Beckman Maria, Forsberg Lars, Lindqvist Helena, Diez Margarita, Enö Persson Johanna, Ghaderi Ata
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
MIC Lab AB, Stockholm, Sweden.
PLoS One. 2017 Jul 27;12(7):e0181715. doi: 10.1371/journal.pone.0181715. eCollection 2017.
A significant number of Swedish practitioners are offered workshop trainings in motivational interviewing through community-based implementation programs. The objective of this randomized controlled trial was to evaluate to what extent the practitioners acquire and retain skills from additional supervision consisting of feedback based on monitoring of practice.
A total of 174 practitioners in five county councils across Sweden were randomized to one of the study's two groups: 1) Regular county council workshop training, 2) Regular county council workshop training followed by six sessions of supervision. The participant's mean age was 43.3 years, and the majority were females (88.1%).
Recruiting participants proved difficult, which may have led to a biased sample of practitioners highly motivated to learn the method. Although slightly different in form and content, all the workshop trainings increased the participants' skills to the same level. Also, consistent with previous research, the additional supervision group showed larger gains in proficiency compared to the group who received workshop training only at the six-month follow-up. However, analyses showed generally maintained levels of skills for all the participants at the follow-up assessment, and the majority of participants did not attain beginning proficiency levels at either post-workshop or follow-up.
The results of this study address the real-life implications of dissemination of evidence-based practices. The maintained level of elevated skills for all participants is a promising finding. However, the low interest for obtaining additional supervision among the Swedish practitioners is problematic. In addition, neither the workshop trainings nor the additional supervision, although improving skills, were sufficient for most of the participants to reach beginning proficiency levels. This raises questions regarding the most efficient form of training to attain and sustain adequate practice standards, and how to create incentive and interest among practitioners to participate in such training.
通过基于社区的实施项目，为大量瑞典从业者提供动机性访谈的工作坊培训。这项随机对照试验的目的是评估从业者从基于实践监测反馈的额外监督中获取并保留技能的程度。
瑞典五个郡议会的174名从业者被随机分为研究的两组之一：1）常规郡议会工作坊培训；2）常规郡议会工作坊培训后再进行六次监督。参与者的平均年龄为43.3岁，大多数为女性（88.1%）。
招募参与者证明很困难，这可能导致了样本偏向于有强烈学习该方法动机的从业者。尽管工作坊培训在形式和内容上略有不同，但所有培训都将参与者的技能提升到了相同水平。此外，与之前的研究一致，在六个月的随访中，额外监督组在熟练程度上的提升比仅接受工作坊培训的组更大。然而，分析表明，在随访评估中所有参与者的技能水平总体上保持稳定，并且大多数参与者在工作坊后或随访时都未达到初级熟练水平。
本研究结果揭示了循证实践传播的现实意义。所有参与者技能水平的持续提高是一个有希望的发现。然而，瑞典从业者对获得额外监督的兴趣较低是个问题。此外，尽管工作坊培训和额外监督都提高了技能，但对大多数参与者来说，这两种方式都不足以达到初级熟练水平。这就引发了关于获得并维持适当实践标准的最有效培训形式的问题，以及如何在从业者中创造参与此类培训的激励和兴趣。
