Why We Train & Coach Clinicians in Communication Skills and Motivational Interviewing

This video was developed by the Veteran Health Administration (VHA)'s National Center for Health Promotion and Disease Prevention (NCP) to help VHA clinicians and leaders recognize the value of participating in NCP's patient-centered communication training. NCP developed two training programs to meet clinicians' needs: 1) TEACH for Success (TEACH), which features basic communication skills in health education and health coaching: and 2) Motivational Interviewing (MI), a clinical method for identifying and building patients' motivation to actively engage in self-care and health behavior change. VHA's TEACH and MI programs were specifically designed for VHA primary care clinicians providing care in Patient Aligned Care Teams (PACT), VHA's version of the patient centered medical home.

The patient-centered communication skills featured in TEACH and MI training enhance clinicians' capacity to provide personalized, proactive, patient-driven care (PPPDC). These skills include relationship-building skills (e.g., open-ended questions to explore patient needs, values and concerns; reflections, empathy, respect); health education skills (e.g., sharing information, teach-back), shared decision making skills, and health behavior counseling skills (e.g., evoking change talk, goal setting, problem-solving).

In addition to participating in face-face, experiential TEACH and MI courses, clinicians are offered opportunities to participate in follow-up clinician coaching to help them apply TEACH and MI skills in clinical encounters with Veterans. To disseminate TEACH and MI training and follow-up clinician coaching, NCP trains and supports over 300 active TEACH and MI Facilitators, who are also extensively trained to provide learner-centered clinician coaching. TEACH and MI facilitators/coaches also serve as VHA facility-based Veterans Health Education Coordinators (VHECs), Health Behavior Coordinators (HBCs) and Health Promotion Disease Prevention Program Managers (HPDP PMs), and work collaboratively with PACT teams to integrate TEACH and MI skills with other tools, resources and programs that support PPPDC. These tools and resources include: an online health risk assessment tool, goal-setting and decision-making tools, an online Veterans Health Library; and access to VHA and community-based programs in tobacco cessation, weight management, self-management and other health behavior change areas.Training and clinician coaching in TEACH and MI is a key component of PACT's "roadmap" for operationalizing PPPDC in primary care.

In the "Why Train" video, PACT leaders, PACT clinicians and Veterans share reflections about the value and impact of TEACH and MI training on Veteran experience, the quality of care and health outcomes. Clinicians also share how training and coaching has enhanced their skills, their  morale and even their overall satisfaction with their work!