Reinventing the reel: an innovative approach to resident skill-building in motivational interviewing for brief intervention.
To enhance the skills of primary care residents in addressing substance misuse, residency screening, brief intervention, and referral to treatment (SBIRT) programs increasingly offer motivational interviewing (MI) training, but seldom include feedback and coaching. This innovative 2-round "Virginia Reel" approach, supplementing 3 hours of basic MI instruction, was designed to teach and coach residents to use MI while providing ongoing medical care. SBIRT/MI-competent facilitators served as both trainers and actors at 8 carefully sequenced Objective Structured Clinical Examination (OSCE) stations, providing instruction, role-play practice, and feedback on 17 microskills in 2 successive clinical "visits"/rounds addressing alcohol misuse and diabetes management. Evaluation included OSCE checklists, overall competency assessments, and responses to open-ended questions. Three residents showed improvement between rounds. Resident evaluations were strongly positive, identifying practice of MI skills and receipt of coaching and feedback from MI experts as particularly valuable. Further study is needed to confirm effectiveness of the approach and explore the impact of fewer OSCE stations of longer duration.
Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, Georgia, USA. cole.bonnie@mccg.org
Bonnie
B
Cole
Denice Crowe
DC
Clark
J Paul
JP
Seale
Sylvia
S
Shellenberger
Alan
A
Lyme
J Aaron
JA
Johnson
Aruna
A
Chhabria
D000437:Alcoholism; D002983:Clinical Competence; D019468:Disease Management; D005194:Family Practice / Q000193:education*; D030141:Feedback, Psychological; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007407:Interviews as Topic / Q000379:methods*; D009042:Motivation; D011614:Psychotherapy, Brief / Q000193:education*; D012017:Referral and Consultation; D015813:Substance Abuse Detection