P4 Combining simulation training and motivational interviewing techniques to enhance health conversations

Abstract

Background Many chronic and life limiting diseases are closely linked to behavioural and lifestyle factors such as smoking, alcohol and substance use, lack of exercise and diet.1 In their guidance ‘Making every contact count’1 NHS England advises that all health professionals have a responsibility to address these issues with patients in a way that supports them to make sustainable changes. Maudsley Simulation has developed two simulation courses to support health professionals to have patient-centred conversations about health and lifestyle choices, using Motivational Interviewing techniques.2 The aim being that health professionals feel better prepared to seize opportunities in their routine interactions with patients to promote and support healthy choices. Summary of work Healthy Bodies, Healthy lives, Healthy Minds A simulation course designed to train participants in using motivational interviewing techniques to address lifestyle choices in their clinical encounters. Opportunistic Interventions in Alcohol and Substance abuse. A multi-professional simulation course designed to enhance participants’ skills in discussing alcohol and substance use. Simulation training was used to help participants practice and consolidate motivational interviewing skills such as reflective listening, open questions, eliciting change talk and affirmations as applied to ‘real life’ scenarios. Specially trained actors were primed to consistently model varied levels of ambivalence and commitment in response to participants’ interventions. The simulations were debriefed with specific attention to identifying the skills demonstrated and reflecting on the client’s ambivalence and stage of change. Pre and post course questionnaires assessed confidence and knowledge specific to course content. Qualitative data was collected through open questions on a post-course evaluation form and examined using thematic analysis. Summary of results Pre and post course measures from both courses showed a general increase in knowledge and confidence around the impact of lifestyle factors on both physical and mental health in addition to specific increases in knowledge and confidence in using motivational interviewing techniques to address these issues. Qualitatively, participants noticed a positive shift in their attitudes towards these type of conversations and a greater appreciation of the many contributory factors that influence lifestyle decisions. Participants valued the experience of learning through simulation and felt they would be able to share their learning with colleagues. Conclusions Our findings suggest that motivational interviewing techniques can be a useful tool to teach communication skills through simulation training. This approach can help health professionals feel more confident and skilled in addressing lifestyle decisions with their patients. References Public Health England, NHS England and Health Education England. Making Every Contact Count (MECC): Consensus statement 2016. London: Public Health England. Miller WR, Rollnick S. Motivational interviewing: Helping people change (3rd Edition) 2013. London: Guilford Press.