JMIR Publications

ABSTRACT

Background:

: Prolonged Grief Disorder(PGD) is a newly recognized mental disorder characterized by pervasive intense grief that persists longer than cultural/social expectations and interferes with functioning . The COVID epidemic has resulted in increased rates of PGD, and yet few clinicians feel confident in treating this condition. Prolonged grief disorder therapy (PGDT)is a simple, short-term, evidence based treatment developed in tandem with validation of the PGD diagnosis. In order to facilitate dissemination of training on PGDT, we developed an on-line therapist tutorial that includes both didactic training on PGDT concepts and principles and interactive multimedia patient scenarios for clinical decision making skills in administering PGDT.

Objective:

Study objectives were to evaluate user satisfaction with the tutorial; whether the tutorial increased trainees’ knowledge of PGDT principles and procedures; and whether the tutorial improved trainees’ clinical decision-making skills in delivering PGDT.

Methods:

Participants were recruited from professional organization mailing lists, announcements to graduates of the Columbia School of Social Work, and by word of mouth. After signing consent, participants completed a brief demographic survey, a 55-item multiple choice pretest on concepts and principles of PGD and PGDT, and a five item interactive pretest to evaluate PGD clinical decision making skills. The link to the course content was then activated. Participants were given 8 weeks to complete the tutorial, which contains interactive exercises, simulated patient scenarios, animated graphics, ongoing interactive self-tests, and video examples of techniques.

Results:

A total of 406 clinicians signed consent, 236 completed the questionnaires and started the tutorial, and 196 (83%) completed all 11 modules. Trainee knowledge of PDGT concepts and procedures improved significantly pre- training to the post-module assessment, with the total number of correct answers increasing from 29.0 (SD=5.5) (53% correct) to 36.7 (SD=5.2), (67% correct) t195=18.93, P < .001. Similarly, trainees scores on the interactive clinical decision making skills test also increased significantly, from 2.6 correct out of 4 (SD=0.7) to 3.1 out of 4 (SD=0.4), t188= 7.02, P < .000. Effect sizes were d=1.44, 95% CI 1.23-1.65 and d= 1.06, 95% CI 0.84-1.29, representing large effect sizes. Trainees generally indicated that they found the tutorial Interesting, enjoyable, clearly presented, and useful for their professional development. Ninety-nine percent said they would recommend the course to others, and felt satisfied or very satisfied with the tutorial. Ninety-four percent said they felt able to apply the skills with clients.

Conclusions:

The current pilot study provides support for the effectiveness of on-line training for teaching clinicians how to administer PGDT. A combined approach using an interactive, multimedia tutorial for didactic training and virtual patient scenarios for clinical decision making skills holds promise in increasing dissemination of training on PGDT and other evidence-based treatments. Clinical Trial: ClinicalTrials.gov Identifier: NCT05121792