Table 1 Teachable Moment Communication Process (TMCP) learning module components and objective
Component | Learning objective |
|---|---|
WEB Module – 50 minute interactive learning module | |
1. Call to Action | Alert audience to systems changes at their health system; convey importance of tobacco cessation counseling; introduce the TMCP as skill-building training. |
2. Teachable Moment | |
A. Rationale | Connect with audience about how difficult it can be to talk about smoking cessation; mention common frustrations and introduce video clip. |
B. What not to do | Demonstrate common frustrations and pitfalls of clinicians and patients talking about smoking cessation. |
C. Background and overview | Provide specific rationale for TMCP, background research, goals of TMCP; introduce schematic of TMCP; describe what is unique about this approach. |
D. Training overview and format | Describe what training consists of and how long it will take. |
3. Teachable Moment Communication Process | |
A. Overview of 5 elements | Introduce the TMCP 5 elements |
B. Salient Concern | FOR EACH OF 5 ELEMENTS: Introduce and define it; explain importance of the element; explain how it connects to the element before and after; provide examples to illustrate; present case studies to illustrate variations and flow from one element to the next. Provide several complete case studies to demonstrate the TMCP approach. |
C. Making a Link | |
D. Brief Intervention using OPEN statements. | |
i. Optimism | |
ii. Partnership | |
iii. Engage to assess readiness | |
iv. No more (allow the patient space to respond before moving forward) | |
E. Assessing Readiness | |
F. Responding in Alignment | |
4 TMCP summary and support | |
A. Putting it all together | Provide a brief summary of the TMCP and expected outcomes. Describe what to expect when implementing the TMCP with own patients. |
B. Coaching session | Introduce and explain Coaching Session |
C. Using the EHR Smartphrase | Introduce the Teachable Moment EHR Smartphrase Present the content of the Smartphrase and instruct on how it can be used to document the TMCP |
5. Conclusion | Summarize and wrap up |
Skills Practice – 60 minute active interaction with Standardized Patients and coaches conducted in exam rooms. Training team consisted of pairs of a coach and a standardized patient. Encounter began with clinician knocking and entering the room and enquiring how can I help you today. SP briefly described reason for visit and revealed a salient concern. Clinicians practiced clarifying salient concern, making a link to tobacco use, expressing concern, assessing readiness and responding in alignment with readiness. Coaches provided feedback, suggestions for improvement and answered questions. | |
6-8 case scenarios | Practice the skills, building self-efficacy with new communication pattern |
Coaching Feedback | Fine tune approach, correct misunderstandings, encourage trying variations, reinforce allowing the patient to express themselves and limiting physician actions to match patient readiness. |