Fu Steven S, Roth Craig, Battaglia Catherine T, Nelson David B, Farmer Melissa M, Do Tam, Goldstein Michael G, Widome Rachel, Hagedorn Hildi, Zillich Alan J
Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, USA; University of Minnesota, Minneapolis, USA.
Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, USA; University of Minnesota, Minneapolis, USA.
Patient Educ Couns. 2015 Jan;98(1):61-8. doi: 10.1016/j.pec.2014.10.007. Epub 2014 Oct 17.
To evaluate implementing two training models for motivational interviewing (MI) to address tobacco use with primary care clinicians.
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.
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.
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.
Results confirm and expand evidence for use of booster sessions to improve the proficiency of MI training programs for primary care clinicians.
评估为初级保健临床医生实施两种动机性访谈(MI)培训模式以解决烟草使用问题的效果。
临床医生被随机分为中等强度组或高强度组。两种培训方式都包括由MI专家培训师主持的为期半天的工作坊。高强度(HI)培训提供六次强化课程,包括与模拟患者的电话互动以及在3个月内由MI倡导者进行的同伴辅导。为评估临床医生实施MI的表现,在工作坊培训前和培训后12周进行了客观结构化临床评估(OSCE)。
招募了34名临床医生;18名被随机分配到HI组。与中等强度组相比,HI组在OSCE中六个整体动机性访谈治疗完整性量表分数中的三个得分显著更高。在MI咨询知识、技能和信心的四项指标中的三项也有显著改善。
在初级保健环境中,将倡导者和与模拟患者的电话互动作为MI培训项目的强化策略是可行的,并且能在MI熟练程度上取得更大提升。
结果证实并扩展了使用强化课程来提高初级保健临床医生MI培训项目熟练程度的证据。