Demonstration of caring and motivational interviewing in online simulation: A cross-sectional observational study.

AIM: The purpose of this paper is to describe an innovative educational approach for pre-licensure nursing students to learn and practice motivational interviewing skills in a telehealth simulation with standardized patients portraying pregnant women with substance use disorder. BACKGROUND: Given the ongoing need for online delivery of both nursing education and clinical practice, providers must continue to find approaches to facilitate the provision of empathetic and personalized care to achieve optimal patient outcomes. Motivational interviewing integrates a person-centered approach with specific communication strategies to encourage and support patients' commitment to change. Motivational interviewing skills can be implemented across a wide variety of patient situations, including mental health and primary nursing care. DESIGN: The study followed a pre-/post-test cross-sectional observational design. METHODS: After completing an online training course to learn motivational interviewing skills, students participated in an online simulation with a standardized patient portraying a woman with substance use disorder during pregnancy. Prior to the simulation, students completed the Caring Behaviors Inventory-24 and the Opening Minds Scale for Health Care Providers. After the simulation, students and standardized patients completed the Simulated Clinical Interview Rating Scale and a 5-item version of the Caring Behaviors Inventory-6. RESULTS: Of the 252 students in the course, 85 (34%) participated in the study. Twenty-six student participants completed both pre- and post-simulation questionnaires; 40 completed only pre-simulation questionnaires; and 19 completed only post-simulation questionnaires. Prior to the simulated patient encounter, students rated themselves most favorably on ability to demonstrate assurance behaviors. After the training and simulation, students and standardized patients reported successful student demonstration of motivational interviewing skills and caring behaviors consistent with fundamental therapeutic communication and motivational interviewing knowledge. There was no statistically significant difference between self-reported student performance and the standardized patients' observations. CONCLUSIONS: Students attained and applied motivational skills and demonstrated caring behaviors in a virtual setting with standardized patients.