Presenters
Summary
BACKGROUND: Effective patient-provider communication is critical to optimizing patient health and well-being [1]. Clinician coaching directly targets these skills [e.g., 2,3]. The current project builds on an established coaching approach used with MD/NP residents in an integrated VA primary care setting. Coaching is delivered by clinical health psychology (CHP) staff and targets: Motivational Interviewing (MI), Shared Decision Making (SDM), and Trauma-Informed Care (TIC). Based on the New World Kirkpatrick training evaluation model [4], the project used previous learner/coaching data [5] and current literature to revise this approach to promote behavioral transfer of skills. METHOD: Population included 24 residents (NP=6, MD=18) who received clinician coaching and feedback from CHP staff during the 2018-2019 academic year. Residents completed a pre-planning session, observation, and coaching in MI, SDM, and TIC. Skills were evaluated on empirically supported checklists. Forms were reviewed by another CHP staff for trends and inconsistencies in ratings and use. Resident satisfaction data were examined. RESULTS: Items observed 100% of the time were removed from the checklists. Low frequency items were starred and coaches are now encouraged to highlight them with residents pre-observation. Residents are now asked to identify an observation appointment where MI is likely to be paramount (e.g., smoking cessation) and one where SDM is likely to be emphasized (e.g., medication changes); TIC continues to be evaluated at all appointments. A self-reflection component was added, prompting learners to rate the extent to which they were guided by MI, SDM, or TIC-based principles during the appointment. The new approach has now been implemented. Formal evaluations will be completed at the end of the academic year. CONCLUSIONS: The updated form/coaching approach, promotion of MI and SDM-specific case selections by residents, and addition of a self-reflection component all serve to support the behavioral transfer of patient-centered communication skills. The presentation will highlight data, present changes, and elicit feedback from conference participants.
Objectives
- Describe an evidenced-based approach to MD/NP resident communication skills coaching used in an integrated VA primary care clinic.
- Identify factors involved in moving this type of educational tool from targeting learning (Level 2) to directly promoting behavioral transfer of skills (Level 3).
- Discuss implications for utilizing this type of learning tool to promote medical education and patient-centered care.
