Shared learning database

Royal College of General Practitioners
Published date:
February 2011

The Essential Knowledge Updates (EKU) programme is an e-learning initiative by the Royal College of General Practitioners (RCGP) that focuses on new and changing information that relate to key clinical areas of national significance (e.g. newly published NICE guidelines that are central to everyday primary care, newly published Gold Standards and new relevant legislation) where there is a dependable consensus about best practice. Since 2008 it has published a new update every 6 months to a total of 16000 registered primary care practitioners.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

To enable general practitioners and other members of the primary care team (practice nurses, physician assistants, practice managers) to be aware of and learn about new and changing information relevant to primary care (important newly published best practice or national guidance or research / consensus of key relevance to GPs), and encourage effective application of that knowledge to enhance the patient's experience. To enable primary care practitioners to meet previously identified or unrealized learning needs in relation to new or changing knowledge and information relevant to general practice. To encourage members of the primary care team to apply the learning of EKU content to enhance their skills. To provide a key element of a GP's annual CPD folder that can be self-accredited or accredited by peer-review within the terms and conditions of the managed RCGP CPD scheme. To contribute, in due course, as part of the managed CPD Credit Scheme, to the provision of evidence of a GP's learning and application in their personal portfolio for recertification/revalidation purposes.

Reasons for implementing your project

Nice Guidelines. White Papers. Green Papers. Cochrane Reviews. Medicine Safety Reports. It feels like the amount of information supposedly vital for frontline general practitioners has increased logarithmically over the years, and over the last decade GPs have adopted online learning as a preferred medium to keep up to date with this overwhelming tidal wave of information. For the Professional Development Board of the Royal College of General Practitioners this development presented a challenge to develop a tool that would deliver a regular concise synthesis of the most important documents aimed at general practitioners that would represent new and changing knowledge. In 2007, when the project was initiated, e-learning specifically for primary care was sparse and there were no products that aimed at updating general practitioners and the members of their teams with regular, concise, peer reviewed knowledge. Devising an online tool to facilitate learning meant an enormous amount of time saved for the learner, as instead of actively needing to search for new and changing knowledge and reading vast guidelines, an editorial board of committed general practitioners would sift through the available material and choose those sources that would be most applicable for front line general practice. A successful learning experience would then be translated in more appropriate prescribing, improved patient care and more efficient referral habits, saving the NHS a significant amount of money.

How did you implement the project

A continuous and rigorous literature search generates about 200 potential sources for each Update which are rated for relevance and importance by an Editorial Board. The Updates are divided into 8 major topics and around 20 minor items ('briefings'). The written content of the major topics includes text, scenarios, self test MCQs, and practice based exercises. At the end of each section there are suggestions for audit, practical tips and a good range of links to other relevant sources. Briefings either summarise new and changing knowledge in discrete aspects of general medical practice, or signpost readers to more detailed updates. The modules are written by a strong team of experienced, committed GPs who work to clear guidelines. After the content has been created, the Updates have to pass two levels of quality assurance by a panel of GPs. After release, EKU content stays current for eighteen months on the College Online Learning Environment (OLE), before being re-purposed and assimilated into existing knowledge resources. The methodologies for knowledge extraction and web delivery were piloted in 2008 with 500 volunteering GPs from the RCGP and after a successful evaluation rolled out in April 2009 as a free CPD tool for all members of the RCGP and the members of the General Practice Foundation. The main costs incurred for the project were associated with the hiring of a clinical lead for the project who would coordinate literature search, supervise authors, liaise with the editorial board and assist in evaluation. This is done by a GP on a part time basis (2 sessions per week). Other costs were the provision of webspace and the maintenance of the online learning environment.

Key findings

Of the 40.000 members of the college, 16.000 are now registered on the online learning environment, using EKU regularly. Feedback by the learner is provided in form of a star rating for each module (1 star very poor/ 5 stars excellent) free text and emails (see attached excel sheet with anonymised feedback for EKU 3-5). Additionally to the constant stream of feedback from the website we are now engaging in a 4 pronged evaluation exercise, seeking qualitative data from users, non-users and academic gps and evaluating our quantitative data for particular usage patterns.

Key learning points

Make sure your content is applicable for your target audience. Ensure quality assurance is rigorous. Seek constant feedback. Respond to concerns from user base. Regularly evaluate your product. Make sure your IT solutions are appropriate. Rigorously document methodologies so changes in staff don't create problems.

Contact details

Dr Dirk Pilat
Essential Knowledge Updates Fellow
Royal College of General Practitioners

Primary care
Is the example industry-sponsored in any way?