Virtual Motivational Interviewing: Developing an App for the Deliberate Practice of Motivational Interviewing Skills

Background and Purpose:

Traditional training methods, including presentation-based training, supervision, and role-plays for learning evidence-based treatments (EBTs), abound. However, a method that allows for extensive skills practice prior to the on-the-job performance of EBTs is rare. In part, this may be due to the difficulties trainers and agencies can encounter. These barriers are often related to the time and resources needed to effectively provide the instruction, feedback, and components necessary for acquiring the complex skills necessary to deliver an EBT. Reliably becoming an expert in child welfare practice is extremely difficult without a way to practice the skills needed to intervene with families effectively.

Research on expert skill acquisition and expertise has illuminated the conditions under which expert levels of performance can be reliably achieved. Effective practice requires learning modalities that enable exercises that are: 1) repeated over time, 2) standardized, 3) scaffolded to increase in difficulty, and 4) followed with immediate feedback.

This presentation will review the development of a phone-based app, Virtual Motivational Interviewing (VMI), for practicing motivational interviewing skills in the context of child welfare practice. We use two theories to guide the development of VMI. The first is the theory of Deliberate Practice, which explains how people reliably learn to perform at expert levels. The second is the theory of Multimedia Learning, which provides a set of practical guidelines for developing any type of electronic learning. Deliberate Practice guides how to learn and Multimedia Learning guides how to construct the learning environment.

Methods: The VMI prototype was demonstrated to cohorts of graduate students enrolled in motivational interviewing courses. Qualitative usability testing was performed with a focus on the methods by which Deliberate Practice is enabled. Design considerations for incorporating Multimedia Learning principles into VMI will be shown as well. Data were collected by observing individual practice sessions and a post-practice survey. Results of a usability study will be presented based on thematic analysis from observation, user feedback, and surveys.

Results: Results of this study are the key findings that will serve as the impetus for further design and development considerations. Initial findings from the usability testing of VMI was highly acceptable to participants (N = 25). However, the successful incorporation of Deliberate Practice and Multimedia Learning principles needed further development. A refined prototype was further tested , focusing on the desirability of app usage and usability outside of the need for a coach or guide. Several challenges and adaptations were identified.

Conclusions and Implications: This study shows it is possible to create a virtual simulation-based training method to assist social workers to learn to perform in complex and volatile situations when engaging with family/team members for child welfare reasons. Future study of the effectiveness of VMI, particularly in comparison with current learning methods, may show if investments in this cutting-edge technology will lead to training that reliably produces highly-skilled social workers.