J. Med. Internet Res. - A pilot study of motivational interviewing training in a virtual world.

Tópicos

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Resumo

CKGROUND: Motivational interviewing (MI) is an evidence-based, patient-centered counseling strategy proven to support patients seeking health behavior change. Yet the time and travel commitment for MI training is often a barrier to the adoption of MI by health care professionals. Virtual worlds such as Second Life (SL) are rapidly becoming part of the educational technology landscape and offer not only the potential to improve access to MI training but also to deepen the MI training experience through the use of immersive online environments. Despite SL's potential for medical education applications, little work is published studying its use for this purpose and still less is known of educational outcomes for physician training in MI using a virtual-world platform.OBJECTIVE: Our aims were to (1) explore the feasibility, acceptability, and effectiveness of a virtual-world platform for delivering MI training designed for physicians and (2) pilot test instructional designs using SL for MI training.METHODS: We designed and pilot tested an MI training program in the SL virtual world. We trained and enrolled 13 primary care physicians in a two-session, interactive program in SL on the use of MI for counseling patients about colorectal cancer screening. We measured self-reported changes in confidence and clinical practice patterns for counseling on colorectal cancer screening, and acceptability of the virtual-world learning environment and the MI instructional design. Effectiveness of the MI training was assessed by coding and scoring tape-recorded interviews with a blinded mock patient conducted pre- and post-training.RESULTS: A total of 13 physicians completed the training. Acceptability ratings for the MI training ranged from 4.1 to 4.7 on a 5-point scale. The SL learning environment was also highly rated, with 77% (n = 10) of the doctors reporting SL to be an effective educational medium. Learners' confidence and clinical practice patterns for colorectal cancer screening improved after training. Pre- to post-training mean confidence scores for the ability to elicit and address barriers to colorectal cancer screening (4.5 to 6.2, P = .004) and knowledge of decision-making psychology (4.5 to 5.7, P = .02) and behavior change psychology (4.9 to 6.2, P = .02) increased significantly. Global MI skills scores increased significantly and component scores for the MI skills also increased, with statistically significant improvements in 4 of the 5 component skills: empathy (3.12 to 3.85, P = .001), autonomy (3.07 to 3.85, P < .001), collaboration (2.88 to 3.46, P = .02), and evocative response (2.80 to 3.61, P = .008).CONCLUSIONS: The results of this pilot study suggest that virtual worlds offer the potential for a new medical education pedagogy that will enhance learning outcomes for patient-centered communication skills training.

Resumo Limpo

ckground motiv interview mi evidencebas patientcent counsel strategi proven support patient seek health behavior chang yet time travel commit mi train often barrier adopt mi health care profession virtual world second life sl rapid becom part educ technolog landscap offer potenti improv access mi train also deepen mi train experi use immers onlin environ despit sls potenti medic educ applic littl work publish studi use purpos still less known educ outcom physician train mi use virtualworld platformobject aim explor feasibl accept effect virtualworld platform deliv mi train design physician pilot test instruct design use sl mi trainingmethod design pilot test mi train program sl virtual world train enrol primari care physician twosess interact program sl use mi counsel patient colorect cancer screen measur selfreport chang confid clinic practic pattern counsel colorect cancer screen accept virtualworld learn environ mi instruct design effect mi train assess code score taperecord interview blind mock patient conduct pre posttrainingresult total physician complet train accept rate mi train rang point scale sl learn environ also high rate n doctor report sl effect educ medium learner confid clinic practic pattern colorect cancer screen improv train pre posttrain mean confid score abil elicit address barrier colorect cancer screen p knowledg decisionmak psycholog p behavior chang psycholog p increas signific global mi skill score increas signific compon score mi skill also increas statist signific improv compon skill empathi p autonomi p collabor p evoc respons p conclus result pilot studi suggest virtual world offer potenti new medic educ pedagogi will enhanc learn outcom patientcent communic skill train

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