Building Practice Capacity in Skin Health and Wound Management in Canada: A Mixed-Methods Evaluation of Two Education Programs in Home and Community Care.

Hard-to-heal wounds place a major burden on patients and the Canadian health system, underscoring the need to strengthen workforce capacity in skin health and wound management. This mixed-methods program evaluation examined two education programs implemented in Ontario home and community care: one for regulated interprofessional providers and one for personal care providers. Quantitative data were collected through pre-, mid- and post-program surveys, and qualitative data through open-ended survey responses and focus groups. Between 2022 and 2025, 164 regulated providers and 203 personal care providers graduated. Across both programs, participants reported increased confidence in prevention, assessment, treatment, communication, teamwork and application of best practices. Importantly, confidence was interpreted as a proxy indicator for readiness to change practice rather than a stand-alone endpoint. Survey and focus group findings indicated that participants applied learning in practice through earlier identification of skin concerns, more effective escalation and communication with interprofessional colleagues, increased use of best practices and greater attention to prevention. Confidence gains ranged from 30% to over 50% in the regulated-provider program and 20% to 45% in the personal care provider program. Qualitative findings reinforced the impact of increased confidence in practice and included improved prevention focus, communication and changes in practice. Thus, these programs, by increasing confidence and self-reported changes in practice, enhanced learners' capacity to deliver quality skin health and wound care. Practice capacity was operationalised in this study as a multidimensional construct that includes role-appropriate knowledge, confidence, readiness to apply evidence-informed practices, communication and escalation behaviours and participation. These programs offer a scalable model to enhance wound care capacity and support health-system sustainability in Canada. Economic outcomes, while not formally measured in this work, should be examined in future studies, as the findings reflect a promising approach to cutting the cost curve in skin health and wound care.