Impacto de la formación en entrevista motivacional para médicos: diseño y evaluación de un Programa Formativo (MOTIVA)

Abstract

AimTo develop a training program in Motivational Interviewing for Family Physicians and assess the impact. Study designMulticenter, double blind and randomized clinical essay, with 2arms, Experimental (EG) and Control (CG) of Family Physicians with a follow up of 12 months. Location32 Primary Healthcare Centers. Sample description54 physicians (CG=28, EG=26). InterventionsTraining Program MOTIVA in ME with an initial presential course (16h), followed by online activities during 12months, and presential meetings (Problem BasedInterviewing with expert feedback). Main measurementsCommunicative skills in MI were assessed based on video-recordings (VR) with the EVEM 2.0 scale by peer reviewers. 236 VR with standardized patients and 96 VR with real patients. ResultsAverage results in EVEM scale (up to 56 points) at the beginning of the study were EG=21.27 (CI 95% 15.8-26.7) and CG=20.23 (CI95% 16.4-23.9) with no differences between both groups (P=.79). After the training, EG punctuation increased by 13.89 points (P<.001), average 35.16 (CI 95% 29.8-40.6). Real patients’ VR in EG over a 12 month period keep their MI skills with an average of 36.9 points (CI 95% 30.3-43.6) versus CG 15.9 points (CI 95% 9.8-22.0). Once ended the MOTIVA Training Program, the EG maintains the acquired skills: final average EG=37.6 (CI 95% 33.2-41.1) versus CG=24.3 (CI95% 19.0-29.2) (P<.001). ConclusionsThe MOTIVA Training Program improves Motivational Interviewing skills, significatively improving after a presential course and sequential keep-alive activities. The effectiveness of the Program has been proven in the Third and Fourth steps of Miller's Pyramid