Introduction: The Imperative for Effective Training in Evidence-Based Practices
The economic impact of substance use disorders in the United States exceeds $500 billion annually (CEA, 2017). The swift and effective implementation of Evidence-Based Practices (EBPs) like Contingency Management (CM) is urgent. Historically, training for EBPs has been conducted in person, often in a workshop format featuring observational and experiential learning elements (Walters et al., 2005; Sholomskas et al., 2005). , including motivational interviewing (Miller et al., 2004). However, the COVID-19 pandemic prompted a pivot towards virtual platforms for professional education. While virtual training has obvious cost-saving implications by reducing travel and venue hire expenses, research is needed to determine how it compares to traditional in-person training regarding utility and cost-effectiveness.
Methodology: Capturing a Unique Opportunity
A study by Bryan Hartzler and several colleagues was recently published in the Journal for Technology in Behavioral Science (CTiBS). The researchers leveraged a natural experiment from a larger cluster-randomized type 3 hybrid trial, MIMIC, focused on CM implementation in Opioid Treatment Programs (OTPs) (Becker et al., 2021). An initial cohort of clinicians from eight OTPs received in-person training, while a later cohort from ten OTPs underwent virtual training. Both groups were assessed post-training using a validated fidelity instrument to evaluate their readiness and proficiency in delivering CM protocols (Curran et al., 2012; Aarons et al., 2011).
Virtual Training Outperforms In-Person Approaches
Benchmarks: Readiness and Proficiency
The outcomes revealed a 12-14% higher attainment rate of readiness and proficiency benchmarks among clinicians who received virtual training.
Cost-Effectiveness: A Noteworthy Differential
Not only did virtual training prove to be more effective in preparing clinicians, but it also resulted in a per-clinician cost-saving of $399 compared to in-person training. The study employed an Incremental Cost-Effectiveness Ratio (ICER) to quantify this differential, ultimately identifying virtual training as the dominant strategy across a range of willingness-to-pay values.
Implications: Redefining the Future of Behavioral Health Training Utility Beyond the Pandemic
While the COVID-19 pandemic acted as a catalyst for the rapid adoption of virtual training platforms, the evidence suggests that the benefits of this modality extend beyond the current crisis. Virtual training has proven not only to be a viable alternative but, in some aspects, a preferable method for preparing clinicians to implement EBPs like CM.
Informing Policy and Practice
These findings present compelling arguments for using virtual training in behavioral health settings. Policymakers and organizational decision-makers are encouraged to recognize the utility, affordability, and cost-effectiveness of virtual training as a potent tool for fast-tracking the implementation of EBPs.
Conclusion: Virtual Training as a Paradigm Shift
The shift from in-person to virtual training was initially viewed as a necessary but temporary response to the COVID-19 pandemic. However, the current study illuminates that virtual training is not just a stop-gap solution but a superior strategy, both in terms of utility and cost-effectiveness, for implementing complex behavioral health interventions like CM.
Virtual Training at Telehealth.org: A Decade of Excellence and Accessibility
While this study fills a vital gap in understanding the efficacy and economy of virtual training, it’s worth noting that Telehealth.org has been pioneering in this domain since
