSS version 22.

Results: A total of 5974 nursing professionals were trained in 17 one day trainings and data for KAP and pre-post assessment data was available for 4647 and 3456 participants respectively, out of which 295 participants were analysed for impact assessment. Correlation coefficient between knowledge, attitude and practice score stated Pre-knowledge score was significantly correlated with attitude (r=0.19, p<0.05) and practice (r=0.20, p<0.05) whereas attitude and practice were also found to be significantly correlated (r=32, p<0.05) with each other.

Conclusion: The results from this study support the use of ILBS-ECHO model in tele mentoring the health care professionals by providing education and training in assessment and management of liver diseases. The technology used in ILBS-ECHO has demonstrated its utility in educating clinicians through co-managed care of underserved patients.