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Effectiveness of a Sequential Simulation and Online Learning Intervention on Psychiatric Mental Health Nurses’ Motivational Interviewing Knowledge, Confidence, and Skill Performance for Medication Adherence: A Cluster-randomized Controlled Trial

Year: 2026

Type: article

Abstract: PURPOSE: To evaluate the effectiveness of a sequential dual-track learning intervention that combined a simulation-based motivational interviewing (MI) workshop with online practice learning in enhancing psychiatric mental health nurses' (PMHNs') knowledge, confidence, and performance in MI for medication adherence. METHODS: A parallel cluster-randomized controlled trial was conducted in four psychiatric hospitals. Participants were allocated to the experimental or control groups. The intervention consisted of an 8-hour simulation-based MI workshop followed by a four-month online practice learning phase. Outcomes-MI knowledge, confidence, and skill performance-were assessed at baseline (T0), immediately after the workshop (T1), and after online practice learning (T2). Changes over time were analyzed using repeated-measures analysis of variance. RESULTS: In total, 107 PMHNs completed all three assessments (experimental = 52; control = 55). The sequential dual-track learning intervention produced significant group-by-time effects for knowledge (F (2, 210) = 4.96, p = .011), confidence (F (2, 210) = 4.63, p = .011), and skill performance (F (2, 210) = 41.20, p < .001). The experimental group showed substantially greater gains than the control group at T1, and these gains were maintained at T2, with no significant T2-T1 differences despite a small decline in mean skill scores. CONCLUSION: The sequential dual-track learning intervention, integrating a simulation-based MI workshop with online practice learning, effectively improved PMHNs' MI knowledge, confidence, and skill performance for medication adherence and provides a flexible, scalable model for evidence-based continuing education in psychiatric nursing. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06004492 (August 16, 2023).

Source: Asian Nursing Research

DOI: 10.1016/j.anr.2026.07.001

Authors: Wen-Ling Hsieh, I-Hsien Li, Tsui-Mei Hung, Chin-Kuai Chiu, Wen-I Liu

Institutions: Hungkuang University, National Taipei University of Nursing and Health Science, Chang Gung University, Taipei City Hospital, Ministry of Health and Welfare

Language: English

Topic: Simulation-Based Education in Healthcare

Subfield: Education

Field: Social Sciences

Domain: Social Sciences

SDGs: Good health and well-being, Quality education

Open Access status: gold

Estimated APC paid: $1,500