The EUROSPINE Diploma for Interprofessional Spine Care (EDISC) is a EUROSPINE effort to put forward and to create an interdisciplinary group of clinicians, educators and researchers to provide continuous education based on evidence for care of spinal disorders (Nunan et al).
Non-surgical clinicians caring for spine disorders is a heterogenous group. The motto for EDISC is to be EPIC i.e. Evidence based practice (Nunan et al 2017), Patient centred, Interprofessional and Collaborative. In these very challenging times of the pandemic, it is important to understand and integrate the continuum of care when caring for patients with spine disorders while making value-based health care decisions (Ten Cate et al 2016).
EUROSPINE assembled an interprofessional task force in 2018 (listed in alphabetical order) with representatives from the following specialties: chiropractic, epidemiology, geriatrics, medical education, naprapathy, occupational therapy, osteopathy, paediatrics, physical therapy, primary care medicine, psychology, radiology, rehabilitation medicine, rheumatology, and spine surgery (Figure 1). Members of the task force were carefully chosen because of their expertise in spine care, expertise in continuing education and spine care clinical research. The EDISC task force developed a list of innovative and priority topics important for spine specialists to deliver evidence-based care. The latest evidence in spine care using modern medical education methods is presented with ample time for discussion and interaction with peers and faculty (Reed et al 2014, Moore et al 2018).
Figure 1
The task force performed a needs assessment that considered the scope of practice of the healthcare professionals, the interaction of the clinical team, the non-clinical activities, the audit and the assessment of risk and identified several gaps: (1) a conceptual gap: Biomedical versus biopsychosocial model, (2) evidence-based gap: How to integrate new evidence into practice, (3) clinical evidence gap and barriers to interprofessional care in treating the spine patient.
The clinical aspects were further explored. Competencies needed for the spine care healthcare professional were identified: (1) managing or organising a patient encounter: how different specialties approach the patient, differential diagnosis, clinical examination skills; history taking and physical examination and proper structured examination (2) indications for further investigations (imaging and labs) (3) indications for best evidence based recommended treatment (4) Indications for referrals to specialist (spine surgeon, rheumatologist, neurologist and others) and managing barriers to interprofessional care.
Seven key priority areas were identified by the task force which became the 7 modules. Three focus on core skills and four areas deal with spine disorders. The three core skills include enhancing skills in critical reading of the literature to improve spine practice, interprofessional spine care, and communication skills with the spine patients. The four areas dealing with spinal disorders are diagnosis, management and prognosis of: 1) low back and neck pain, 2) the ageing patient seeking spine care; 3) deformities of the spine; 4) and prevention and rehabilitation of spine related disability and loss of function. The task force then translated these areas of interest into 7 modules of learning. The EDISC modules are shown in Figure 2 below.
Figure 2
The task force carefully developed specific course modules that describe the aims, learning outcomes, self-learning material, involved faculty and assessments for each module. Before releasing, the EUROSPINE Educational Committee, Executive Committee and external multidisciplinary reviewers approved the programme. In total 50 active clinicians and researchers interested in spine outcomes reviewed the EDISC programme with very favourable comments. For more detailed information for each module please see https://www.eurospine.org/edisc.htm.
The task force has converted the programme into a virtual programme which will be delivered in 2021. All EUROSPINE continuing educational courses are accredited by the European Accreditation Council for Continuing Medical Education (EACCME) in support of the EDISC audience. Healthcare providers rely on accredited CME as a support system that help drive improvements in practice and optimise health care delivery and the wellness of patients.
Stay tuned and WELCOME to EDISC 2021!
References:
Nunan D, O’Sullivan J, Heneghan C, Pluddemann A, Aronson J, Mahtani K. Ten essential papers for the practice of evidence-based medicine [published correction appears in Evid Based Med. 2018 Feb;23 (1):25-28]. Evid Based Med. 2017;22(6):202-204. doi:10.1136/ebmed-2017-110854
Ten Cate O, Hart D, Ankel F, et al. Entrustment Decision Making in Clinical Training. Acad Med. 2016;91(2):191-198. doi:10.1097/ACM.0000000000001044
Reed S, Shell R, Kassis K, et al. Applying adult learning practices in medical education. Curr Probl Pediatr Adolesc Health Care. 2014;44(6):170-181. doi:10.1016/j.cppeds.2014.01.008
Donald E. Moore Jr, Kathy Chappell, Lawrence Sherman & Mathena Vinayaga- Pavan (2018): A conceptual framework for planning and assessing learning in continuing education activities designed for clinicians in one profession and/or clinical teams, Medical Teacher, DOI: 10.1080/0142159X.2018.1483578
Acknowledgement:
A warm thank you to EDISC task force members for hours and weekends dedicated. We are grateful to EUROSPINE Presidential Line, Executive committee and staff for all support. Special thanks to, Sandy Sutter, Manager Education and Research, EUROSPINE.
Authors:
Margareta Nordin, Dr.Med.Sci., PT. Professor (Research), Departments of Orthopaedic Surgery and Environmental Medicine, New York University, New York, NY, USA. EUROSPINE Past President.
Pierre Côté, DC, PhD, Professor and Canada Research Chair in Disability Prevention and Rehabilitation, Faculty of Health Sciences, Ontario Tech University. Director, Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, ON, Canada
Julie-Lyn Noël MD, MBA, Director of Education and Research, EUROSPINE, the Spine Society of Europe, Zurich, Switzerland.
