"Old Dogs" and New Skills: How Clinician Characteristics Relate to Motivational Interviewing Skills Before, During, and After Training
"Old Dogs" and New Skills: How Clinician Characteristics Relate to Motivational Interviewing Skills Before, During, and After Training
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DOI：
10.1037/a0028362
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发表时间：
2012-08-01
影响因子：
5.9
通讯作者：
Nunes, Edward V.
中科院分区：
文献类型：
--
作者：
Carpenter, Kenneth M.;Cheng, Wendy Y.;Nunes, Edward V.
目的：探讨卫生保健专业人员在培训前、培训中、培训后的职业、教育和语言认知特征与其动机访谈（MI）技能的关系。方法：58名社区成瘾临床医生（M = 42.1岁，SD = 10.0； 66%为女性）在参加为期2天的MI培训研讨会之前进行评估，并随机分配到三种研讨会后监督方案中的一种：通过电话会议进行现场监督（TCS），标准磁带监督（Tape）或单独的研讨会培训。在研讨会前和研讨会后1、8和20周，用动机性访谈治疗完整性（MITI）编码系统v 2.0对与客户的录音会议进行MI技巧评分。采用相关系数和广义线性模型检验各评估点临床医生特征与心肌梗死技能之间的关系。结果：基线心肌梗死技能水平是监测前后表现最可靠的预测因子。临床医生特征与培训过程中MI精神和反思倾听技能相关，并调节工作坊后监督方法对MI技能的影响。在没有研究生学位和词汇表现较强的临床医生中，TCS在练习过程中提供即时反馈，对提高MI精神和反思性倾听最有效。磁带监督对于提高具有研究生学位的临床医生的这些技能更有效。此外，TCS和Tape最有可能在口头和抽象推理表现较差的临床医生中增强MI精神。结论：临床医生属性影响用于促进社区从业人员获得循证实践的方法的有效性。
Objective: The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their motivational interviewing (MI) skills before, during, and after training were investigated. Method: Fifty-eight community-based addiction clinicians (M = 42.1 years, SD = 10.0; 66% Female) were assessed prior to enrolling in a 2-day MI training workshop and being randomized to one of three post-workshop supervision programs: live supervision via tele-conferencing (TCS), standard tape-based supervision (Tape), or workshop training alone. Audiotaped sessions with clients were rated for MI skillfulness with the Motivational Interviewing Treatment Integrity (MITI) coding system v 2.0 at pre-workshop and 1, 8, and 20 weeks post-workshop. Correlation coefficients and generalized linear models were used to test the relationships between clinician characteristics and MI skill at each assessment point. Results: Baseline MI skill levels were the most robust predictors of pre- and post-supervision performances. Clinician characteristics were associated with MI Spirit and reflective listening skill throughout training and moderated the effect of post-workshop supervision method on MI skill. TCS, which provided immediate feedback during practice sessions, was most effective for increasing MI Spirit and reflective listening among clinicians with no graduate degree and stronger vocabulary performances. Tape supervision was more effective for increasing these skills among clinicians with a graduate degree. Further, TCS and Tape were most likely to enhance MI Spirit among clinicians with low average to average verbal and abstract reasoning performances. Conclusions: Clinician attributes influence the effectiveness of methods used to promote the acquisition of evidence-based practices among community-based practitioners.