Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study

Abstract

Background: Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers.

Objective: The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI.

Methods: We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session.

Results: We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant.

Conclusions: Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).

Keywords: Web-based learning; cardiovascular diseases; coronary artery disease; e-learning; health behavior change; motivational interviewing; pilot study.

Figure 1

MOTIV@COEUR homepage (in French).

Figure 2

The 4 clinical cases and motivation profiles presented in MOTIV@CŒUR.

Figure 3

Structure of MOTIV@CŒUR, a web-based e-learning platform for brief motivational interviewing.

Figure 4

MOTIV@CŒUR study participation flowchart.