Second Life
Healthcare providers dedicated to helping their patients stop smoking participated in three Smoking Cessation through Motivational Interviewing sessions in Second Life, one of the best-known and most popular online 3D virtual worlds. Due to its immersive quality, ease of use, zero expense and global reach, Second Life was selected to allow participants from as far away as Brazil and Indonesia to interact with one another and earn up to six AMA PRA Category 1 TM and/or AAFP Prescribed credits.
Healthcare providers interested in participating in the project, sponsored by the California Academy of Family Physicians as part of the Cease Smoking Today (CS2day) collaborative supported by an unrestricted educational grant from Pfizer, registered prior to the sessions and were offered Second Life tutorials if they were not yet familiar. Real-time technical assistance was also available during each session for those who needed it.
Led by a team of two faculty members (Jay W. Lee, MD, MPH, Director of Health Policy, Long Beach Memorial Family Medicine Residency Program and Suzanne Mitchell, MD, MS, Assistant Professor Family Medicine, Boston University School of Medicine), CS2day staff and healthcare providers engaged with each other gaining in-depth exposure to Motivational Interviewing through didactic presentations, coaching and extensive role-playing practice.
The immersive nature of Second Life proved to be the ideal venue for Motivational Interviewing for Smoking Cessation Continuing Medical Education (CME). Healthcare providers learned, practiced, and stretched themselves in this novel environment. While they interacted easily with colleagues, they also enjoyed the anonymity of being present as an avatar - all accomplished from the comfort of their own offices and homes.
Second Life training advantages include:
- Anonymity to stretch and risk new learning
- Immediate opportunity to receive feedback and insights
- Multiple streams of communication between learners and facilitators and among learners
- Video capture of practice interviews for later review
- Ability to simulate things that aren't possible in the real world (take too long, are too big/small, etc.)
- Great practice environment
- Convenience - no cost, travel, or time zone hassles
After the healthcare providers created their avatars they were ready for the three, two-hour events. Drs. Mitchell and Lee presented an overview of Motivational Interviewing and then healthcare providers were assigned to one of two learning platforms. This allowed for small group configurations, ideal for role-plays and personalized coaching. Many of the healthcare providers were so engaged in the sessions that they opted to stay 30 minutes past the session quit time in order to explore further.
By definition, Motivational Interviewing is a person-centered directive (guided) method of communication for enhancing intrinsic motivation to change by exploring and resolving ambivalence and resistance.
Specifically, healthcare providers learned about:
1. Motivational Interviewing Spirit
a. Empathy
b. Caring
c. Collaboration
2. Motivational Interviewing Goals
a. Establish empathic partnership
b. Elicit change talk
c. Promote positive change
3. Challenges in Health Behavior Change
a. Resistance
b. Ambivalence
c. Discrepancy
4. Motivational Interviewing Skills
a. Roll with resistance
b. Express empathy
c. Avoid argumentation
d. Amplify Ambivalence
e. Develop discrepancy
f. Support self-efficacy
5. Motivational Interviewing Tools
a. Explore line of reasoning
b. Provide a menu of options
c. Confidence rulers
d. A look over the fence
6. Motivational Interview Results
a. Importance, confidence and readiness
b. Autonomyc. Respect and understanding
7. Motivational Interviewing Assistance
a. Quit plan
b. Tools
c. Treatment options
d. Gratification statistics
e. Patient monitoring scheduler
The Smoking Cessation with Motivational Interviewing in Second Life learning experience was deemed a resounding success. The modeling, role-play, coaching and video review elements all combined to provide a meaningful and high impact experience for the healthcare providers.
A follow up evaluation will be conducted by researchers at the University of Wisconsin - Madison to assess learning retention and determine how well the healthcare providers incorporate Motivational Interviewing with their smoking patients.
Healthcare providers interested in participating in future Second Life Motivational Interviewing for Smoking Cessation sessions can contact Cynthia Kear at ckear@familydocs.org.
Review the session images to see our partners, faculty, volunteers and healthcare providers in action.
