General practitioners’ knowledge of whiplash guidelines improved with online education
Authors: Rebbeck T. , Macedo L. , Paul P. , Trevena L. , Cameron I. D. 
Published: October 2013

Objective
The primary objective of this study was to evaluate the effect of an online education program used to implement the Australian (New South Wales) whiplash guidelines with general practitioners (GP). The secondary aim was to identify factors associated with learning.

Methods
An online educational and evaluation activity was developed to reflect the key messages for GP from the Australian whiplash guidelines. The educational activity was hosted on the Royal Australian College of General Practitioners’ website (www.gplearning.com.au) for a period of 3 years. Participants were recruited through advertisement and media releases. Participants completed a baseline evaluation of their knowledge, participated in the interactive educational activity and completed a post-knowledge questionnaire. The primary outcome was change in professional knowledge, predictors of learning were computed using linear regression.

Results
Two hundred and fifteen GP participated. Knowledge significantly improved between baseline and post-knowledge questionnaire scores (P < 0.00001). A total of 57.2% of participants improved their knowledge by more than 20%, indicating a large effect. Low baseline knowledge predicted learning, accounting for 71% of the variance.

Conclusions
Online education of GP significantly improved their knowledge in relation to guidelines for whiplash. Those with low baseline knowledge improved their knowledge the most, suggesting that implementation strategies should be targeted at this group.

What is known about the topic?
Clinical guidelines are usually developed to improve knowledge and ultimately change clinical practice to reflect best practice management of that condition. However, developing and publishing guidelines alone rarely changes knowledge or clinical practice. With GP, effective implementation strategies to improve knowledge have included face to face education such as interactive educational meetings and educational outreach. However, these strategies are expensive and time consuming. Whiplash is a significant health problem in Australia, and although GP are commonly consulted for this condition, an individual GP may only see one whiplash case per year, meaning that face to face implementation strategies may not be pragmatic for this condition.

What does this paper add?
This paper shows that online education was effective in improving GP knowledge of clinical guidelines for whiplash. The effect was as large as the reported effects for face to face education in other studies. Importantly this paper shows that the less GP knew about whiplash, the more they learnt, indicating that the strategy was effective for those who most required the education. Finally, the online strategy reached GP in rural and remote places in Australia. This paper therefore shows that online education can be an effective method to improve GP knowledge about managing whiplash. It is hoped that it may provide the impetus to use this strategy for implementing clinical guidelines for other conditions.

What are the implications for practitioners?
Practitioners can be confident that using an online educational program will improve their knowledge of managing conditions they previously knew little about. It is hoped that this will translate into a change in clinical practice. For example, GP using this strategy improved knowledge in knowing when to X-ray, when to refer and what interventions to provide for people with whiplash. For any health practitioners managing whiplash access to this information is still available using the New South Wales Motor Accident Authority website (www.maa.nsw.gov.au)