The Community Fracture Capture (CFC) Learning Hub: A Qualitative Analysis of Primary Care Physicians’ Interactions with a Novel Web-based Active Learning Tool (Preprint)

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BACKGROUND Osteoporosis poses a significant global health burden and is responsible for over 8.9 fragility fractures annually. Despite evidence-based guidelines and treatment, a substantial care gap persists, with only a low percentage of fracture patients receiving guideline-concordant care. Primary care physicians (PCPs) are pivotal in community-based fracture prevention but face challenges in translating knowledge into practice. While hospital-based fracture liaison services (FLS) are effective, their reach is limited, necessitating scalable alternatives. Virtual Communities of Practice (VCoPs) and web-based learning tools offer promising avenues for PCP professional education, yet their application in osteoporosis management remains underexplored. The Community Fracture Capture (CFC) Learning Hub was developed as an interactive, case-based platform to address these gaps by enhancing PCPs’ knowledge, confidence, and engagement in osteoporosis care. OBJECTIVE The study aimed to conduct qualitative evaluations of PCPs interactions with the CFC Learning Hub, focusing on barriers and facilitators of online learning, PCP perceptions of the program, and challenges in osteoporosis management in general practice. METHODS A qualitative analysis was performed using data from 55 PCPs across four 6-week cycles of the CFC Learning Hub (May 2022 - October 2023). Data sources included discussion forum comments and responses to open-ended questions in end-of-cycle evaluations. Relational content analysis was employed, with two researchers independently coding data using semantic and latent approaches. Themes were identified through iteratives discussions and validated against existing literature. RESULTS Four themes emerged from PCP interactions: (1) User Experience-Guided Platform Design, where participants emphasized intuitive navigation, minimized fragmented sections, and clarity of interface as critical for engagement; (2) Learning-Supportive Course Structure, highlighting the importance of explicit links between case studies and foundational knowledge, weekly summaries, and quizzes aligned with content; (3) Learners’ Different Styles and Preferences, with diverging needs for synchronous versus asynchronous learning, didactic sessions, and peer-to-peer interactions; and (4) Program Content, where participants requested expanded topics and post-program refreshers. CONCLUSIONS The CFC Learning Hub demonstrated efficacy as a specialist- and peer-to-peer online learning model for PCPs, addressing osteoporosis care gaps through user-centred design, adaptable content delivery, and collaborative moderation. Key successes included resolving usability issues iteratively and accommodating diverse learning preferences. These findings underscored the potential of the Hub to enhance primary care professional education and fracture prevention. The study advocated for broader adoption of the platform to bridge osteoporosis care disparities.

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