Digital education in healthcare: A mixed methods evaluation of the advanced breast cancer for nurses (ABC4Nurses) eLearning programme

Background: Advanced breast cancer affects approximately 30 % of people diagnosed with breast cancer, leading to distressing symptoms and unmet needs. Despite the consensus on the need for specialist care, access remains inconsistent due to disparities in specialist cancer nurse education. Objectives: The aim of this study was to evaluate the acceptability, usability, learning experience and perceived impact of the advanced breast cancer for nurses (ABC4Nurses) eLearning programme on learners' clinical practice. Design: The ABC4Nurses programme was co-designed with people affected by advanced breast cancer and evaluated using a mixed methods approach. Setting: The programme was made available freely online in English, Czech, Spanish, and Turkish. Participants: During the evaluation period, 272 nurses commenced the programme, with 79 completing it. Methods: The programme content was developed following a systematic review and Delphi study. Pre- and post-programme questionnaires and post-programme semi-structured interviews were conducted, guided by the Kirkpatrick Evaluation Framework. Results: The programme, comprising six modules, was positively evaluated. Participants commended the accessibility, quality of materials, and relevance of content to clinical practice. Despite the self-directed nature of the programme influencing progression, participants reported increased confidence in caring for people living with advanced breast cancer. Conclusion: The co-designed, multi-lingual online learning programme effectively enhanced cancer nurses' confidence in delivering care to people living with advanced breast cancer. The translation of programme materials broadened its reach, and future work will focus on expanding the programme's availability to underserved contexts through further translations.