The clinician intervention was based
on a model shown to improve treatment knowledge for primary
care clinicians. Over the course of the study’s 12-month intervention
period, clinicians in both interventions groups received two
academic detailing visits for CME credit on the clinician
management of depression from a team consisting of a primary
care physician and a consultation-liaison psychiatrist. The
visits focused on the latest advances in depression diagnosis
and assessment (visit one) as well as treatment and referral
(visit two). Additionally, the consultation-liaison psychiatrists
were available via telephone to clinicians throughout the
intervention period to discus difficulty with patient diagnosis,
motivation to initiate treatment, adherence to treatment,
and response to treatment.
Standard Clinician Workbook
The patient-centered clinician intervention workbook guided
each clinician through his or her personal interactive communication
skills training program in a one-on-one or small group format.
The program featured a CD-ROM containing the clinician’s interview
with a simulated patient at baseline, fully analyzed using
the Roter Interaction Analysis System (RIAS). This sophisticated
coding software generated tabular and graphic analyses of
the verbal components. Using the CD-ROM and companion workbook
clinicians were introduced to the RIAS and guided them through
case-based exercises for skill practice. An example of the
workbook and RIAS interactive program is displayed here.
