Process and impact evaluation of a practicum in motivational interviewing

Abstract

ABSTRACT A practicum course was designed to offer undergraduate students the opportunity to learn motivational interviewing (MI), a skill commonly used in health coaching (HC). The 16-week course included online video lectures, in-class activities, experiential training, and supervised practicum experiences. This study evaluated the process, impact, and outcomes of the course (n = 46; 74% female; age 21.9 ± 3.7). Surveys were administered pre- and post-training to assess participant satisfaction of the course and the impact of training on communication using 7-point Likert scales. Recorded MI conversations were obtained after initial training (Week 8) and again following the supervised practicum (Week 16) to assess the fidelity outcomes (n = 23). Recordings were independently coded using the Motivational Interviewing Treatment Integrity (MITI) Coding Manual 4.2.1, with inter-rater agreement calculated between two trained coders. Paired samples t-tests and post-hoc analyses examined differences in pre-post fidelity levels, followed by Cohen’s d effect sizes. Survey results demonstrated that students felt comfortable (5.0 ± 0.7) and confident (4.8 ± 0.6) using MI. Inter-rater reliability among coders was high (ICC = 0.92 [95% CI: 0.90–0.93]). MITI results showed that 97.5% of coaches met proficiency for technical and 90.0% for relational at week 8. At week 16, all trainees met proficiency levels for both technical and global ratings, with t-tests reporting improvements in fidelity scores. Behavior counts were much lower, with the majority of participants not meeting proficiency at either timepoint. Extended real-world practice enhanced MI fidelity levels, and trained students reported high likelihood of continued skill use 1 year after training completion.