Effect of Training on Primary Care Residents’ Performance in Brief Alcohol Intervention: A Randomized Controlled Trial

Abstract

BACKGROUND: Brief alcohol interventions (BAI) reduce alcohol use and related problems in primary care patients with hazardous drinking behavior. The effectiveness of teaching BAI on the performance of primary care residents has not been fully evaluated. METHODS:A cluster randomized controlled trial was conducted with 26 primary care residents who were randomized to either an 8-hour, interactive BAI training workshop (intervention) or a lipid management workshop (control). During the 6-month period after training (i.e., from October 1, 2003 to March 30, 2004, 506 hazardous drinkers were identified in primary care, 260 of whom were included in the study. Patients were interviewed immediately and then 3 months after meeting with each resident to evaluate their perceptions of the BAI experience and to document drinking patterns. RESULTS:Patients reported that BAI trained residents: conducted more components of BAI than did controls (2.4 vs 1.5, p=.001); were more likely to explain safe drinking limits (27% vs 10%, p=.001) and provide feedback on patients' alcohol use (33% vs 21%, p=.03); and more often sought patient opinions on drinking limits (19% vs 6%, p=.02). No between-group differences were observed in patient drinking patterns or in use of 9 of the 12 BAI components. CONCLUSIONS:The BAI-trained residents did not put a majority of BAI components into practice, thus it is difficult to evaluate the influence of BAI on the reduction of alcohol use among hazardous drinkers.

The effectiveness and applicability of motivational interviewing: a practice‐friendly review of four meta‐analyses

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Promoting Substance Use Education Among Generalist Physicians: An Evaluation of the Chief Resident Immersion Training (CRIT) Program

“…Other successful interventions have increased the knowledge and skills of generalist residents, 26,32 but have not demonstrated the potential to shift the values and culture of a residency program to include more SU training. In addition to being pivotal educators in the clinical training of students and residents, CRs have additional strengths.…”

“…16,29,30 Substance use education aimed at improving physician trainees' attitudes and clinical practice has been effective. 31,32 Confidence in ability to screen and refer patients is positively associated with perceived responsibility and clinical practice. 33 Wider dissemination of these practices requires creative strategies to develop a workforce that is knowledgeable about stateof-the-art approaches to patient management and motivated to implement such practices in a range of settings.…”

Training in motivational interviewing: A systematic review

“…However, Miller, Yahne, Moyers, Martinez, and Pirritano (2004), in evaluating a more in-depth training process, found significantly more change talk and less resistance in clients of MI-trained counselors and that this change was sustained at 4 months for counselors who received follow-up and coaching. More recently, Chossis et al (2007) found no difference between MI-and non-MItrained residents relating to a clients' reported number of drinks consumed and mean number of drinks per week. Yet, Brug et al (2007) found patients of MI-trained dietitians had significantly lower saturated fat intake at posttreatment.…”