NONPF 39th Annual Meeting
Effective skills for chronic disease self-management support are essential for the DNP prepared nurse practitioner and an important part of a successful interprofessional team-based approach to primary care practice. These skills, based on motivational interviewing and adapted to brief behavior change counseling methods, help the team support patients to be proactive in managing their disease. To achieve this goal, interprofessional collaboration is necessary to provide health care that is safe, high quality, accessible, and patient-centered. An important part of this skill development is the opportunity to learn and practice with members of other health care professions.
A series of 3 workshops was developed to build skills in communication for chronic disease self- management support. These workshops were conducted over a 6 month period at the VA Center of Excellence in Primary Care, an innovative and collaborative model of education for medicine and nursing in patient-centered primary care management. Participants included first year internal medicine residents and FNP DNP students. The workshops covered the following content: 1) challenges to chronic disease management in primary care, 2) Chronic Disease Model and the Patient Centered Medical Home, 3) Brief Behavior Change Counseling methods, 4) roadblocks to effective communication, 5) reflective listening and agenda setting, 6) recognizing /eliciting change talk and managing ambivalence, and 7) using Decisional Balance and Elicit-Provide-Elicit as tools for shared decision making.
Each workshop devoted considerable time to skill practice with simulated patients using chronic disease case scenarios. Debriefing sessions for each participant included self-critique, simulated patient feedback and discussion with colleagues and faculty. The practice component was well received once the group grew comfortable with each other and the format of the sessions. Between sessions participants had the opportunity to practice integrating skills into real patient care. Ongoing evaluation will be used to modify workshops for future use.
Supported by funds from the Department of Health and Human Services Health Resources and Services Administration D09HP07344, and US Department of Veterans Affairs (VA) Office of Academic Affiliations Centers of Excellence in Primary Care Education.
