Steven S Fu1, Craig Roth2, Catherine T Battaglia3, David B Nelson2, Melissa M Farmer4, Tam Do5, Michael G Goldstein6, Rachel Widome2, Hildi Hagedorn5, Alan J Zillich7. 1. Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, USA; University of Minnesota, Minneapolis, USA. Electronic address: Steven.Fu@va.gov. 2. Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, USA; University of Minnesota, Minneapolis, USA. 3. Denver Seattle Center for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Denver, USA; Colorado School of Public Health, University of Colorado, Denver, USA. 4. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System, Los Angeles, USA. 5. Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, USA. 6. VHA National Center for Health Promotion and Disease Prevention, Durham, USA. 7. Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, USA; College of Pharmacy, Purdue University, West Lafayette, USA.
Abstract
OBJECTIVES: To evaluate implementing two training models for motivational interviewing (MI) to address tobacco use with primary care clinicians. METHODS: Clinicians were randomized to moderate or high intensity. Both training modalities included a single ½ day workshop facilitated by MI expert trainers. The high intensity (HI) training provided six booster sessions including telephone interactions with simulated patients and peer coaching by MI champions over 3 months. To assess performance of clinicians to deliver MI, an objective structured clinical evaluation (OSCE) was conducted before and 12 weeks after the workshop training. RESULTS:Thirty-four clinicians were enrolled; 18 were randomly assigned to HI. Compared to the moderate intensity group, the HI group scored significantly higher during the OSCE for three of six global Motivational Interviewing Treatment Integrity scale scores. There was also significant improvement for three of the four measures of MI counseling knowledge, skills and confidence. CONCLUSIONS: Using champions and telephone interactions with simulated patients as enhancement strategies for MI training programs is feasible in the primary care setting and results in greater gains in MI proficiency. PRACTICE IMPLICATIONS: Results confirm and expand evidence for use of booster sessions to improve the proficiency of MI training programs for primary care clinicians. Published by Elsevier Ireland Ltd.
RCT Entities:
OBJECTIVES: To evaluate implementing two training models for motivational interviewing (MI) to address tobacco use with primary care clinicians. METHODS: Clinicians were randomized to moderate or high intensity. Both training modalities included a single ½ day workshop facilitated by MI expert trainers. The high intensity (HI) training provided six booster sessions including telephone interactions with simulated patients and peer coaching by MI champions over 3 months. To assess performance of clinicians to deliver MI, an objective structured clinical evaluation (OSCE) was conducted before and 12 weeks after the workshop training. RESULTS: Thirty-four clinicians were enrolled; 18 were randomly assigned to HI. Compared to the moderate intensity group, the HI group scored significantly higher during the OSCE for three of six global Motivational Interviewing Treatment Integrity scale scores. There was also significant improvement for three of the four measures of MI counseling knowledge, skills and confidence. CONCLUSIONS: Using champions and telephone interactions with simulated patients as enhancement strategies for MI training programs is feasible in the primary care setting and results in greater gains in MI proficiency. PRACTICE IMPLICATIONS: Results confirm and expand evidence for use of booster sessions to improve the proficiency of MI training programs for primary care clinicians. Published by Elsevier Ireland Ltd.
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