Using Virtual Patient Simulations to Prepare Primary Health Care Professionals to Conduct Substance Use and Mental Health Screening and Brief Intervention

Albright, Glenn; Bryan, Craig J.; Adam, Cyrille; McMillan, Jeremiah; Shockley, Kristen M.

doi:10.1177/1078390317719321

Cited by 41 publications

(48 citation statements)

References 26 publications

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“…The full text of 46 studies was obtained to determine eligibility against the review criteria. Of these 46 studies, 8 were included in the review [ 23 - 30 ]. The primary reasons for exclusion of ineligible studies were as follows: non–randomized controlled trials (non-RCTs; n=17), nondigital studies (n=6), not specifically KT (n=6), protocol only (n=4), based on the clinical setting (n=4), or had no digital TEKT outcome (n=1).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

Brown¹,

Barnes²,

Byaruhanga³

et al. 2020

J Med Internet Res

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Background Knowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health. Objective This study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes. Methods A search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies. Results Of the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes. Conclusions This review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.

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Section: Resultsmentioning

confidence: 99%

“…All 8 studies were RCTs, of which 4 were cluster RCTs [ 25 , 27 , 29 , 30 ]. A total of 3 studies were conducted in the United States [ 23 - 25 ], 2 in the Netherlands [ 26 , 28 ], 2 in Canada [ 27 , 30 ], and the remaining study was conducted in China [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

Brown¹,

Barnes²,

Byaruhanga³

et al. 2020

J Med Internet Res

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“…Web-based didactic content for alcohol brief intervention training is already widely available. Newer technologies allow providers to practice skills in computer-simulated training environments with a computerized patient and get feedback on actual performance 38 39. Much remains to be known, however, about how to best incorporate and use such emerging technologies with routine trauma providers delivering alcohol brief interventions or other types of behavioral interventions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients

Darnell

Parker

Engstrom

et al. 2019

Trauma Surg Acute Care Open

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background Traumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills. Methods We present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change. results Seventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=−2.53, p=0.02, Cohen's d=−0.39) was observed among those providers with available pre-post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p<0.01) and post-training (F(3, 41)=8.10, p<0.01). Discussion Findings underscore the need for training in patient-centered alcohol brief interventions and suggest that even a modest training helps providers engage in a more patient-centered way during a role-play assessment. Level of evidence Level V, therapeutic/care management. bACkgrounD

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“…VPS training is a modality which allows providers to practice communication with patients without fear of judgment, which is critical to increasing a provider's comfort around talking about the subject of suicide with their patients. Simulation-based training has demonstrated feasibility in teaching suicide-related knowledge and skills (24), and has been shown to increase the perceived ability to identify patients at risk for suicide and engage them in treatment planning (25), as well as the preparedness, likelihood, and self-efficacy to identify individuals experiencing psychological distress such as depression and suicide ideation (26). The purpose of this study was to test the feasibility and acceptability of a simulation-based traininga novel online VPS developed using SIMmersion ® PeopleSim ® technology-as well as assess pre-post changes in suicide-related knowledge from a pilot of the VPS with 20 practitioners.…”

Section: Original Articlementioning

confidence: 99%

Suicide risk assessment training using an online virtual patient simulation

O’Brien

Fuxman

Humm

et al. 2019

mHealth

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Background: Improving the identification of and intervention with patients at risk for suicide requires innovative training techniques that safely and effectively teach or enhance practitioners' skills. Virtual patient simulations (VPS) can be particularly effective for this purpose because they allow for repetition in skill building as well as a safe space to practice difficult interactions with patients. The purpose of this study was to assess the feasibility and acceptability of a novel VPS that trains practitioners in suicide risk assessment, as well as to examine pre-post changes in suicide-related knowledge through a pilot of the VPS training. Methods: Practitioners (n=20) were recruited from a Federally Qualified Health Center in the northeastern United States to test the feasibility and acceptability of a VPS suicide risk assessment training. A paired samples t-test was conducted to compare mean differences in practitioners' suicide risk assessment knowledge scores from pre-to post-training, on a scale of 0 to 10. Results: The VPS was feasible to implement, with 18 of 20 participants using the VPS for an average of 21 to 95 minutes, and was acceptable to participants, with an average satisfaction rating of 5.82 out of 7. Participants' knowledge scores improved significantly by an average of 1.86 points from pre-to post-training. Conclusions: The VPS was feasible and acceptable to this sample of practitioners and significantly increased knowledge from pre-to post-training. As such, VPS holds promise as a technique to develop skills in suicide risk assessment.

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Using Virtual Patient Simulations to Prepare Primary Health Care Professionals to Conduct Substance Use and Mental Health Screening and Brief Intervention

Abstract: Results strongly suggest that role-play simulation experiences can be an effective means of teaching screening and brief intervention.

Cited by 41 publications

References 26 publications

Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients

Suicide risk assessment training using an online virtual patient simulation

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