Application of the ECHO Model in Continuing Education for General Practitioners in Geriatrics in China

Background The global population is aging rapidly, yet general practitioners (GPs) often lack adequate training in geriatric care. This study explored the implementation and perceived impact of the Extension for Community Healthcare Outcomes (ECHO) model, a tele-education approach, on the geriatric care competencies of GPs in primary care settings in China. Methods This longitudinal case study involved 22 GPs who completed the geriatrics module of the ECHO program at Tongji University between September and December 2024. Questionnaire surveys and online tests were administered before, immediately after, and three months post-training to assess changes in knowledge, self-efficacy, and clinical practice behaviors. Data were analyzed using descriptive statistics, paired t-tests, Spearman correlation, and Welch's independent samples t-test. Results Participants reported high satisfaction and perceived gains in knowledge and self-efficacy, with the item "Enhanced knowledge regarding geriatric diseases" receiving the highest rating (mean 4.45/5). Post-training test scores showed a non-significant mean increase of 5.09 ± 19.13 points (95% CI: -3.39, 13.57; p = 0.226), with a moderate positive correlation between score improvement and course engagement (r = 0.557, p = 0.007.). At three-month follow-up, participants reported significant improvements in screening for cognitive impairment (mean difference 0.69, p = 0.035, d = 0.61) and assessing caregiver burden (mean difference 1.97, p < 0.001, d = 1.63). No significant changes were observed in other practices. Conclusion The ECHO model, featuring interactive collaboration between generalists and specialists, appears feasible for delivering geriatric continuing education to GPs and may enhance perceived competence and specific clinical practices. This exploratory study provides preliminary insights for implementing such tele-education models in China.