The WONCA Anniversary Project 2015

WP3: Evaluation of the international

e-learning course about

Motivational Interviewing (MI)

Andree Rochfort, Tina Eriksson, Clair Colins, Mercedes Schelle, Ilkka Kunnamo, Ulrik Kirk

and Jochen Gensichen

Professor Jochen Gensichen

Motivational interviewing

• Motivational interviewing (MI) is defined as a means of communication in a way that the patient becomes motivated to carry out necessary changes in his/her lifestyle.

• The objective of MI is that the patient takes more responsibility of his/her wellbeing and health.

• The course is suitable for physicians, nurses, and other professionals that counsel patients.

The evaluation of the MI e-learning course

• An cross-sectional observational study• Online survey in July 2014 -Aug 2015• At the end of the course participants took

15 minutes to respond a 17 item (5 point Lickert-scale) questionnaire (modified 'Behaviour Change Counselling Index') English and German Version

• Open recruitment across Europe, using professional networks

Noordmana J, van der Leea I, Nielena M, Vlekb H, van der Weijden T, van Dulmena S. Do Trained Practice Nurses Apply Motivational Interviewing Techniques in Primary Care Consultations?J Med Res 2012, 2012;4(6):393-401

The results MI - e-learning course - sample

• N= 598• 24 European countries:

- English language N= 149- German language N= 449

• Profession- GP N=352- GP Trainee N= 152- Medical Student N=83- Other N=11

I took the course (N =573)

N=314… at home N=180… at school / university / office N=79 … during patient-time in the clinic

The results MI - e-learning course - process

I feel that the course helped to improve my skills and competence (N=576).

Fully agree Partly agree Do not agree0

50

100

150

200

250

300

350

400

450

64 62

6

338

106

EnglishGerman

The results MI - e-learning course – effects I

Applicability of the skills and knowledge I obtained from the course in my clinical practice. (N=575)

Excellent Good Fair Poor0

50

100

150

200

250

300

350

400

450

16

96

19 1

284 111

48

EnglishGerman

The results MI - e-learning course – effects II

The course motivated me to learn and reflect upon the topic. (N=575)

Yes Somewhat Only a little Not at all0

50

100

150

200

250

300

350

400

450

86

28 17 1

342

101

EnglishGerman

The results MI - e-learning course – effects III

The most essential yield for me was:

0

5

10

15

20

25

The results MI - e-learning course – effects IV

- Results are not representative, an exact descriptive population is not possible, since it relies in the evaluation of the non-audited self-reporting of participants.

- Use of a non-validated modified mesure.- Multiple assessments cannot be excluded.

The limitationsMI - e-learning course

The knowledge about motivational interviewing is deepened and clarified is the possibility of practical application. The shape of the E-learning seems to be well received by the participants.

The discussionMI - e-learning course

The results shows that the e-learning course on Motivational Interviewing is a valide possibility of transfer of knowledge and skills.

The conclusionMI - e-learning course

…. additional slides ! (R1-5)

Which teaching method was best?

0

50

100

150

200

250

300

350

400

450

500

59 4192

41 6311

276

164

339

221

337

175

German English

N=1819

The results MI - e-learning course – effects R1

W10: After taking the course I know better how to invite the patient to talk about behavior change.

W11: After taking the course I know better how to encourage the patient to talk about behavior change.

W12: After taking the course I know better how to actively convey respect for the patient’s choice about behavior change.

W13: After taking the course I and the patient exchange ideas about how the patient could change current behavior.

W14: In MI it is important to listen empathically to the problems, but not engaging in them, to really concentrate and act on change talk. After taking the course I know better how to get a good balance in my consultations between empathic listening to problems, and active engagement in change talk.

W15: In MI it is important to know that the tool is not useful for every consultation. After taking the course I know better how to select the right patients at the right time to use MI.

W16: After taking the course I think it is feasible for me to per-form MI (with some patients) in my daily general practice.

W17: After taking the course I plan to use MI in my daily practice.

Not at all Minimally To some extent A good deal A great extent0

50

100

150

200

250

300

350

W10 W11 W12 W13 W14 W15 W16 W17

Which competences improved after the course?

The results MI - e-learning course – effects R2

W10 W11 W12 W13 W14 W15 W16 W17

Mittelwert 3,29 3,10 3,11 3,16 3,17 2,80 3,29 3,42

N 566 566 566 564 565 561 563 558

Standardabweichung ,769 ,806 ,842 ,775 ,720 ,938 ,789 ,808

Median 3,00 3,00 3,00 3,00 3,00 3,00 3,00 4,00

W10: After taking the course I know better how to invite the patient to talk about behavior change.

W11: After taking the course I know better how to encourage the patient to talk about behavior change.

W12: After taking the course I know better how to actively convey respect for the patient’s choice about behavior change.

W13: After taking the course I and the patient exchange ideas about how the patient could change current behavior.

W14: In MI it is important to listen empathically to the problems, but not engaging in them, to really concentrate and act on change talk. After taking the course I know better how to get a good balance in my consultations between empathic listening to problems, and active engagement in change talk.

W15: In MI it is important to know that the tool is not useful for every consultation. After taking the course I know better how to select the right patients at the right time to use MI.

W16: After taking the course I think it is feasible for me to per-form MI (with some patients) in my daily general practice.

W17: After taking the course I plan to use MI in my daily practice.

The results MI - e-learning course – effects R3

Which competences improved after the course?

My suggestions to improve the course?

even

mor

e vid

eos

and

inter

activ

e ele

men

ts

tech

nical

impr

ovem

ent

cut t

he to

ol

noth

ing

langu

age

Exam

ples

of d

ifficu

lt co

mm

unica

tion

tool

for d

ownlo

adot

her

02468

101214

The results MI - e-learning course – effects R4

I would like to have e-Learning courses of the following topics in the future.

Communication

Difficu

lt pati

ent

Quality

Elderl

y care

Bad new

s

Empath

y

Lifest

yles r

elated

issues

Violence

Diabete

s care

Smokin

g cess

ation

Manag

ing a disp

ute

Business

Palliati

ve ca

re

Dealin

g with

grief

Relationsh

ip in th

e 1st

infancy

Dealin

g with

a pati

ent c

omplaint

Other0

10

20

30

40

50

60 57

49

44 43 42

34 34 3331

28 27 26 2623

21 20

52

The results MI - e-learning course – effects R5