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HOČEVAR T, ANSTISS T, ROTAR PAVLIČ D. Content Validity and Cognitive Testing in the Development of a Motivational Interviewing Self-Assessment Questionnaire. Zdr Varst 2024; 63:46-54. [PMID: 38156336 PMCID: PMC10751900 DOI: 10.2478/sjph-2024-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Aim To develop and content validate a self-assessment questionnaire on motivational interviewing (MI) practice as the first stages in forming the questionnaire to be used in cross-sectional studies involving practitioners conducting the MI-based alcohol screening and brief intervention (ASBI). Methods A comprehensive mixed methods approach included a literature review, 3 rounds of expert panel (EP) opinions (n=10), cognitive testing (CT) with 10 MI-based ASBI practitioners, and questionnaire piloting with 31 MI-based ASBI practitioners. Based on the EP opinions in the second round, content validity indices (CVIs) and the modified kappa coefficient (k*) were calculated, focusing on the relevance and understandability of questions and comprehensiveness and meaningfulness of the response options. This analysis was performed in 2020, at the conclusion of the national "Together for a Responsible Attitude Towards Alcohol Consumption" ("Skupaj za odgovoren odnos do pitja alkohola", SOPA) project's pilot implementation. Results On a scale level, CVI values based on universal agreement for the entire questionnaire were high for 3/4 categories (S-CVI-UA>0.80), and CVI values based on average agreement were high across all categories (S-CVI-Ave>0.90). At the item level, CVI values (I-CVI) were never <0.50 (automatic item rejection), and the modified kappa value (k*) indicated poor validity for two items in the understandability category (k*=0.33). All problematic parts of the questionnaire were further tested and successfully modified based on the results of CT, and accepted in the third round of testing. Conclusions The final version of the questionnaire demonstrated appropriate content validity for use in studies among Slovenian MI-based ASBI practitioners and is now ready for further psychometric testing.
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Affiliation(s)
- Tadeja HOČEVAR
- National Institute of Public Health, Trubarjeva 2, 1000Ljubljana, Slovenia
| | - Tim ANSTISS
- University of Reading, Henley Business School, Whiteknights Rd, Reading RG6 6UD, United Kingdom
| | - Danica ROTAR PAVLIČ
- University of Ljubljana, Medical Faculty, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
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Chang YP, Cassalia J, Warunek M, Scherer Y. Motivational interviewing training with standardized patient simulation for prescription opioid abuse among older adults. Perspect Psychiatr Care 2019; 55:681-689. [PMID: 31187888 DOI: 10.1111/ppc.12402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 04/14/2019] [Accepted: 05/05/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aimed to examine the effect of motivational interviewing (MI) education on the doctorate of nursing practice (DNP) students' learning outcomes. DESIGN AND METHODS This study used a one-group with preposttest design. The sample consisted of 31 DNP students who received an MI training, including a didactic lecture, role-playing exercise, and standardized patient simulation. FINDINGS Findings indicated a significant increase in students' knowledge and confidence regarding MI at both posttests compared with baseline. PRACTICE IMPLICATIONS Findings suggested that MI training with standardized patient simulation demonstrated preliminary promising effects on DNP students' knowledge and confidence in MI techniques to manage prescription opioid abuse among older adults. This study showed the potential to enhance the care of older adults who abuse opioids to address this problem in practice.
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Affiliation(s)
- Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, New York
| | - Jade Cassalia
- Newark-Wayne Community Hospital, Rochester, New York
| | - Molli Warunek
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, New York
| | - Yvonne Scherer
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, New York
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Miller-Matero LR, Tobin ET, Fleagle E, Coleman JP, Nair A. Motivating residents to change communication: the role of a brief motivational interviewing didactic. Prim Health Care Res Dev 2019; 20:e124. [PMID: 31451128 PMCID: PMC6713881 DOI: 10.1017/s146342361900015x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/18/2018] [Accepted: 03/03/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Motivational interviewing (MI) is a patient-centered approach that encourages patients to change behaviors. MI training programs have increased residents' knowledge and use of MI skills; however, many residency programs may not have the time to dedicate to lengthy MI programs. The purpose of this study was to evaluate the benefits of a brief MI didactic for residents in an academic internal medicine patient-centered medical home. METHODS Thirty-two residents completed a 1-h MI training between October 2016 and June 2017 and completed measures on their knowledge of, confidence using, and utilization of MI skills prior to the training, immediately after the training, and at a 1-month follow-up. RESULTS The residents' knowledge of and confidence using MI skills increased from pre-test to post-test and also increased from pre-test to the 1-month follow-up. CONCLUSION The utilization of MI skills increased from pre-test to the 1-month follow-up. A 1-h didactic offers benefits to residents.
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Affiliation(s)
- Lisa Renee Miller-Matero
- Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Behavioral Health, Henry Ford Health System, Detroit, MI, USA
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Erin T. Tobin
- Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Behavioral Health, Henry Ford Health System, Detroit, MI, USA
| | - Elizabeth Fleagle
- Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Behavioral Health, Henry Ford Health System, Detroit, MI, USA
| | - Joseph P. Coleman
- Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Behavioral Health, Henry Ford Health System, Detroit, MI, USA
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Anupama Nair
- Internal Medicine, Henry Ford Health System, Detroit, MI, USA
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Boykan R, Gorzkowski J, Marbin J, Winickoff J. Motivational Interviewing: A High-Yield Interactive Session for Medical Trainees and Professionals to Help Tobacco Users Quit. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10831. [PMID: 31773059 PMCID: PMC6868517 DOI: 10.15766/mep_2374-8265.10831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/29/2019] [Indexed: 06/01/2023]
Abstract
Introduction Motivational interviewing (MI) is a collaborative patient-focused counseling technique that is effective in promoting smoking cessation but is not consistently taught/practiced in training. Methods This training session was implemented in a pediatric residency training program and also given four times to pediatric practitioners as part of a 2-day tobacco training sponsored by the American Academy of Pediatrics (AAP). Pediatric residents (N = 33) participated in a 1-hour interactive session focused on addressing tobacco. Knowledge was assessed with pre- and 6-month postsurveys. Retention of skills was evaluated between 6 and 9 months posttraining by resident performance on two scenarios with standardized patients, which was scored utilizing the Behavior Change Counseling Index (BECCI), by two MI-trained physicians. AAP trainees (N = 115) participated in tobacco trainings with a session dedicated to MI; sessions were evaluated by pre- and posttests. Results Residents who completed the session (n = 12) performed significantly better on eight of 10 items of the BECCI and on the overall BECCI score (p < .001) compared with those who had not completed the session (n = 12). Feedback on AAP training sessions (N = 115) indicated that practitioners felt able to perform MI and incorporate MI into practice. The percentage of trainees who felt comfortable counseling about tobacco doubled from pre- to posttraining. Discussion A hands-on MI training session provided pediatric residents and practicing clinicians with knowledge and skills to address tobacco use with patients/families. The session is easily incorporated into different training environments.
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Affiliation(s)
- Rachel Boykan
- Associate Professor, Department of Pediatrics, Renaissance School of Medicine at Stony Brook University
| | - Julie Gorzkowski
- Director, Adolescent Health Promotion, American Academy of Pediatrics
| | - Jyothi Marbin
- Associate Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine
| | - Jonathan Winickoff
- Professor, Pediatrics, Harvard Medical School
- Professor, Pediatrics, MassGeneral Hospital for Children
- Director of Translational Research, American Academy of Pediatrics Julius B. Richmond Center of Excellence
- Director of Pediatric Research, Tobacco Research and Treatment Center, Massachusetts General Hospital
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Thomas KEH, Kisely S, Urrego F. A Tale of Smoking Cessation Promotion: The Utilization of a Children's Book to Increase Screening and Counseling in the Pediatric Clinic. Clin Pediatr (Phila) 2017; 56:1142-1147. [PMID: 28056540 DOI: 10.1177/0009922816684607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the addition of a children's book in the pediatric clinic could result in an increase in the rate in which pediatricians screened for secondhand smoke exposure (SHSe) and counseled caregivers to stop smoking. STUDY DESIGN This randomized controlled study was performed at 7 pediatric clinics. METHODS Seven pediatric clinic sites were randomly assigned to either an intervention or control group. Pediatricians in the intervention group were given children's books about SHSe to distribute to their patients while the control group did not receive any materials. RESULTS At baseline, there was no difference between the control group and intervention group in rates at which pediatricians screened for SHSe ( P = .8728) and counseled caregivers to stop smoking ( P = .29). After the intervention, screening for SHSe and counseling caregivers to stop smoking were statistically significantly greater in the intervention group, when compared to controls ( P < .01 and P < .001, respectively). CONCLUSIONS The use of a health promotion children's book in the pediatric setting can increase the rate at which pediatricians screen for SHSe and counsel caregivers to stop smoking. Future research should examine the effect of the storybook on various parameters of smoking cessation and future smoking behaviors.
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Affiliation(s)
| | - Steve Kisely
- 2 University of Queensland, Brisbane, Queensland, Australia
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Hall K, Kisely S, Urrego F. The Use of Pediatrician Interventions to Increase Smoking Cessation Counseling Among Smoking Caregivers: A Systematic Review. Clin Pediatr (Phila) 2016; 55:583-92. [PMID: 26928569 DOI: 10.1177/0009922816632347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Katharine Hall
- Ochsner Health System, New Orleans, LA, USA School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Steve Kisely
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Juárez-Jiménez MDLV, Pérez-Milena A, Valverde-Bolívar FJ, Rosa-Garrido C. [Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)]. Aten Primaria 2015; 47:659-68. [PMID: 25704792 PMCID: PMC6983614 DOI: 10.1016/j.aprim.2014.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/02/2014] [Accepted: 11/04/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To determine the frequency of offering clinical counseling against the consumption of alcohol, tobacco and illegal drugs by internal specialist residents (EIR) of Andalusia, and the factors related to such advice. DESIGN Multicenter cross-sectional study by self-administered questionnaire sent by mail. SETTING AND PARTICIPANTS EIR of Andalusia. MAIN MEASUREMENTS The questionnaire collected the frequency of counseling against the use of alcohol, tobacco and illegal drugs (dependent variable). INDEPENDENT VARIABLES age/gender, specialty, drug consumption and Fagerström test. RESULTS Out of a total of 4245 participants, 66% responded, 29% did not respond, and 5% poorly completed questionnaires. The mean age was 29.1(±SD 5.1) years, 69% female, 89% Spanish nationality, 84% in medical training (73% hospital, 27% family medicine). The frequency of counseling against tobacco (85%) and alcohol (82%) is higher than illegal drugs (56%, p<.001, χ(2) test). Counseling against alcohol consumption is related to family medicine (OR=2.8; 95% CI [1.4-4.6]) and nursing (OR=2.5 [1.7-4.4]), and the age of first alcohol consumption (OR=1.07 [1.03-1.1]). Counseling against smoking is related to family medicine (OR=12.9;[7.6-21.9]) and nursing (OR=8.4;[4.3-16.5]), personal consumption of tobacco (OR=1.5 [1.2-2.0]), and wine (OR=1.1 [1.04-1.3]), and age of first alcohol consumption (OR=1.06 [1.01-1.1]). Counseling against illegal drugs is related to the age of first alcohol consumption (OR=1.09 [1.05-1.1]) and smoking (OR=.58 [.4-.7]). CONCLUSION There is a high frequency of counseling against consumption of tobacco and alcohol by EIR, although remarkably smaller for illegal drugs. The influencing factors are both formative elements of their own specialty such as personal consumption of alcohol and tobacco, which should be considered for improvement of this preventive activity.
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Affiliation(s)
| | - Alejandro Pérez-Milena
- Centro de Salud El Valle, Distrito Sanitario de Jaén (Servicio Andaluz de Salud), Jaén, España.
| | | | - Carmen Rosa-Garrido
- Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental Alejandro Otero (Consejería de Salud, Junta de Andalucía), Jaén, España
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Factors Influencing Smoking Cessation Counselling: A Qualitative Study of Medical Residents. J Smok Cessat 2015. [DOI: 10.1017/jsc.2013.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Physicians in training must be able to counsel their patients on smoking cessation, however, little is known about the barriers that they face to counselling their patients.Aims: The study sought to identify barriers to smoking cessation counselling specific to physicians in training.Methods: Qualitative interviews in the form of focus groups were conducted with 30 medical residents. Focus groups were audio taped, transcribed verbatim and coded by two independent reviewers. Similar codes were grouped to form categories and then aggregated to form themes.Results: Seven themes emerged describing resident barriers to provision of smoking cessation counselling : (1) Lack of self-efficacy for providing counselling; (2) their perception that patients are not willing to change; (3) a lack of available resources/information for providers and patients; (4) differences in supervising physician's recommendations; (5) perceived lack of time; (6) a perception of lack of continuous care; and (7) a lack of practical skills in counselling.Conclusions: This study highlighted residents’ perceived barriers to providing smoking cessation counselling. These barriers are similar to those encountered by other providers. Additional barriers specific to residency exist and more training is necessary.Practice Implications: The barriers that physicians encounter to smoking cessation counselling must be addressed early on in residency training.
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Educating Physical Therapist Students in Tobacco Cessation Counseling: Feasibility and Preliminary Outcomes. ACTA ACUST UNITED AC 2015; 29:68-79. [PMID: 26848209 DOI: 10.1097/00001416-201529030-00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Smoking is the leading preventable cause of chronic disease and premature morbidity. People with physical disabilities experience elevated smoking prevalence when compared with their non-disabled peers. The physical therapy profession is dedicated to meeting needs of people with physical disabilities, yet most physical therapists (PT) do not typically provide tobacco cessation interventions. Similar deficits exist among other health professions, creating a demand for improved services to address smoking-related health burdens. Within other health professions, insufficient tobacco cessation counseling (TCC) education has been linked to a lack of interventions and may account for similar deficits in physical therapy practice. STUDY PURPOSE Goals were to assess feasibility, implementation, and results of a tailored TCC educational program for entry-level physical therapist (PT) students. SUBJECTS Two cohorts of entry-level physical therapist (PT) students (n = 12 and n = 17). METHODS Educational objectives were established based on prior review of the literature, a survey of national PT education programs, and clinical guidelines for TCC established by the United States Public Health Service (USPHS). Based on these objectives, the team designed a 3-hour workshop involving didactic content and problem-based skills practice. A pre- and post-test survey was used to measure 6 dimensions: knowledge, perceived barriers, perceived facilitators, self-efficacy, outcome expectations, and self-rated skill in TCC. Within each cohort, changes in score were compared using a paired t test. The ability to apply clinical guidelines for TCC was assessed using case scenarios and structured observation. These outcomes were selected based on the Theory of Reasoned Action, which states that future behavior is determined by intention to act. Intention to act is a product of knowledge, a positive balance between perceived barriers and facilitators, strong self-efficacy, favorable outcome expectations, and necessary skills. Student satisfaction with training was assessed through anonymous written feedback. Feasibility was based on cost analysis, including material resources, as well as faculty time and effort. RESULTS Following participation, both cohorts improved in knowledge, perceived facilitators, outcome expectations, and self-rated skill. Cohort 2 also showed an increase in self-efficacy (P < .01). Structured observation revealed competencies in application of clinical guidelines for case-based scenarios. Mean student satisfaction ratings for the educational experience were 5/5, and cost-estimate for delivery of the 3-hour educational intervention was approximately $32 per student. CONCLUSIONS This research study demonstrated feasibility and impact of an evidence-based curricular model designed to increase likelihood of TCC by future PTs by enhancing factors known to promote TCC behaviors. The program was well-received by students, and objectives were achieved through efficient use of faculty time and resources. Subsequent research should examine the effects of training on the provision of TCC within clinical settings, as well as the impact of TCC on smoking quit rates for patients who have received this intervention as a component of their physical therapy plan of care.
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Dunhill D, Schmidt S, Klein R. Motivational interviewing interventions in graduate medical education: a systematic review of the evidence. J Grad Med Educ 2014; 6:222-36. [PMID: 24949125 PMCID: PMC4054720 DOI: 10.4300/jgme-d-13-00124.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 08/21/2013] [Accepted: 11/25/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Motivational interviewing (MI) is a patient-centered method of behavior change counseling. It has shown promise in enabling patients to identify and improve problem health behaviors. Incorporating MI education into residency training may be beneficial. OBJECTIVE To review the current evidence regarding the impact of MI education in graduate medical education. RESULTS Of the 9 studies of MI education in graduate medical education training, most noted favorable outcomes after MI education. Outcomes included improvements in residents' view of MI, MI skill use and competency, and resident satisfaction with MI interventions. Of the 5 studies that looked at residents' views of MI, 3 found improvements in resident assessments of the importance of and confidence in using MI. Of the 4 studies of MI skills, 3 reported improvements in residents' use of and competency in the MI skill. The quality of MI education in the graduate medical education literature is limited by overreliance on preintervention and postintervention analysis as a study design, the variable intensity of educational interventions, and limited use of validated assessment tools and quantitative outcome measures. CONCLUSIONS Review of the literature shows that MI education can be successfully implemented within the residency education environment. The intensity of MI interventions, coupled with experiential learning and feedback, correlated with favorable outcomes in terms of resident use of MI skills and resident satisfaction. Further study is needed to determine which MI skills are most effectively taught to residents, the impact of MI training on resident behavior in clinical settings, and the impact on clinical outcomes.
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Childers JW, Bost JE, Kraemer KL, Cluss PA, Spagnoletti CL, Gonzaga AMR, Arnold RM. Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation. PATIENT EDUCATION AND COUNSELING 2012; 89:281-287. [PMID: 22910139 DOI: 10.1016/j.pec.2012.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 06/28/2012] [Accepted: 08/02/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine whether a motivational interviewing (MI) curriculum is effective in teaching internal medicine residents core MI skills and the empathic, nonjudgmental MI style. METHODS Nineteen third-year residents met for 12 h with a faculty instructor. Teaching methods included lecture, written exercises, a simulated patient exercise, and discussion of residents' behavior change issues. RESULTS Residents' adoption of MI skills was evaluated before and after the course with the Helpful Responses Questionnaire. Residents decreased use of closed-ended questions (from a score of 1.13 to 0.37, p=0.036) and MI roadblocks (4.00-1.08, p<0.001), and increased the use of reflections (1.87-4.87, p<0.001), and use of MI strategies (0.45-0.97, p=0.017). Residents' use of open-ended questions decreased from 1.97 to a mean of 1.05, p=0.023. Residents' ratings of the course on a 5-point scale varied from 3.7 for written exercises to 4.6/5 for the simulated patient exercise. After the course, residents rated behavior change counseling skills as more important. DISCUSSION AND CONCLUSION A 12-h course increased residents' use of core MI communication skills in a written measure, and was highly rated. PRACTICE IMPLICATIONS Future work should examine whether teaching of the empathic, collaborative MI stance impacts patient outcomes.
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Affiliation(s)
- Julie W Childers
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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Mitchell J, Brown JB, Smith C. Interprofessional education: a nurse practitioner impacts family medicine residents' smoking cessation counselling experiences. J Interprof Care 2010; 23:401-9. [PMID: 19242852 DOI: 10.1080/13561820802490941] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This qualitative research paper describes a successful example of interprofessional education with family medicine residents (FMR) by a nurse practitioner (NP) colleague. The educational impact of the NP role in regard to smoking cessation counselling is revealed by the analysis of 16 semi-structured interviews using a phenomenological approach. The key themes depicted the NP as an educator and mentor, encourager and referral resource. Outcomes of improved knowledge, skills, and motivation towards providing smoking cessation counselling are described. This research provides some understanding of how professional students' learning and practice can be affected by a member of another profession through direct and indirect approaches. The experiences identified how interprofessional education and collaborative clinical practice can affect FMRs' attitudes, knowledge and behaviours. This learning can guide us in enhancing the quality of education provided to all health care professionals.
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Affiliation(s)
- Joan Mitchell
- Byron Family Medical Centre, London, Ontario, Canada.
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13
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Abramowitz SA, Flattery D, Franses K, Berry L. Linking a motivational interviewing curriculum to the chronic care model. J Gen Intern Med 2010; 25 Suppl 4:S620-6. [PMID: 20737238 PMCID: PMC2940440 DOI: 10.1007/s11606-010-1426-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unhealthy lifestyle choices frequently cause or worsen chronic diseases. Many internal medicine residents are inadequately trained to provide effective health behavior counseling, in part, due to prioritization of acute care in the traditional model of medical education and to other systemic barriers to teaching psychosocial aspects of patient care. AIM To address this gap in training, we developed and piloted a curriculum for a Primary Care Internal Medicine residency program that links a practical form of motivational interviewing (MI) training to the self-management support (SMS) component of the chronic care model. PARTICIPANTS AND SETTING All 30 primary care residents at Alameda County Medical Center were trained in the curriculum since it was initiated in 2007 during the California Academic Chronic Care Collaborative. PROGRAM DESCRIPTION Residents participated in three modules during which the chronic care model was introduced and motivational interviewing skills were linked to the model's self-management support component. This training was then reinforced in the clinical setting. Case-based interactive instruction, teaching videotapes, group role-plays, faculty demonstration, and observation of resident-patient interactions in the clinical setting were used to teach the curriculum. PROGRAM ASSESSMENT: A preliminary, qualitative assessment of this curriculum was done from a program standpoint and from the perspective of the learners. Residents reported increased sense of confidence when approaching patients about health behavior change. Faculty directly observed residents during clinical encounters using MI and SMS skills to work more collaboratively with patients and to improve patient readiness for self-management goal setting. CONCLUSION A curriculum that links motivational interviewing skills to the chronic care model's self-management support component and is reinforced in the clinical setting is feasible to develop and implement. This curriculum may improve residents' confidence with health behavior counseling and with preparing patients to become active participants in management of their chronic conditions.
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Affiliation(s)
- Sharone A Abramowitz
- Primary Care Internal Medicine, Alameda County Medical Center, Highland Hospital, Oakland, CA 94602, USA.
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Walsh SE, Singleton JA, Worth CT, Krugler J, Moore R, Wesley GC, Mitchell CK. Tobacco Cessation Counseling Training with Standardized Patients. J Dent Educ 2007. [DOI: 10.1002/j.0022-0337.2007.71.9.tb04381.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sarah E. Walsh
- Kentucky Cancer Program, James Graham Brown Cancer Center; University of Louisville
| | - Jacqueline A. Singleton
- Dental Hygiene Program, Department of Periodontics, Endodontics, and Dental Hygiene; University of Louisville School of Dentistry
| | - Celeste T. Worth
- Kentucky Cancer Program, James Graham Brown Cancer Center; University of Louisville
| | - Jacqueline Krugler
- Standardized Patient Program; University of Louisville School of Medicine
| | - Regan Moore
- Department of Periodontics, Endodontics, and Dental Hygiene; University of Louisville School of Dentistry
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Collins BN, Levin KP, Bryant-Stephens T. Pediatricians' practices and attitudes about environmental tobacco smoke and parental smoking. J Pediatr 2007; 150:547-52. [PMID: 17452234 PMCID: PMC4402571 DOI: 10.1016/j.jpeds.2007.01.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 11/02/2006] [Accepted: 01/03/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess pediatric resident and preceptor environmental tobacco smoke (ETS)-reduction practices and attitudes to inform the development of resident tobacco intervention training. STUDY DESIGN Pediatricians in a teaching hospital anonymously completed a 65-item survey. RESULTS Residents' and preceptors' (n = 93) ETS actions were generally similar. Pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses (eg, 60% "always" assessed during asthma visits, 13% during otitis visits). Less than 50% "always" explained ETS risks to smoking parents and less than 33% "always" advised about creating smoke-free homes. Most pediatricians reported negative attitudes toward smoking parents; however, attitudes were not related to actions. Most frequently cited barriers to ETS action were lack of time and low confidence in effectiveness. CONCLUSION Understanding barriers to ETS intervention could promote transdisciplinary (TD) training and intervention approaches that effectively promote pediatrician advice while offloading the time burden of intensive smoking intervention. ETS intervention training should foster pediatrician confidence and TD relationships with affiliated health professionals who could facilitate intervention, referral, and follow-up necessary to sustain smoking behavior change.
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Affiliation(s)
- Bradley N Collins
- Health Behavior Research Clinic, Department of Public Health, Temple University, Pennsylania 19122, USA.
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