Background: There is clear evidence in the psychology literature that beyond “people skills,” providers who give the patient an active role in developing the treatment plan can increase the adherence to the medical plan by 70%. Though this is utilized extensively in psychology, medical trainees are not routinely taught these communication skills. To arm our fellows with these necessary skills, we worked with our clinical psychologist, Dr. Kathryn Lenberg, to develop an integrated curriculum over the 2-year period of the fellowship. Implementation: We began a phased roll out of the curriculum in 2020. During elective rotations, fellows spent 1 hour a week with a clinical psychologist reviewing and role playing the steps of Motivational Interviewing (MI). The psychologist then observed their skills on at least one occasion to assess their ability to apply these skills correctly. Fellows were given writing assignments to reflect on the impact this had in their clinical practice. In 2021 we added didactics on trauma informed care to supplement the skills training. In 2022, we added two baseline assessments; a self-assessment on their knowledge of and comfort with MI and trauma informed care, and an observation session with a clinical psychologist to assess their baseline skill in MI and utilization of working alliance. Results: The greatest success of this intervention has been the endorsement by the fellows. They have been universally appreciative of the skills they learned, and their writing assessments reflect changes in perceptions and attitudes. In future, finding more partners (licensed behavioral health therapists, clinical psychologists, etc.) will be key to ensuring the sustainability of the program.
Salas, N Mariam and Kathryn Lenberg. "Care through Connection: Patient Mutuality and Working Alliance Curriculum." (2023). https://digitalrepository.unm.edu/hsc_ed_day/156
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