| Description |
Background: Psychiatric Mental Health Nurse Practitioners (PMHNPs) treating patients at a Salt Lake City outpatient clinic are rarely able to connect with rural clients, given the urban locale of the clinic. The Nurse Practitioner group was seeking a way to connect with the rural patient population. Telemental Health (TMH) is an evidence-based care that provides an opportunity to offer care to patients throughout Utah. Methods: The purpose of this project was to create, assign and evaluate a TMH training course for two PMHNPs in an outpatient medical and mental health clinic. The course was intended to improve knowledge and confidence around use of TMH and additionally, prepare the practitioners for change, using the care model Normalization Process Theory guidelines. A Likert scale of 2 questions was used to determine degree of knowledge and confidence around use of TMH pre- and post-completion of a Canvas training course. Additionally, the practitioners were graded on quiz scores, for a total of 4 quizzes with 5 questions each. A cumulative percentage was used to determine retention of information and quality of quiz questions. Finally, a qualitative interview was conducted with each practitioner separately. Qualitative interview questions were both closed- and open-ended and asked for feedback on the training course, how likely practitioners would use TMH in their day-to-day practice, and if they would recommend this training and use of TMH to other PMHNPs. The two practitioners participating in the training were chosen based on their employment at the faculty practice site, their expertise in patient care and their willingness to participate. Two additional practitioners were approached about the opportunity to participate but declined due to time constraints. Results: Post-training course responses to knowledge and confidence around use of TMH improved from "modest" and "somewhat" confident to "very" confident and having "considerable knowledge" for both practitioners, respectively. The increase in knowledge post-course rose 33% from baseline for both Practitioner 1 & 2 and the post-course confidence rose 33% for Practitioner 1 and 67% for Practitioner 2. Assessment of quiz scores showed an average of 90% correct for Practitioner 1 and 84.5% for Practitioner 2. Both practitioners self-reported a time frame of approximately 40 minutes per module including the reading and review of material in addition to quiz taking. Qualitative interview responses were primarily encouraging, with practitioners agreeing that the training was valuable and they would recommend it to peers. They also agreed the training gave them a sense that they would be ready to utilize TMH as a normal part of their day-to-day practice. Both practitioners had recommendations for improving quiz questions and also identified use of a video example of an average TMH visit as an additional idea for visual learning. Conclusion: TMH care is likely to become a standard option for mental health therapy and prescribing. In preparation for this inevitability, completing a brief but comprehensive training course to PMHNPs seems to be an effective tool for improving knowledge, confidence, and acceptance of a change in care model. Improvements in the quality of quiz questions and use of visual examples of care would further improve this project and allows for implementation of TMH services. Keywords:Telemental Health, TMH, confidence, knowledge, normalization, training module, Psychiatric Mental Health Nurse Practitioners, clinicians. |
