Dairy herd health management activities in relation to training of veterinarians in motivational interviewing.

ABSTRACT

Communication has been identified as one constraint for cattle veterinarians to act as proactive health consultants. Motivational Interviewing (MI), an evidence-based client-centered communication methodology, may therefore be a useful tool in veterinary herd health management (VHHM). The aim of this exploratory study was to investigate associations between training in MI and different measures of performance in VHHM. MI skills of 36 Swedish cattle veterinarians randomly assigned to two groups - MI veterinarians (n = 18) who had received six-months training in MI and control veterinarians (n = 18) who were not trained - were assessed using the MI Treatment Integrity coding system. Skills were categorized as untrained, trained_poor, trained_near moderate and trained_moderate. Veterinarians each visited two to six cattle farms for VHHM consultations and revisited the same farms three to six months later to document implementation of recommendations. A gamma model and logistic or ordered logistic regression models were used to evaluate associations between MI training and performance measured as a) proportion of consultations resulting in written herd health plans, b) proportion of recommended measures fully or partially implemented, c) Likert scores of different estimates of client satisfaction and d) total time during 6 months allocated to VHHM visits on cattle farms. We found no evidence of any significant effects of MI training on the eight performance variables analyzed. However, a pattern of numerically higher values (better performance) in trained veterinarians with poor or moderate MI skills than in untrained veterinarians was observed in most variables. Clients were highly satisfied with veterinarians' attitude, competence and time efficiency. Farms implemented a median of 66.7% (interquartile range 50-100) of the measures partially or fully. Veterinarians allocated little time to VHHM visits (median 2.2; interquartile range 0.65-4.1 h per week of full-time work within cattle). Veterinarians with moderate skills spent 2.14 times more time on VHHM visits than untrained veterinarians, but the confidence interval was wide (0.88-5.21). The pattern of numerically higher values in trained veterinarians supported findings from other studies in the same project indicating a positive effect of MI training on VHHM. Our observations suggest a considerable potential to increase veterinarians' engagement in VHHM.