Abstract ID: 3527

Primary Topic: Clinical skills-building
Secondary Topic: Interprofessional education

Using Health Coaching Skills to Enhance Patient Engagement & Autonomy
Blaire Morriss, ANP; Mark Dreusicke, MD, , San Diego, CA, United States; Ann King, MA, National Board of Medical Examiners, Philadelphia, PA, United States; Linda Manning, PhD, , Nashville, TN, United States

Late Breaker: No

Overview

Informed, activated patients are essential to prevention, and treatment of chronic disease. Emerging healthcare delivery practices implicitly and explicitly demand that patients possess the skills to participate constructively in their care, achieve coordinated care, increase treatment adherence, and improve patient health outcomes. Yet clinicians are often either not trained to support patient behavior change, or believe it would be much more time-intensive than it needs to be. This experiential workshop will teach health coaching skills to practitioners of all types to deepen their ability to enhance patients’ autonomy, motivation, and ability to participate in their care.

This workshop will provide clinicians with instruction and multiple practice opportunities to use health coaching skills to address patient desires and needs in the moment in a way that  empowers behavioral change. Participants will learn to optimize intake forms to build patient autonomy, and learn 7 key health coaching skills to enhance growth-promoting relationships that support behavioral change. These skills include: mindful listening; agenda setting in clinical encounters; provision of accurate and meaningful reflections and summaries; affirmation of patient strengths and values; utilization of open-ended questions to empower patients; patient-centered education using Elicit-Provide-Elicit; and Brief Action Planning. Practitioners will also learn to identify patients in the pre-contemplation and contemplation stages of change, and practice coaching skills to assist these patients to move forward in behavior change.

The workshop will be highly experiential, with brief overviews provided to explain the rationale and use of each health coaching skill and demonstrations of how the skills fit together. Each skill will be demonstrated and practiced in clinically-relevant scenarios using various configurations including dyads, triads, group practice, and use of a new digital communication tool.

Objectives

After completing this workshop, participants will:

1)   Understand the scientific and theoretical rationale for utilizing key health coaching skills to enhance patient autonomy and motivation to change behavior;

2)   Optimize intake forms to empower patients;

3)   Recognize the contribution of foundational health coaching skills (i.e., mindful listening) to growth-fostering relationships that support behavioral change;

4)   Practice addressing patient desires and needs in the moment utilizing mindful listening and the other 6 additional health coaching and motivational interviewing skills. In these practices, participants will learn to:

  • facilitate agenda setting in clinical encounters;
  • provide accurate and meaningful reflections and summaries;
  • clarify and support patient strengths and values through affirmations;
  • utilize open-ended questions to empower patients;
  • use Elicit-Provide-Elicit to educate patients in a highly patient-centric manner; and
  • support behavior change through Brief Action Planning.

5)   “Stack” or assemble the skills into usable formats in case-based practices;

6)   Formulate appropriate steps forward in patient behavior change by identifying patients in the pre-contemplation and contemplation stage of change and utilize appropriate skills from the workshop to target this stage of change; and

7)   Demonstrate the integration of their new skills using a digital communication tool.

Methods/Session Format

This workshop is highly experiential to include tiered practice of individual health coaching skills and “stacked” skills (1-3 linked skills used together). The general flow is as follows, but times vary depending on the complexity of the skill and how quickly participants adopt each skill.

  • Introduction of a digital communication tool developed by the National Board of Medical Examiners. The tool describes clinical scenarios and provides brief patient clips in video format to allow clinicians to practice responding quickly using new skills. The tool also allows clinicians to record their responses for self-evaluation. (15 min)
  • Overview with slides to frame the coaching skills to be practiced in the workshop
    • Current science on gap between provider training and patient needs to improve health behaviors (10 min)
    • Learning/Developmental paradigm of health coaching (vs conventional medicine paradigm) and key foundational theories (15 min)
  • Optimization of patient forms to increase patient autonomy (5 min intro and 20 min small  group exercise)
  • Brief introduction of each skill (5-15 min per skill), followed by faculty demonstration of each skill (5-25 min per skill), group practice, including use of a new digital communication tool (15 – 20 min per skill) or dyad and triad practices (10- 45 min), group discussion articulating what was learned (5-20 min)
  • Introduction to the pre-contemplation and contemplation stages of behavioral change (10 min lecture with 10 min group game)
  • Adaptation of coaching skills for these two stages of behavioral change to assist patients in these stages to move forward:
      • Pre-Contemplation demonstration (5 min) and triad practice (25 min)
      • Contemplation demo (15 min) and triad practice (40 min)
  • Skill integration practice using digital communication tool (10 min) and action planning (10 min)
  • Closing discussion with participant-identified take-homes and plans for skill integration (20 min)
  • Time will be incorporated for two movement breaks and a lengthy lunch

Materials to be Distributed

Handouts on the skills practiced, access to the new digital communication tool

Special Equipment Request

Participants must bring smart phones or tablets, workshop will have access to internet, LCD projector with working audio links, flip-chart & markers, lavalier microphone

Room Set-up Request

Tables in U-shaped format (can manage up to 60 if the room allows)