Creation and implementation of a national interprofessional integrated primary care competency training program: Preliminary findings and lessons learned

Training mental health providers to function in the fast-paced culture of primary care is critical to the success of integrated primary care (IPC) programs. Appropriate training of mental health providers in IPC settings includes hands-on, competency-based clinical skill development, providing a higher likelihood of skills translation in clinical settings when compared with classroom didactic training alone. In 2017, the Department of Veterans Affairs began a national rollout of a comprehensive interprofessional competency-based training utilizing a regional, train-the-trainer program. More than 1,600 interdisciplinary providers would be trained over an 18-month period utilizing a multidimensional competency assessment process to include demonstration of clinical skill through role play on standardized cases, provider self-report of fidelity, and administrative data to assess application in clinical practice. This multidimensional assessment was administered at baseline and 3-and 6-month follow-up intervals. This paper describes the training program and preliminary outcomes for the regional and local trainers. Initial findings indicate statistically significant improvement at 3 and 6 months on the Primary Care Behavioral Health Provider Adherence Questionnaire-2 in several domains, attainment and sustainment of demonstrated clinical skill in role play situations, and improvement in 30-min appointment length fidelity. Implications for other health care systems are discussed with a focus on practical lessons learned for interprofessional training aimed at improving fidelity in IPC practice.