A Meta-Analytic Review of Behavior Modeling Training

Interventions That Target or Affect Voice or Speech Production During Public Speaking: A Scoping Review

OBJECTIVES

Public speaking (PS) is frequently necessary in many professional, educational, and personal settings. Mastering this communication skill is particularly important in today's society. Training techniques for PS have been described in the literature. Given that PS anxiety affects performance, especially voice characteristics and speech fluency, the purpose of this scoping review is to examine, map, and narratively summarize the available evidence on PS interventions that target or affect voice or speech.

METHODS

An extensive literature search was conducted in three bibliographic databases: Medline ALL/Ovid, PsycINFO/Ovid, and Eric/Ovid. Of the 850 studies identified, 22 met the eligibility criteria, and one was added from the reference lists of the included studies.

RESULTS

A total of 23 studies were included. The interventions identified aim to improve speaking skills either by explicitly targeting the voice or speech (direct intervention, n = 15) or by targeting the cognitive, behavioral, psychological, or physical environment impacting the speaker's production (indirect intervention, n = 8).

CONCLUSIONS

This scoping review provides the first published methodological summary of the characteristics of existing PS interventions that target or affect voice and speech. Heterogeneous characteristics were observed. Further studies are needed to determine which interventions are most effective.

A Survey on Autism Care, Diagnosis, and Intervention Based on Mobile Apps Focusing on Usability and Software Design

This article presents a systematic review on autism care, diagnosis, and intervention based on mobile apps running on smartphones and tablets. Here, the term "intervention" means a carefully planned set of activities with the objective of improving autism symptoms. We guide our review on related studies using five research questions. First, who benefits the most from these mobile apps? Second, what are the primary purposes of these mobile apps? Third, what mechanisms have been incorporated in these mobiles apps to improve usability? Fourth, what guidelines have been used in the design and implementation of these mobile apps? Fifth, what theories and frameworks have been used as the foundation for these mobile apps to ensure the intervention effectiveness? As can be seen from these research questions, we focus on the usability and software development of the mobile apps. Informed by the findings of these research questions, we propose a taxonomy for the mobile apps and their users. The mobile apps can be categorized into autism support apps, educational apps, teacher training apps, parental support apps, and data collection apps. The individuals with autism spectrum disorder (ASD) are the primary users of the first two categories of apps. Teachers of children with ASD are the primary users of the teacher training apps. Parents are the primary users of the parental support apps, while individuals with ASD are usually the primary users of the data collection apps and clinicians and autism researchers are the beneficiaries. Gamification, virtual reality, and autism-specific mechanisms have been used to improve the usability of the apps. User-centered design is the most popular approach for mobile app development. Augmentative and alternative communication, video modeling, and various behavior change practices have been used as the theoretical foundation for intervention efficacy.

Assertive communication training for nurses to speak up in cases of medical errors: A systematic review and meta-analysis

BACKGROUND

Several authors have previously assessed the effects of assertive communication training for nurses to speak up in cases of medical errors. Inconsistent results regarding the nurses' attitudes, behaviors, and confidence levels were noticed.

OBJECTIVE

To identify the effectiveness of assertive communication training on nurses' behaviors, attitudes, and confidence levels for speaking up in cases of medical errors and to identify vital components for success.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, ERIC, Embase, Scopus, and CINAHL were searched up for studies published from the inception of the database to December 16, 2022.

METHODS

Two researchers independently performed a primary screening of titles and abstracts for relevant studies, followed by a review of full texts if the references met inclusion criteria and quality assessment. Data were retrieved for nurses and nursing students who received medical error-related assertive communication training for speaking up, and learning outcomes for attitudes, behaviors, and confidence levels were reported based on pooled data. Pooled estimates were calculated using a random-effects model.

RESULTS

A total of eleven studies with 1299 participants were included in systematic review, and among them nine studies with 804 participants were analyzed in meta-analysis. From the pooled results, the intervention group, which received assertive communication training, exhibited substantially improved speaking-up behaviors compared with the control group (SMD = 0.58; 95 % CI, 0.14-1.03). Considerable differences were noted in the nurses' times of speaking up in cases of medical errors between pretest (38 %; 95 % CI, 0.14-0.68) and posttest (78 %; 95 %CI, 0.70-0.85) based on the pooled data. The nurses' attitudes and confidence levels for speaking up varied markedly between pretest and posttest.

CONCLUSION

Structured assertive communication training may improve nurses' speaking-up behaviors in cases of medical errors. To conduct effective assertive communication training, nursing educators should incorporate multiple teaching approaches into structured training and ensure an adequate training duration.

Safety training in context: technical, cultural and political factors affecting its design, delivery and transfer

INTRODUCTION

Safety training is integral to modern safety management systems. However, what is trained in the classroom is not always adopted and applied in the workplace, creating the training transfer problem. Taking an alternative ontological stance, the aims of this study were to conceptualize this problem as one of 'fit' between what is trained and the contextual factors in the work environment of the adopting organization.

METHOD

Twelve semi-structured interviews were conducted with experienced health andsafety trainers having diverse backgrounds and experience. Data were thematically coded 'bottom-up' to capture reasons for safety training and where consideration of context occurs in the design and delivery of training. Then, the codes were thematically grouped against a pre-existing framework to categorize contextual factors that affect 'fit' into technical, cultural, and political factors each operating at different levels of analysis.

RESULTS

Safety training occurs to satisfy external stakeholder expectations and meet internal perceptions of need. Consideration of contextual factors can occur both in the design and delivery of training. A range of technical, cultural, and political factors were identified, which can operate at individual, organizational, or supra-organizational levels to influence safety training transfer.

CONCLUSIONS

The study draws particular attention to the influence of political factors and the impact of supra-organizational factors on the successful transfer of training, areas not consistently considered in safety training design and delivery.

PRACTICAL APPLICATION

The application of the framework adopted in this study provides a useful tool for discriminating between different contextual factors and the level at which they operate. This could enable more effective management of these factors to improve the potential for transfer of safety training from the classroom to the workplace.

Deliberate Erring Improves Far Transfer of Learning More Than Errorless Elaboration and Spotting and Correcting Others' Errors

Transfer of learning is a fundamental goal of education but is challenging to achieve, especially where far transfer to remote contexts is at stake. How can we improve learners' flexible application of knowledge to distant domains? In a counterintuitive phenomenon termed the derring effect, deliberately committing and correcting errors in low-stakes contexts enhances learning more than avoiding errors. Whereas this benefit has been demonstrated with tests in domains similar to those in the initial learning task, the present set of three experiments (N = 120) investigated whether deliberate erring boosts far transfer of conceptual knowledge to dissimilar domains. Undergraduates studied scientific expository texts either by generating conceptually correct responses or by deliberately generating conceptually erroneous responses then correcting them. Deliberate erring improved not only retention (Experiment 1), but also far transfer on inferential test questions that required applying the learned concepts to remote knowledge domains (e.g., from biology/vaccines to geography/forest management techniques; Experiment 2). This advantage held even over a control that further involved spotting and correcting the same errors that one's peers had deliberately made (Experiment 3). Yet, learners failed to predict or recognize the benefits of deliberate erring even after the test. Altogether, these results suggest that the derring effect is specific to generating incorrect, but not correct, elaborations. Neither does mere exposure to others' errors nor juxtaposing these errors with the correct responses suffice. Rather, guiding learners to personally commit and correct deliberate errors is vital for enhancing generalization and far transfer of learning to distant knowledge domains.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10648-023-09739-z.

AI avatar tells you what happened: The first test of using AI-operated children in simulated interviews to train investigative interviewers

Previous research has shown that simulated child sexual abuse (CSA) interview training using avatars paired with feedback and modeling improves interview quality. However, to make this approach scalable, the classification of interviewer questions needs to be automated. We tested an automated question classification system for these avatar interviews while also providing automated interventions (feedback and modeling) to improve interview quality. Forty-two professionals conducted two simulated CSA interviews online and were randomly provided with no intervention, feedback, or modeling after the first interview. Feedback consisted of the outcome of the alleged case and comments on the quality of the interviewer's questions. Modeling consisted of learning points and videos illustrating good and bad questioning methods. The total percentage of agreement in question coding between human operators and the automated classification was 72% for the main categories (recommended vs. not recommended) and 52% when 11 subcategories were considered. The intervention groups improved from first to second interview while this was not the case in the no intervention group (intervention x time: p = 0.007, η_p ² = 0.28). Automated question classification worked well for classifying the interviewers' questions allowing interventions to improve interview quality.

Training design in mediating the relationship of participants’ motivation, work environment, and transfer of learning

Purpose

The purpose of this paper is to examine the relationship among training design, trainee motivation and work environment on the transfer of learning for teachers enrolled in a continuing professional education (CPE) training program and the confirmation of potential positive, predictive relationships of trainee motivation, work environment and training design to transfer of learning. This study investigated the contribution of training efficiency and relevance as measured by the training design; work environment as measured by work autonomy, work complexity and work variability; and trainee’s motivation of training (learning- and job-oriented) to the transfer of knowledge and skills from the training program to their workplace. Both direct and indirect effects of mentioned components on the learning transfer were explored.

Design/methodology/approach

This study included 160 teachers working in high-needs schools with large numbers of English learners (ELs) Southwest USA. Teachers in this study primarily needed professional development to empower them and enhance their instructional capacity for ELs and economically challenged students. During the recruitment, participants completed a demographic information (e.g. gender, ethnicity, number of years teaching, age, educational background) survey.

Findings

A mediation model with training design as the mediating factor was developed and analyzed. The results revealed that training design fully mediated the relationship between trainees’ work environments and the transfer of knowledge, skills and attitude acquired from the training to their workplace. Furthermore, it partially mediated the relationship between learning-oriented motivation and the transfer of learning. These findings further amplify the significance of CPE program training design and foster important considerations for future research regarding the isolation of specific training design aspects that significantly contribute to the mediation of these relationships.

Research limitations/implications

Considering the significance of learning transfer in developing professional knowledge and skills for target employees and trainees, confirming the mediating effects of training design on training transfer holds critical implications for future research. Specific and purposeful attention needs to be given to the design of CPE training. Investigations into the effects of training design and successful elements such as the training platform (online, hybrid or in-person), sample size, group structure, facilitation and participant demographics are warranted.

Practical implications

The finding of this research provides a preliminary guide for scholar-practitioners. Results of the study confirmed the role that learning-oriented motivation, job-oriented motivation, work variability or flexibility, work complexity and training design play in transfer of learning. In practice, training professionals will be more comfortable pinpointing the factors that lead to the transfer of learning or the lack of it.

Originality/value

Learning transfer has been found to be imperative for target employees and trainees to develop professional knowledge, skills and attitudes. Results of this study reveal variables that promote the positive transfer of learning to the workplace.

A web-based psychoeducational simulation game for adults in stepfamilies (GSteps)-study protocol for a randomized controlled feasibility trial

Background

Stepfamilies are a prevalent family form. However, less stable than nuclear, first marriage families due to the presence of risk factors such as the absence of social norms and the presence of stepchildren. Stepfamilies have unique educational needs regarding stepparenting and co-parenting issues. The development and documentation of psychoeducational intervention strategies can facilitate dissemination of ongoing studies and promote transparency. This article describes the background, design and protocol of a randomized controlled trial (RCT) evaluating the eficacy and feasibility of a web-based Psychoeducational Simulation Game (GSteps). Behavior-modeling video training (BMT) is used to demonstrate and promote relational skills, stepparenting and co-parenting effective strategies for adults in stepfamilies. A mental health professional will be available within the GSteps platform for clarification or emotional support.

Methods/design

A RCT design is presented to evaluate the outcomes of a self-administered, interactive and web-based psychoeducational Game targeting dyadic marital adjustment and interpersonal skills as the primary outcomes and remarriage beliefs, family function and stepparenting and co-parenting attitudes as the secondary outcomes. Other outcome measures include satisfaction with GSteps, participants' knowledge learned after the intervention and a purposive sampling method will be used to access feasibility. The minimum required sample size is 112 participants (56 per condition) randomly allocated either to an experimental group (EG), receiving GSteps intervention, or to a wait-list control group (CG). A survey is conducted electronically. Assessments take place at baseline (T₀ ), after the intervention (T₁ ) and 1-month follow-up (T₂ ).

Discussion

This protocol presents a RCT aimed at evaluating the efficacy of a web-based psychoeducational intervention (GSteps) designed for improving marital, stepparenting and co-parenting skills in adults who live in stepfamilies. The use of the protocol and results of intervention studies may guide the use and refinement of web-based psychoeducational intervention for stepfamilies. Additionally, GSteps may become a tool for health professionals to enhance stepfamily functioning, stepparenting skills, and marital adjustment of remarried adults.

Are Strategies for Women in Compensation Negotiations More Appealing When It Is Explained How They Are Meant to Impact Negotiation Outcomes?

Women perceive specific strategies developed to support their performance in compensation negotiations as ineffective and are unlikely to use them—suggesting an implementation gap. We examined whether providing theoretical rationales—explaining how specific strategies are meant to work—attenuates this gap. Furthermore, we explored a novel cause of it: women's expectations regarding the perpetuation of gender roles upon using a strategy. In two studies ( N = 1,254), we observed that regardless of the provision of the rationales, women expected all examined specific strategies to be less economically effective and most of them to perpetuate gender roles more than regular assertiveness. Moreover, especially women's expectations regarding economic outcomes decreased their intentions to use most specific strategies. Women also expected most specific strategies to lead to less favorable social evaluations than yielding, which again led to their lower intentions to use them. Altogether, negotiation trainers and educators should consider that explaining how specific strategies are meant to work is not enough to close the implementation gap and to reduce gender inequality in negotiations. To attenuate the implementation gap, they may need to enable women to more fully experience how using specific strategies can improve their negotiation performance. Additional online materials for this article are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843221128484 .

Invited Reaction 1: Theorizing Human Resource Development Practices in Expanded Contexts

This reaction begins with three positive aspects of the article: (a) effects of cultural differences on HRD interventions; (b) shaping and skilling as separate HRD outcomes, and (c) unlearning or deskilling as HRD outcomes. In terms of critique, Wang and Doty emphasize open and closed systems but fail to provide clear definitions. Indeed, some aspects of closed systems appear in Western or more “open” societies. Another issue, reducing usability of this work, involves the mathematical formulations. An HRD practitioner and emerging scholar living in China adds some critique, suggesting that China may be better characterized as a semi-closed system. Further, based on experience, positive outcomes can result from closed shaping and negative skilling-in a closed host institution system (HIS). Nevertheless, the manuscript can hopefully lead to some new explorations in HRD research and theory and potentially practitioner use.

The influence of learner characteristics, instructional design and work environment on the transfer of training

Purpose

This study aims to highlight the role of individual and instructional design factors on training transfer and explore and review focal training factors that influence the transfer of training.

Design/methodology/approach

A conceptual framework has been developed for this study to better present the prevalent factors that have been empirically validated.

Findings

The facets of transfer encompassed in this study have gathered enough evidence to demonstrate a positive association with the transfer. This review points out that all predictor variables (learner characteristics, instructional design and environmental factors) positively and significantly influence the transfer of training. A mix of variables is proposed, with further investigation recommended to develop a robust training transfer hypotheses.

Research limitations/implications

This study contributes to the training transfer literature in three ways. First, the authors have shown the positive influence of pre-training factors on training transfer. This study is grounded in a robust theoretical framework, thus fulfilling the previous gaps. This conceptual study elaborates on the importance of factors to establish the training transfer hypothesis. Future studies should test the suggested framework and look for other things that could help learners be more effective and motivated so that training can be more effective and transferable.

Practical implications

This study has significant findings for organizations operating in the current business scenario to enhance learning transfer, where the transfer is very low and a significant cause of concern for every organization. By making management aware of the success factors of training transfer, they can ensure a better training transfer. In this study, the transfer design considerations are discussed in detail, and their practical consequences are provided for training transfer in general and training professionals in particular.

Originality/value

The training transfer literature showcases two significant gaps; first, it lacks appropriate characteristics, and second, there is variability in the results. This study bridges the gaps and attempts to advance our understanding of training transfer grounded in the theoretical framework by focusing on learner characteristics, instructional design and work environment in training transfer, which predictor variables can improve training transfer. This study also contributes to the current training transfer literature by proposing a combination of factors that provide a theoretical foundation for developing a solid training transfer theory.

NoiBene, a Group Intervention for Promoting Mental Health Among University Students: A Study Protocol for a Randomized Controlled Trial

University students’ mental health has become a public health issue since increasingly students report high levels of psychological distress. Mental health difficulties influence students’ lives, such as academic performance, relationships satisfaction, and quality of life. Moreover, different kinds of obstacles often hinder help-seeking behavior. Such evidence strongly suggests the need to implement prevention and promotion strategies to increase health and well-being in educational contexts. This article presents a study protocol for implementing and evaluating NoiBene, an evidence-based group intervention that aims to promote mental health and well-being, improve a series of transversal competencies (e.g., emotional awareness, commitment to values, assertiveness, goal setting), and decrease dysfunctional transdiagnostic mechanisms (i.e., perfectionism, repetitive thinking, experiential avoidance). A randomized controlled trial will be conducted to evaluate the protocol’s efficacy. Participants will be assigned to one of the three conditions: the NoiBene Group condition (NB-G), the NoiBene guided web-based condition (NB-WB), or the waiting list condition (WLC). The NB-G intervention consists of six face-to-face group meetings, each dedicated to specific issues related to well-being or vulnerabilities. Every meeting includes an explanation of the theoretical contents, individual and group exercises, and role-plays. The NB-WB intervention covers the same topic addressed in the NB-G intervention. In this case, participants carry out a series of online modules, including theoretical explanations, practical exercises, useful activities, and self-monitoring tools. Students will individually meet the Tutor once every 2 weeks. The primary outcome will include an increase in mental health and well-being. Secondary outcomes will include changes in emotional awareness, assertiveness, perfectionism, rumination, worry, self-criticism, experiential avoidance, and academic performance and satisfaction. We expect that participants in both NoiBene conditions will show these outcomes. However, we hypothesized that the NB-G conditions will be more effective than the NB-WB in improving assertiveness. Besides treatment efficacy, we expect that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. Outcomes will be assessed at pre-, post-intervention and 6-months follow-up. In conclusion, we believe that NoiBene is a promising tool that can improve students’ well-being, and it could have positive implications for preventing mental health disorders among students.

Safety gaps in medical team communication: Closing the loop on quality improvement efforts in the cardiac catheterization lab

Closed-loop communication (CLC) is a fundamental aspect of effective communication, critical in the cardiac catheterization laboratory (cath lab) where physician orders are verbal. Complete CLC is typically a hospital and national mandate. Deficiencies in CLC have been shown to impair quality of care. Single center observational study, CLC for physician verbal orders in the cath lab were assessed by direct observation during a 5-year quality improvement effort. Performance feedback and educational efforts were used over this time frame to improve CLC, and the effects of each intervention assessed. Responses to verbal orders were characterized as complete (all important parameters of the order repeated, the mandated response), partial, acknowledgment only, or no response. During the first observational period of 101 cases, complete CLC occurred in 195 of 515 (38%) medication orders and 136 of 235 (50%) equipment orders. Complete CLC improved over time with various educational efforts, (p < 0.001) but in the final observation period of 117 cases, complete CLC occurred in just 259 of 328 (79%) medication orders and 439 of 581 (76%) equipment orders. Incomplete CLC was associated with medication and equipment errors. CLC of physician verbal orders was used suboptimally in this medical team setting. Baseline data indicate that physicians and staff have normalized weak, unreliable communication methods. Such lapses were associated with errors in order implementation. A subsequent 5-year quality improvement program resulted in improvement but a sizable minority of unacceptable responses. This represents an opportunity to improve patient safety in cath labs.

Impact of training design on trainees' motivation: an empirical study

Purpose

This study aims to advance understanding of the critical role of training variables (trainer performance, transfer design and an identical element) and motivation to improve work through learning (MTIWL) the least researched construct of motivation in human resource development (HRD).

Design/methodology/approach

A self-report online survey was conducted to collect responses from 280 managers working in different industries. Participants attended open skills training program organized by an in-house training institute in India.

Findings

The trainer performance and transfer design had a positive and significant impact on MTIWL. However, an identical element found no significant direct impact on MTIWL.

Practical implications

The trainer performance positively cultivates trainees’ MTIWL and training approaches according to trainees’ preferences improve MTIWL. The training content is needed to resemble with work assignment for enhancement of trainees MTIWL.

Originality/value

This study improved understanding of the impact of training variables on a comprehensive and practical aspect of trainees' motivation in HRD, MTIWL.

Retention and Transfer of Cognitive Bias Mitigation Interventions: A Systematic Literature Study

Cognitive biases can adversely affect human judgment and decision making and should therefore preferably be mitigated, so that we can achieve our goals as effectively as possible. Hence, numerous bias mitigation interventions have been developed and evaluated. However, to be effective in practical situations beyond laboratory conditions, the bias mitigation effects of these interventions should be retained over time and should transfer across contexts. This systematic review provides an overview of the literature on retention and transfer of bias mitigation interventions. A systematic search yielded 52 studies that were eligible for screening. At the end of the selection process, only 12 peer-reviewed studies remained that adequately studied retention over a period of at least 14 days (all 12 studies) or transfer to different tasks and contexts (one study). Eleven of the relevant studies investigated the effects of bias mitigation training using game- or video-based interventions. These 11 studies showed considerable overlap regarding the biases studied, kinds of interventions, and decision-making domains. Most of them indicated that gaming interventions were effective after the retention interval and that games were more effective than video interventions. The study that investigated transfer of bias mitigation training (next to retention) found indications of transfer across contexts. To be effective in practical circumstances, achieved effects of cognitive training should lead to enduring changes in the decision maker's behavior and should generalize toward other task domains or training contexts. Given the small number of overlapping studies, our main conclusion is that there is currently insufficient evidence that bias mitigation interventions will substantially help people to make better decisions in real life conditions. This is in line with recent theoretical insights about the “hard-wired” neural and evolutionary origin of cognitive biases.

Incorporating Administrative Staff in Trans-Affirmative Care Training: A Cognitive-Behavioral Learning Approach

Administrative staff play an integral role in providing trans-affirmative health care. However, few trans-affirmative education and training interventions have been developed for non-medical health care staff. In this short report, we describe the development and piloting of a trans-affirmative care training intervention designed expressly for administrative staff. Based on our piloting, we put forth recommendations for the inclusion of administrative staff in trans-affirming education and training in health care systems. We hope to stimulate further development and evaluation of our approach, as well as changes in policies, so as to create more inclusive, trans-affirming health care systems.

Implementing an evidence-based competency model for science team training and evaluation: TeamMAPPS

INTRODUCTION

In response to a call issued by the National Research Council to investigate the knowledge, skills, and attitudes of effective science teams, we designed a team training program for conducting science in collaborative contexts.

METHODS

We reviewed the literature to develop an evidence-based competency model for effective science teams along with exemplary behaviors that can be used for founding team training and evaluation. We discuss the progress of teamwork and team development research that serves as a foundation for this work, as well as previous research involving team-based competencies.

RESULTS

Three overarching competencies emerged from the literature as key for science team effectiveness: psychological safety, awareness and exchange, and self-correction and adaptation. These competencies are fully described, including their evidence base.

CONCLUSIONS

We developed a competency model and implementation plan for a team training program specific to science teams - TeamMAPPS (Team Methods to Advance Processes and Performance in Science). This paper details steps in the implementation process, including plans for consortia dissemination, evaluation, and future development.

Are they ready yet?: A theory-driven evaluation of suicide risk assessment trainings in psychology graduate programs

OBJECTIVES

The present study sought to understand the state of suicide risk assessment trainings in clinical psychology graduate programs.

METHODS

We surveyed 167 clinical psychology doctoral students' behavioral competency in responding to suicidal clients and their attitudes, perceived behavioral control, subjective norms, and intentions related to suicide risk assessment. Hypotheses were tested using path analysis.

RESULTS

Ninety six percent of participants reported receiving some type of suicide risk assessment training at their program. Results provided partial support for significant relationships between attitudes, perceived behavioral control, subjective norms, and intentions. Unexpectedly, amount of training in suicide risk assessments was not related to theory of planned behavior variables including behavioral competency.

CONCLUSION

These findings have implications regarding the effectiveness of current suicide risk assessment training practices and ways to improve trainings to help increase the number of clinical psychologists competent in suicide risk assessment and management.

The combination of feedback and modeling in online simulation training of child sexual abuse interviews improves interview quality in clinical psychologists

BACKGROUND

Previous research has shown the effectiveness of simulation training using avatars paired with feedback in improving child sexual abuse interview quality. However, it has room for improvement.

OBJECTIVE

The present study aimed to determine if the combination of two interventions, feedback and modeling, would further improve interview quality compared to either intervention alone.

PARTICIPANTS

Thirty-two clinical psychologists were randomly assigned to a feedback, modeling, or the combination of feedback and modeling group.

METHODS

The participants conducted five simulated child sexual abuse interviews online while receiving the intervention(s) corresponding to their allocated group. Feedback was provided after each interview and consisted of the outcome of the alleged cases and comments on the quality of the questions asked in the interviews. Modeling was provided after the 1st interview and consisted of learning points and videos illustrating good and bad questioning methods.

RESULTS

The proportion of recommended questions improved over the five interviews when considering all groups combined. The combined intervention (vs. feedback alone) showed a higher proportion of recommended questions from the 2nd interview onward while the difference between the combined intervention and modeling alone and the difference between the modeling alone and feedback alone were mostly not significant. The number of correct details were affected in the same way. No significant differences in the number of incorrect details were found.

CONCLUSIONS

The results show that the combination of feedback and modeling achieves improvement greater than that of feedback alone.

ProwisT – Ein Instrument zur Einschätzung des professionellen Handlungswissens von Trainer/innen

Der vorliegende Beitrag in der Zeitschrift Gruppe. Interaktion. Organisation (GIO) beinhaltet die Vorstellung, theoretische Einordnung und inhaltliche Validierung eines Selbst- und Fremdbewertungsinstruments für Trainerwissen.

Trainer/innen sind Personen, die berufliche und betriebliche Fort- und Weiterbildungsangebote durchführen. Von ihren Kompetenzen und ihrem Wissen hängt die Qualität betrieblicher Weiterbildungen ab. Ausgehend von einer literaturbasierten Anforderungsermittlung wurde zunächst ein Fragebogen bezüglich des von Trainer/innen benötigten professionellen Handlungswissens entwickelt. Dieser Fragebogen lässt sich in einer modifizierten Form, dem Instrument zur Einschätzung des professionellen Handlungswissens von Trainer/innen (ProwisT), auch für die Selbst- oder Fremdeinschätzung des Wissens von Trainer/innen einsetzen. Das Instrument umfasst 41 Wissensfacetten, die sich auf 10 übergeordnete, theoretisch fundierte Wissensdimensionen verteilen. Dazu gehören neben dem Wissen über die Planung und Konzeption von Trainings Kenntnisse über Gruppenmanagement, die methodische Umsetzung von Trainings, Diagnostik, bildungswissenschaftliche Grundlagen, individuelle Unterschiede der Teilnehmenden, Fachwissen, fachdidaktisches Wissen, Organisationswissen sowie Kenntnisse über Beratung und Coaching.

Die 41 Wissensfacetten wurden zunächst von 200 Trainer/innen, 253 Teilnehmenden und 93 Personalverantwortlichen auf einer sechsstufigen Skala im Hinblick auf ihre Relevanz für die Trainertätigkeit beurteilt. Mit wenigen Ausnahmen wurde die Relevanz der 41 Facetten durch die Befragten bestätigt. Die Teilnehmenden scheinen bei der Bewertung der Facetten teilweise andere Schwerpunkte zu setzen als Trainer/innen und Personalverantwortliche.

Das modifizierte Instrument ProwisT kann von Trainer/innen zum Abgleich des eigenen professionellen Wissens und damit für eine individualisierte Kompetenzentwicklung genutzt werden. Außerdem kann es als Standard für Trainerausbildungen, Trainingsanbieter und Personalabteilungen dienen.

Wie baue ich ein erfolgreiches Netzwerk auf? Konzeption, Durchführung und Evaluation eines Networking-Trainings

Dieser Beitrag der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) berichtet von der Entwicklung, Durchführung und Evaluation eines Networkingtrainings. Networking gilt branchenübergreifend als wichtige Kompetenz für den Aufbau tätigkeitsrelevanter Ressourcen und Fertigkeiten und gewinnt in Zeiten der individualisierten, wissensintensiven und digitalisierten Berufstätigkeit weiter an Bedeutung. Die „Kunst des Netzwerkens“ zu erlernen ist deshalb essentiell. Basierend auf der Handlungsregulationstheorie und sozialkognitiven Ansätzen wird in dieser Evaluationsstudie die Wirksamkeit eines Networking-Trainings (N = 37) für Berufstätige untersucht. Das Training vermittelt Kompetenzen zu Aufbau, Pflege und Nutzung von Kontakten im beruflichen Kontext. Es wird im Rahmen eines Pretests und drei Posttests bis zu einem Jahr nach dem Training und einer nicht-äquivalenten Kontrollvariablenstrategie auf mehreren Ebenen evaluiert. Es zeigen sich signifikante Verbesserungen in den Bereichen Wissen, networkingbezogene Selbstwirksamkeit und Networkingverhalten, sowie eine Zunahme an Kontakten in beruflichen Online-Netzwerken. Basierend auf den genannten trainingstheoretischen Grundlagen gelingt den Teilnehmenden die Entwicklung ihrer Networkingkompetenzen, d. h. sich ein berufliches Online- und Offline-Netzwerk aufzubauen, dieses zu pflegen und zu nutzen.

The Science of Workplace Instruction: Learning and Development Applied to Work

Learning is the engagement in mental processes resulting in the acquisition and retention of knowledge, skills, and/or affect over time and applied when needed. Building on this definition, we integrate the science of training and the science of learning to propose a new science of workplace instruction, linking the design of instructional events to instructional outcomes such as transfer and job performance through the mediating effects of learner events and learning outcomes. We propose three foundational elements: the learner, instructional principles, and training delivery (methods and media). Understanding and applying instructional principles are the primary methods for enhancing training effectiveness; thus, we detail 15 empirically supported principles. We then discuss the erroneous pursuit of aptitude-by-treatment interactions under the guise of learner styles and age-specific instruction. Finally, we offer suggestions for future research that draw on the foundation of instructional principles to optimize self-directed learning and learning in synthetic learning environments.

Design of a Pharmacy Curriculum on Patient Centered Communication Skills

For delivering high quality pharmaceutical care pharmacy students need to develop the competences for patient centered communication. The aim of the article is to describe how a curriculum on patient centered communication can be designed for a pharmacy program. General educational principles for curriculum design are based on the theories of constructive alignment, self-directed learning and the self-determination theory. Other principles are paying systematic and explicit attention to skills development, learning skills in the context of the pharmacy practice and using a well-balanced system for the assessment of students’ performance. Effective educational methods for teaching communication skills are small group training sessions preferably with (simulation) patients, preceded by lectures or e-learning modules. For (formative or summative) assessment different methods can be used. The Objective Structured Clinical Exam (OSCE) is preferred for summative assessment of communication competence. The principles and educational methods are illustrated with examples from the curriculum of the master Pharmacy program of Utrecht University (The Netherlands). The topics ‘pharmaceutical consultations on prescription medicine,’ ‘pharmaceutical consultations on self-care medication’ and ‘clinical medication reviews’ are described in detail. Finally, lessons learned are shared.

Volunteering via Smart-Phone for People With Psychosis-Protocol of a Feasibility Trial

The literature suggests that volunteering can be used to address social isolation and support patients with psychosis in the community. However, many expect in person meetings, requiring a greater effort of availability and commitment. There is therefore a need for more flexible, easily accessible support. Volunteering via smart-phone could be a useful intervention for people with psychosis. One patient and one volunteer have been matched for a duration of 12 weeks, and participants have been encouraged to communicate through a variety of communication methods (audio calls, video calls, text messages, WhatsApp messages and e-mails). The Phone Pal study aimed to investigate the feasibility of recruitment, participant retention, data collection procedures, intervention usage of the methods of communication and changes in outcome data. At baseline and follow-up outcome measures collected from patients and volunteers included their quality of life, physical activity, self-esteem and social comparison. Additional outcomes assessed patients' attachment, social contacts and symptoms; for volunteers, their social distance was evaluated. At follow-up both patients and volunteers rank their perception of their relationship with each other. This mixed method feasibility study has been conducted in two phases, the first stage evaluating a smaller sample of patients and volunteers recruited in London, and then a second phase with a larger sample of volunteers recruited from across the United Kingdom. Trial registration: ISRCTN17586238.

Why Is It Hard to Fight Herding?

The ubiquity of information, in part a consequence of the fast growth of Internet technologies, provides individuals with previously unknown opportunities to acquire and share information about new technology products. We witness numerous situations where potential adopters observe the decisions (but not the reasoning) of others and imitate their adoption behaviors. This implies that herd behavior can lead to en mass adoption. However, individuals possessing different characteristics exhibit different degrees of herd behavior. The characteristics of a given technology must also fit with the requirements of the task(s) that a technology adopter wants to fulfill. It is important to understand these phenomena in the herding context because they can influence a technology's staying power. We examine how several different user and technology characteristics interact with the antecedents of herd behavior, observed popularity of prior adoption and perceived uncertainty, to predict one's individual propensity for imitation in technology adoption. We test our research model via an online experiment with 260 respondents. One key finding is that while prior research has not found uncertainty to have the expected effect on propensity to imitate, it does in fact have a significant effect when various individual difference and technology moderators are taken into account.

Nonprofessional Peer Support to Improve Mental Health: Randomized Trial of a Scalable Web-Based Peer Counseling Course

BACKGROUND

Millions of people worldwide are underserved by the mental health care system. Indeed, most mental health problems go untreated, often because of resource constraints (eg, limited provider availability and cost) or lack of interest or faith in professional help. Furthermore, subclinical symptoms and chronic stress in the absence of a mental illness diagnosis often go unaddressed, despite their substantial health impact. Innovative and scalable treatment delivery methods are needed to supplement traditional therapies to fill these gaps in the mental health care system.

OBJECTIVE

This study aims to investigate whether a self-guided web-based course can teach pairs of nonprofessional peers to deliver psychological support to each other.

METHODS

In this experimental study, a community sample of 30 dyads (60 participants, mostly friends), many of whom presented with mild to moderate psychological distress, were recruited to complete a web-based counseling skills course. Dyads were randomized to either immediate or delayed access to training. Before and after training, dyads were recorded taking turns discussing stressors. Participants' skills in the helper role were assessed before and after taking the course: the first author and a team of trained research assistants coded recordings for the presence of specific counseling behaviors. When in the client role, participants rated the session on helpfulness in resolving their stressors and supportiveness of their peers. We hypothesized that participants would increase the use of skills taught by the course and decrease the use of skills discouraged by the course, would increase their overall adherence to the guidelines taught in the course, and would perceive posttraining counseling sessions as more helpful and their peers as more supportive.

RESULTS

The course had large effects on most helper-role speech behaviors: helpers decreased total speaking time, used more restatements, made fewer efforts to influence the speaker, and decreased self-focused and off-topic utterances (ds=0.8-1.6). When rating the portion of the session in which they served as clients, participants indicated that they made more progress in addressing their stressors during posttraining counseling sessions compared with pretraining sessions (d=1.1), but they did not report substantive changes in feelings of closeness and supportiveness of their peers (d=0.3).

CONCLUSIONS

The results provide proof of concept that nonprofessionals can learn basic counseling skills from a scalable web-based course. The course serves as a promising model for the development of web-based counseling skills training, which could provide accessible mental health support to some of those underserved by traditional psychotherapy.

Transfer of an interprofessional emergency caesarean section training program: using questionnaire combined with outcome data of newborn

PUPROSE

An emergency caesarean section is a potentially life-threatening situation both for the mother and the newborn. Non-technical skills can be improved by simulation training and are necessary to manage this urgent situation successfully. The objective of this study was to investigate, if training of emergency caesarean section can be transferred into daily work to improve the outcome parameters pH an APGAR of the newborn.

METHODS

In this pre-post study, 141 professionals took part in a training for emergency caesarean section. Participants received a questionnaire, based on the tools "Training Evaluation Inventory" and "Transfer Climate Questionnaire" 1 year after training. Outcome data of the newborn were collected from the hospitals information system.

RESULTS

Except the scale "extinction", Cronbach's alpha was higher than 0.62. All scales were rated lower than 2.02 on a 5-point Likert Scale (1 = fullest approval; 5 = complete rejection). "Negative reinforcement" was rated with 2.87 (SD 0.73). There were no significant differences in outcome data prior. The questionnaire fulfils criteria for application except the scale "extinction".

CONCLUSION

The presented training course was perceived as useful by the professionals and attitudes toward training were positive; the content was positively reinforced in practice 1 year after training. Parameters of the newborn did not change. It is conceivable that other outcome parameters (e.g. posttraumatic stress disorder) are addressed by the training. The development of relevant outcome parameters for the quality of emergency sections needs further investigation.

Are you sitting (un)comfortably? Action-based supervision and supervisory drift

Action-based methods such as behavioural experiments, role-play and (by extension) ‘chairwork’ are powerful techniques recommended in core supervisory texts for cognitive behavioural therapy (CBT). Despite this, experiential methods are seldom used by supervisors, suggesting that supervision often drifts from a ‘doing process’ to a ‘talking process’. A number of factors contribute to this divergence from best practice, including limited confidence and a lack of familiarity with experiential procedures amongst supervisors. To address this, the current paper presents a variety of action-based techniques for enhancing supervisees’ technical, perceptual, interpersonal, reflective and personal competencies. Behavioural experiments, empty-chair, multi-chair and role-playing exercises for maintaining treatment fidelity, enhancing empathic attunement, repairing therapeutic ruptures, resolving impasses and working through negative countertransference are described, amongst others. Further research is needed to establish the nature and extent of supervisory drift, as well as the efficacy of action-based methods.

Key learning aims

As a result of reading this paper, readers should:(1)

The Effectiveness of Teaching Clinical Empathy to Medical Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

Clinical empathy is a necessary trait to provide effective patient care, despite differences in how it is defined and constructed. The aim of this study was to examine whether empathy interventions in medical students are effective and how confounding factors potentially moderate this effect.

METHOD

The authors performed a systematic review and meta-analysis. They searched the literature published between 1948 and 2018 for randomized controlled trials that examined empathy interventions in medical students. The search (database searching, citation tracking, hand-searching relevant journals) yielded 380 studies, which they culled to 16 that met the inclusion criteria. For the meta-analysis, they used a random effects model to produce a pooled estimate of the standardized mean difference (SMD), then completed subgroup analyses.

RESULTS

The authors found evidence of the possibility of response and reporting bias. The pooled SMD was 0.68 (95% confidence interval 0.43, 0.93), indicating a moderately positive effect of students developing empathy after an intervention compared with those in the control groups. There was no evidence of publication bias, but heterogeneity was significantly high (I = 88.5%, P < .01). Subgroup analyses indicated that significant moderating factors for developing empathy were age, country, scope of empathy measurement, type of empathy intervention, and presence of rehearsal. Moderating factors with limited evidence were sex, study quality, journal impact factor, and intervention characteristics.

CONCLUSIONS

Despite heterogeneity and biases, empathy interventions in medical students are effective. These findings reinforce arguments in the literature and add considerable rigor from the meta-analysis. The authors propose a conceptual model for educators to follow when designing empathy interventions in medical students.

A Pilot Randomized Trial of Intervention Components Addressing Drug Use in Couples HIV Testing and Counseling (CHTC) with Male Couples

Men who have sex with men (MSM) experience high rates of substance use and HIV infection. Main partners are the source of many (35-68%) of these new HIV infections. This study developed and examined the efficacy of two adjunct components to couples HIV testing and counseling (CHTC)-communication training (CT) videos and a substance use module (SUM)-to reduce drug use and sexual HIV transmission risk in MSM couples. Participants included 70 male couples randomized into one of four conditions: CHTC, CHTC + CT videos, CHTC + SUM, and CHTC + CT videos + SUM. Participants completed a survey pre-intervention and 1-, 3-, and 6-months later. Completion of the SUM in the absence of CT videos was associated with significant immediate decreases in drug use and related problems; however, at 3- and 6-month follow ups, the SUM was only associated with reductions in drug use and related problems among men who also viewed the CT videos. There were no between-condition differences in sexual behavior. CHTC may serve as a vehicle for the delivery of brief substance use intervention for MSM couples.ClinicalTrails.gov NCT # 03125915.

Rethinking the Gold Standard With Multi-armed Bandits: Machine Learning Allocation Algorithms for Experiments

In experiments, researchers commonly allocate subjects randomly and equally to the different treatment conditions before the experiment starts. While this approach is intuitive, it means that new information gathered during the experiment is not utilized until after the experiment has ended. Based on methodological approaches from other scientific disciplines such as computer science and medicine, we suggest machine learning algorithms for subject allocation in experiments. Specifically, we discuss a Bayesian multi-armed bandit algorithm for randomized controlled trials and use Monte Carlo simulations to compare its efficiency with randomized controlled trials that have a fixed and balanced subject allocation. Our findings indicate that a randomized allocation based on Bayesian multi-armed bandits is more efficient and ethical in most settings. We develop recommendations for researchers and discuss the limitations of our approach.

Adolescent Male Couples-Based HIV Testing Intervention (We Test): Protocol for a Type 1, Hybrid Implementation-Effectiveness Trial

Background

Young men who have sex with men (YMSM), particularly those who are partnered, are at unique risk for HIV. YMSM are among those at highest risk for HIV. Meanwhile, despite the fact that primary partners account for many—possibly most—new HIV infections, partnered men who have sex with men perceive themselves to be at much lower risk for HIV infection and therefore test less often than single men. In response to the risk of primary partner HIV transmission, couples HIV testing and counseling (CHTC) procedures have been developed for use in adult populations. Although promising, YMSM couples may require additional support to complete CHTC given their developmental context in which sexual and romantic relationships are relatively new, and communication skills are emergent.

Objective

The aim of this study was to test the additive benefit of adjunct treatment components tailored for YMSM, which enhance communication skills before the completion of CHTC. The intervention tests a continuum of prevention packages including assertive communication training videos and motivational interviewing focused on assisting with identification and development (MI-AID) before entering into the dyadic intervention components. This protocol is part of the Adolescent Medicine Trials Network (ATN) Scale It Up program described in this issue.

Methods

This is a comparative effectiveness trial that will be executed in 3 phases. Phase 1 will gather qualitative data related to intervention development and implementation from partnered YMSM at 4 subject recruitment venues (SRVs). Phase 2 will compare a continuum of these interventions in a pilot randomized controlled trial (RCT) at 2 SRVs. Phase 3 will compare the most successful adapted intervention package from phase 2 to CHTC as usual in a larger RCT at 4 SRVs. This phase is focused on implementation and sustainment phases of the Exploration, Preparation, Implementation, and Sustainment framework.

Results

Phase 1 data will be drawn from qualitative interviews with partnered YMSM (n=24) and staff from ATN sites (n=20). Baseline enrollment for phase 2 is expected to begin across 2 SRVs in June 2018 (n_couples=36). In phase 2, survey data collection along with HIV and sexually transmitted infection (STI) testing will occur at baseline, and 1- and 3-month (postintervention) follow-ups. Phase 3 will begin enrollment across 4 SRVs in September 2019 (n_couples=144) and follow-ups will occur at 1, 3, 6, and 9 months postintervention.

Conclusions

Although MI-AID, video-based assertive communication training, and CHTC have established efficacy when administered on their own, this study will be the first to evaluate the strongest adjunctive version of these interventions to address the specific developmental needs of partnered YMSM.

Trial Registration

ClinicalTrials.gov NCT03386110; http://clinicaltrials.gov/ct2/show/NCT03386110 (Archived by WebCite at http://www.webcitation.org/75mlO7GCx)

International Registered Report Identifier (IRRID)

DERR1-10.2196/11186

Development and acceptability of a video-based vaccine promotion tutorial for obstetric care providers

A prenatal care provider's recommendation for maternal vaccines is one of the strongest predictors of vaccine acceptance during pregnancy. Aside from basic talking points, few resources exist to help obstetric care providers effectively navigate conversations with vaccine hesitant patients. This paper describes the development and acceptability of "VaxChat," an hour-long, evidence-based video tutorial aimed at improving obstetric care providers' ability to promote maternal vaccines. Between June and November 2017, 62 obstetric care providers registered to receive continuing medical education credit for viewing VaxChat. Of the post-tutorial responses received, over 90% said VaxChat increased their knowledge of what to say to vaccine hesitant patients, increased their confidence in addressing vaccinations with their pregnant patients, and will help them improve their practice culture regarding maternal vaccine promotion. Eighty percent intend to change how they approach vaccine conversations. These data suggest VaxChat may be a welcome complement to existing provider-to-patient talking points.

Proposing a Mechanistic Model of Clinician Training and Consultation

To make evidence-based treatments deliverable, effective, and scalable in community settings, it is critical to develop a workforce that can deliver evidence-based treatments as designed with skill. However, the science and practice of clinician training and consultation lags behind other areas of implementation science. In this paper, we present the Longitudinal Education for Advancing Practice (LEAP) model designed to help span this gap. The LEAP model is a mechanistic model of clinician training and consultation that details how training inputs, training and consultation strategies, and mechanisms of learning influence training outcomes. We first describe the LEAP model and then discuss how key implications of the model can be used to develop effective training and consultation strategies.