Presented By: Alexa Gathman Ries, University of Utah School of Medicine
Co-Authors: Todd Brown, University of Utah School of Medicine
Rachel Codden, University of Utah Health
Bethany Lewis, University of Utah Health
Morgan Millar, University of Utah School of Medicine

Purpose 
This study evaluates knowledge gaps in dermatology among Clinical Officers in Uganda. The effectiveness of Project ECHO (Extension for Community Healthcare Outcomes) as an educational intervention was evaluated with pre- and post-questionnaires. 

Methods 
The effectiveness of monthly didactic and case-based ECHO sessions was gauged using pre- and post-session surveys assessing practice type and perceived lecture impact. The study focused on a convenience sample of Clinical Officers, and statistical analysis was performed to determine knowledge average change. 

Results 
Out of the convenience sample, respondents represented multiple work settings but were most commonly from urban out-patient (41%) and rural out-patient (34%) settings. Analysis of 5 months' survey data revealed that the percentage of respondents reporting "very knowledgeable" of the session topic increased from 2% pre-survey to 51% post-survey. All but one respondent felt the session was a "good mix of lecture and learning." Ninety-four percent of respondents said they are "somewhat likely" or "very likely" to treat complex patients in their practice instead of referring to specialty care. Regarding the application of learned concepts, 68 participants indicated "Definitely Yes", and 13 "Probably Yes". Fifty-six participants reported no barriers to applying their knowledge; fourteen cited the need for additional training or resources. 

Conclusions 
The ECHO sessions enhanced dermatological skills and confidence among Clinical Officers in Uganda. The participants' increased comfort level treating complex patients themselves, rather than referral, suggests a promising impact on dermatology healthcare accessibility and quality. These outcomes underscore the effectiveness of the ECHO model as a transformative approach to medical education and care in resource-limited settings.