Virtual Training Is More Cost-Effective Than In-Person Training for Preparing Staff to Implement Contingency Management.
Virtual Training Is More Cost-Effective Than In-Person Training for Preparing Staff to Implement Contingency Management.
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在培训员工实施应急管理方面，虚拟培训比面对面培训更具成本效益。
DOI：
10.1007/s41347-022-00283-1
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发表时间：
2022-10-12
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行为疗法的实施部分依赖于培训，以培养辅导员的技能，为忠实地提供服务做准备。在新冠肺炎疫情期间，职业教育竞技场见证了从面对面培训到虚拟培训的快速转变，但这些模式的相对效用和费用尚不清楚。在阿片类药物治疗计划（OTP）中实施应急管理（CM）的群集随机混合3型试验的背景下，多队列设计提供了比较虚拟与面对面培训的成本效益的难得机会。来自8个OTP的初始辅导员队列（n = 26）参加了面对面培训，来自10个OTP的后续队列（n = 31）参加了虚拟培训。共同的培训要素是主持人、学习目标和教育战略/活动。所有临床医生提交了一份培训后的角色扮演，使用经过验证的保真度工具进行独立评分，并将其表现与代表初始准备和高级熟练程度的基准进行比较。为了检查面对面和虚拟培训的效用和费用，计算了队列特定的基准实现率，并估计了每位临床医生的费用。通过普通最小二乘法估计校正后的队列间差异，并计算增量成本效果比（ICER）。参加虚拟培训的临床医生达到准备和熟练基准的比率高出12-14%，其总成本表明，相对于面对面培训，每位临床医生节省了399美元。因此，ICER将虚拟培训确定为主导战略，反映了支付意愿价值观的更高成本效益。研究结果证明，虚拟培训的效用更大，费用更低，成本效益更高，这可能会为大流行后传播CM和其他疗法提供信息。
Behavior therapy implementation relies in part on training to foster counselor skills in preparation for delivery with fidelity. Amidst Covid-19, the professional education arena witnessed a rapid shift from in-person to virtual training, yet these modalities’ relative utility and expense is unknown. In the context of a cluster-randomized hybrid type 3 trial of contingency management (CM) implementation in opioid treatment programs (OTPs), a multi-cohort design presented rare opportunity to compare cost-effectiveness of virtual vs. in-person training. An initial counselor cohort (n = 26) from eight OTPs attended in-person training, and a subsequent cohort (n = 31) from ten OTPs attended virtual training. Common training elements were the facilitator, learning objectives, and educational strategies/activities. All clinicians submitted a post-training role-play, independently scored with a validated fidelity instrument for which performances were compared against benchmarks representing initial readiness and advanced proficiency. To examine the utility and expense of in-person and virtual trainings, cohort-specific rates for benchmark attainment were computed, and per-clinician expenses were estimated. Adjusted between-cohort differences were estimated via ordinary least squares, and an incremental cost effectiveness ratio (ICER) was calculated. Readiness and proficiency benchmarks were attained at rates 12–14% higher among clinicians attending virtual training, for which aggregated costs indicated a $399 per-clinician savings relative to in-person training. Accordingly, the ICER identified virtual training as the dominant strategy, reflecting greater cost-effectiveness across willingness-to-pay values. Study findings document greater utility, lesser expense, and cost-effectiveness of virtual training, which may inform post-pandemic dissemination of CM and other therapies.