Evaluation of an Online Course in Five Languages for Inpatient Cardiac Care Providers on Promoting Cardiac Rehabilitation: Reach, Effects and Satisfaction

Purpose: Evidence proves health care providers should promote cardiac rehabilitation (CR) to patients face-to-face to increase CR enrollment. An online course was designed to promote this at the bedside; it is evaluated herein in terms of reach, effect on knowledge, attitudes, discussion self-efficacy and practices, and satisfaction.

Methods: Design was observational, one-group pretest-posttest. Some demographics were requested from learners taking all language versions of the 20-minute course: English, Portuguese, French, Spanish, and simplified Chinese, available at https://globalcardiacrehab.com/CR-Utilization. Investigator-generated items in the pre- and post-test and evaluation survey administered using Google Forms were based on Kirkpatrick’s training evaluation model.

Results: The course was initiated by 522 learners from 33/203 (16.3%) countries; most commonly female (n=341, 65.3%) nurses (n=180, 34.5%) from high-income countries (n=259, 56.7%), completing the English (n=296, 56.7%) and Chinese (n=108, 20.7%) versions. 414 (79.3%) completed the post-test and 302 (57.9%) completed the evaluation. Median CR attitudes were 5/5 on the Likert scale at pre-test, suggesting some selection bias. Mean CR knowledge (7.22±2.14/10), discussion self-efficacy (3.86±0.85/5), and practice (4.13±1.11/5) significantly improved after completion of the course (all P<.001). Satisfaction was high regardless of language version (4.44±0.64/5; P=.593).

Conclusions: This free, open-access course is effective in increasing CR knowledge, self-efficacy, and encouragement practices among participating inpatient cardiac providers, with high satisfaction. While testing impact on actual CR use is needed, it should be more broadly disseminated to increase reach, in an effort to increase patient enrollment in CR, to reduce morbidity and mortality.