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Celebration of Scholarship and Creative Activity 2021

Improving Motivational Interviewing Skills Among Pre-Licensure Baccalaureate Nursing Students Through the Use of High-Fidelity Software

Hannah Hicks

Senior, Nursing

Abstract

Adolescent substance use trends are concerning. Use of alcohol and drug are linked to acute and long-term consequences among adolescents. Motivational interviewing (MI) is a style of communication guiding individuals in behavior change through exploration of ambivalence. Education on MI remains minimal within nursing curricula, leaving nurses ill-equipped to utilize MI when at-risk behaviors are identified. This retrospective data analysis evaluates whether online interactive virtual patient simulations bridge the educational gap and improves MI skills among pre-licensure baccalaureate nursing students. Methods: Students (N=297) completed a targeted educational simulation on Screening, Brief Intervention, and Referral to Treatment (SBIRT) with adolescents (SBI with adolescents, Kognito®). A retrospective data analysis was conducted on self-perceived competence with MI via pre- and post-survey. Values were compared with a paired sample t-test and chi-square analysis, using a significance level of .05. Findings: Improvement in self-perceived competence in using MI skills to gather information about adolescents’ substance use to provide feedback (p < .001) was noted following simulation. Conclusions: Interactive SBIRT simulation resulted in significant improvement on self-reported competence of MI skills. Interactive virtual patient simulation may be a feasible method of integrating SBIRT and MI education into undergraduate nursing curricula.

Project Background 

I chose to pursue this research because I am interested in working as a pediatric nurse after graduation. I wanted to complete my senior capstone honors thesis on a topic that affects the pediatric population and adolescents fall into this category. My advisor, Kathy Elertson, sparked my interest in the topic of adolescent substance use. Trends in adolescent substance use are not reassuring. One of the most notable recent trends is that the decade long decrease in cigarette smoking has been replaced by a drastic spike in the vaping of nicotine and marijuana (THC) among 8th, 10th, and 12th graders. It has doubled or tripled among these grades. Despite the alarming rates of adolescent substance use, healthcare providers are failing to appropriately screen. 57% of nurses, nurse practitioners, and physicians do not feel adequately prepared to screen patients for substance use, resulting in missed opportunities to improve patient health and well-being. To address the dual issue of escalating adolescent substance use and inadequacy of healthcare professionals to screen for substance use, Dr. Elertson is conducting an ongoing research project about incorporation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) education for pre-licensure baccalaureate nursing students at UWO and asked if I would be interested in branching off of her work. SBIRT is a comprehensive, evidence-based tool used to screen for risky substance use behaviors, provide early intervention, and referral to treatment among diverse populations. Using Dr. Elertson’s research as a base, I chose to focus on Motivational Interviewing (MI). MI is a non-confrontational conversation tactic used to facilitate discussion of substance use with the goal of eliciting intrinsic motivation to change. This interviewing technique is an essential component for the successful delivery of SBIRT and is a skill that can be applied to various patient situations to promote behavior change. MI has proven to be successful in initiating adaptive behavior change among adolescents for both substance use and non-substance use maladaptive behaviors. Nurses are in the ideal position to utilize SBIRT and MI as they make up the largest group of health professionals in the United States (4 million). Nurses are consistently viewed as the profession with the highest honesty and ethics, suggesting that patients perceive nurses to be trustworthy. This trust allows nurses to establish effective therapeutic relationships that instill comfort in patients, placing them in the ideal position to discuss sensitive topics like substance use. Therefore, nurses are well-positioned to utilize MI and deliver SBIRT. SBIRT and MI education has remained mostly absent from nursing curricula. One contributing factor is the need for nursing faculty. The U.S. is facing a nation-wide nursing faculty shortage and a wave of retirements is expected in the near future as the average age of faculty in 2019-2020 was 49-62 years old. In the face of the faculty shortage, online interactive patient simulation provides a practical and sustainable method for educating nursing students on SBIRT and MI.

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