This study will utilize a three-phase approach that is informed by a theory-driven implementation framework to: 1) conduct a needs analysis in order to identify individual-, health care team-, and practice-level barriers and facilitators to conducting adherence counseling in safety-net primary care practices; 2) develop a virtual communication simulation designed to improve the quality of adherence counseling by allowing nurses repeated opportunities to practice discussing medication adherence with virtual patients; and 3) conduct a pilot study to evaluate the feasibility, acceptability and preliminary efficacy of the simulation on changes in: a) nurses' collaborative communication skills, b) medication adherence, and c) reduction in BP in a sample of 20 patients with uncontrolled hypertension (HTN) who are non-adherent to their medications.

Inclusion Criteria:

• PCPs and nurses will be enrolled if they fulfill the following criteria:

  1. male or female healthcare provider (MD/DO, NP, and Registered Nurse) practicing at the clinic
  2. age 18 years or older.

No exclusions will be made based on provider race/ethnic origin. We will oversample males to examine differential communication skills based on gender.

• Patient eligibility criteria include:

  1. receiving care at the participating clinic
  2. having uncontrolled HTN (BP>140/90 mmHg) at two visits in the past year
  3. being prescribed at least one antihypertensive medication and are non-adherent
  4. are ≥age 18 years
  5. fluent in English

Exclusion Criteria:

• Unable to give consent
• Have a diagnosis of cognitive dysfunction or significant psychiatric comorbidity,
• Participating in another HTN-related study.

Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices). Will be used for secondary data analysis approved by the investigator

Beginning 3 months and ending 5 years following article publication.

Researchers who provide a methodologically sound proposal.