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卫生专业教育中的 SBIRT 培训现状:SBIRT 课程和教育研究的跨学科综述与评估。

The Status of SBIRT Training in Health Professions Education: A Cross-Discipline Review and Evaluation of SBIRT Curricula and Educational Research.

机构信息

N.W. McAfee is assistant professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi; ORCID: 0000-0002-7992-9124 .

J.A. Schumacher is professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi.

出版信息

Acad Med. 2022 Aug 1;97(8):1236-1246. doi: 10.1097/ACM.0000000000004674. Epub 2022 Jul 21.

Abstract

PURPOSE

To assess the quality of curricular research on the Screening Brief Intervention and Referral to Treatment (SBIRT) approach and determine the presence of useful training modalities, particularly motivational interviewing (MI) training, across health care training curricula.

METHOD

The authors conducted a systematic review of published, peer-reviewed studies in PubMed, ERIC, CINAHL, Ovid HealthSTAR, and PsycINFO databases through March 2021 for English-language studies describing SBIRT, a curriculum for health care trainees, and curricular intervention outcomes. After the records were independently assessed, data were extracted and 20% of the studies were double-coded for interrater reliability.

RESULTS

Of 1,856 studies, 95 were included in the review; 22 had overlapping samples and were consolidated into 10 nested studies, leaving 83 total. Interrater reliability ranged from moderate (κ = .74, P < .001) to strong (κ = .91, P < .001) agreement. SBIRT training was delivered to trainees across many professions, including nursing (n = 34, 41%), medical residency (n = 28, 34%), and social work (n = 24, 29%). Nearly every study described SBIRT training methods (n = 80, 96%), and most reported training in MI (n = 54, 65%). On average, studies reported 4.06 (SD = 1.64) different SBIRT training methods and 3.31 (SD = 1.59) MI training methods. Their mean design score was 1.92 (SD = 0.84) and mean measurement score was 1.89 (SD = 1.05). A minority of studies measured SBIRT/MI skill (n = 23, 28%), and 4 studies (5%) set a priori benchmarks for their curricula.

CONCLUSIONS

SBIRT training has been delivered to a wide range of health care trainees and often includes MI. Rigor scores for the studies were generally low due to limited research designs and infrequent use of objective skill measurement. Future work should include predefined training benchmarks and validated skills measurement.

摘要

目的

评估有关 SBIRT(Screening Brief Intervention and Referral to Treatment,筛查性简短干预和转介治疗)方法的课程研究质量,并确定在医疗保健培训课程中是否存在有用的培训模式,特别是动机访谈(MI)培训。

方法

作者通过 PubMed、ERIC、CINAHL、Ovid HealthSTAR 和 PsycINFO 数据库,对截至 2021 年 3 月发表的同行评审英文研究进行了系统回顾,这些研究描述了 SBIRT、医疗保健受训者的课程以及课程干预结果。在独立评估记录后,提取数据,并对 20%的研究进行了双编码以进行评分者间可靠性评估。

结果

在 1856 项研究中,有 95 项被纳入综述;22 项研究的样本重叠,并整合为 10 项嵌套研究,共有 83 项研究。评分者间可靠性的范围从中度(κ=0.74,P<.001)到高度(κ=0.91,P<.001)一致。SBIRT 培训已在许多专业的受训者中开展,包括护理(n=34,41%)、医学住院医师(n=28,34%)和社会工作(n=24,29%)。几乎每一项研究都描述了 SBIRT 培训方法(n=80,96%),并且大多数研究都报告了 MI 培训(n=54,65%)。平均而言,研究报告了 4.06(SD=1.64)种不同的 SBIRT 培训方法和 3.31(SD=1.59)种 MI 培训方法。它们的平均设计评分是 1.92(SD=0.84),平均测量评分是 1.89(SD=1.05)。少数研究测量了 SBIRT/MI 技能(n=23,28%),并且 4 项研究(5%)为其课程设定了事先的基准。

结论

SBIRT 培训已在广泛的医疗保健受训者中开展,并且通常包括 MI。由于研究设计有限且很少使用客观技能测量,因此研究的严格程度通常较低。未来的工作应包括预先设定的培训基准和经过验证的技能测量。

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