Motivational Interviewing Knowledge Research Articles

Opioid use disorder and motivational interviewing: Training physician assistants for the epidemic.

(1) To evaluate the effectiveness of a curriculum on physician assistant (PA) students' knowledge about opioid use disorder (OUD) treatment and management and (2) present student satisfaction with the curriculum. Three cohorts of PA students completed pre- and post-intervention questionnaires about their knowledge of motivational interviewing (MI) for OUD. One cohort of students completed the 11-item questionnaire without exposure to the intervention (control group). Students' satisfaction with the curriculum was assessed as was their pre- and post-intervention knowledge about using MI for OUD. Bivariate statistical tests were used to analyze the quantitative data. Three hundred complete and usable responses were obtained from the four cohorts of PA students (n = 300, 87.7 percent response rate). The intervention groups answered a higher number of items correctly (median = 7) than the control group (median = 6, Wilcoxon sign test M = 31, p < 0.0001). Among the intervention group, there was not a statistically significant between cohort difference on: (1) the number of identical pre- and post-intervention questionnaire items answered correctly (Chi-square = 3.77, DF = 2, p = 0.15), and (2) the total number of items answered correctly on the post-intervention questionnaire (Chi-square = 0.32, DF = 2, p = 0.85). Student comments suggest students were supportive of the curriculum, with improvements noted on how to deliver the material. An educational intervention using MI for PA students was found to be valuable, and students who completed the intervention had greater knowledge about using MI with OUD patients than those who did not complete the training. The size of the effect was small, and more research on the curriculum is necessary prior to widespread adoption.

Closing the gap in substance use disorder treatment through paraprofessional counselor training

ABSTRACT There is currently an insufficient supply of licensed substance use disorder counselors (SUDCs) to meet demand for services and the gap between supply and demand is projected to grow. Paraprofessional SUDCs offer one path to helping close this gap. The current study presents outcomes from a paraprofessional SUDC certificate program for Bachelor of Social Work (BSW) students. Student data (N = 66) were used to examine pre- to post-program changes in generalized SUDC knowledge and pre- to posttest changes in knowledge and self-efficacy from evidence-based workshops. Paired sample t-tests indicated that program participation significantly increased generalized SUDC knowledge. Participation in workshops significantly increased knowledge of motivational interviewing, integrative medicine, harm reduction, and grief and loss and self-efficacy for integrative medicine and harm reduction. BSW students gained generalized and treatment-specific knowledge via participation in a SUDC certificate program. The deployment of paraprofessionals SUDCs may provide one strategy to reduce treatment gaps.

Motivational interview-based health mediator interventions increase intent to vaccinate among disadvantaged individuals

ABSTRACT Coverage for recommended COVID-19 and diphtheria-tetanus-poliomyelitis (DTP) booster shots is often inadequate, especially among disadvantaged populations. To help health mediators (HMs) involved in outreach programs deal with the problems of vaccine hesitancy (VH) in these groups, we trained them in motivational interviewing (MI). We evaluated the effectiveness of this training among HMs on their MI knowledge and skills (objective 1) and among the interviewees on their vaccination readiness (VR) and intention to get vaccinated or accept a booster against COVID-19 and/or DTP (objective 2). Two MI specialists trained 16 HMs in a two-day workshop in May 2022. The validated MISI questionnaire evaluated HMs’ acquisition of MI knowledge and skills (objective 1). Trained HMs offered an MI-based intervention on vaccination to people in disadvantaged neighborhoods of Marseille (France). Those who consented completed a questionnaire before and after the interview to measure VR with the 7C scale and intentions regarding vaccination/booster against COVID-19 and DTP (objective 2). The training resulted in HMs acquiring good MI skills (knowledge, application, self-confidence in using it). HMs enrolled 324 interviewees, 96% of whom completed both questionnaires. VR increased by 6%, and intentions to get vaccinated or update COVID-19 and DTP vaccination increased by 74% and 52% respectively. Nearly all interviewees were very satisfied with the interview, although 21% still had questions about vaccination. HMs assimilated MI principles well. MI use in outreach programs appears to show promise in improving vaccine confidence and intentions among disadvantaged people.

Can in-house, whole team training in motivational interviewing lead to changes in knowledge and confidence? Findings from an inpatient rehabilitation unit for people experiencing complex psychosis

The most recent NICE guidelines for mental health rehabilitation for adults with complex psychosis recommend training all staff in psychologically informed approaches such as motivational interviewing [NG181]. This project sought to understand the feasibility of training all staff in an inpatient rehabilitation unit and collaboratively developing ideas and strategies to establish a community of practice to support the transfer of these skills into routine clinical practice. This paper first reports the findings of a pilot training and demonstrates the implementation of feedback from participants to adapt ongoing training. Secondly, the paper reports the findings of a further two cohorts of training. The evaluation aimed to observe any changes in knowledge of, and confidence using, motivational interviewing to have conversations about change with patients experiencing complex psychosis. Staff who attended the training completed questionnaires at the start of day 1 and the end of day 2 training. The results show that staff knowledge of motivational interviewing and confidence using it improved following two-day training. Qualitative feedback highlighted that the practice exercises utilised during training were helpful and staff members found the gap between workshop days was useful to consolidate knowledge through practice. The staff team’s ideas for creating a community of practice include fortnightly 30-minute check-ins, a motivational interviewing noticeboard and away day sessions. Whilst this evaluation has not yet explored the long-term effects of this ongoing supervision, there are promising effects shared by the trainer. Recommendations are made for services considering this training in future.

Pilot Study of a Motivational Interviewing Training on Practitioners' Skill Set for Patient Centered Communication.

Increase practitioners' Motivational Interviewing (MI) skill set to develop intrinsic motivation and behavior change competencies. Pilot comparing intervention group with waitlist-control group. Health Plan in northeast of U.S. Training program including a 3day 19hour MI training intensive, 1.5hour follow-up skill-building trainings, and quality assurance review using an MI assessment tool paired with strengths-based mentoring. Cohort 1 (experimental group) received the intervention for 6-months and cohort 2 for 3months (control group). Practitioners' MI skill set was assessed pre- and post-intervention using Motivational Interviewing Competency Assessment (MICA). Practitioners' MI knowledge and attitudes were assessed pre- and post-training using adapted Motivational Interviewing Knowledge and Attitudes Test (MIKAT). Active learning and confidence questionnaires were administered post-training. A generalized linear mixed model with repeated measures to analyze difference in MICA growth rates; paired T-test for MIKAT pre/post training analysis. Descriptive statistics for active learning and confidence. MICA scores significantly improved for both cohorts (P < .0001). Practitioners had significant increase in knowledge and attitudes for MI (P < .001) and confidence in using MI (P < .01). High levels of active learning were observed (93-100%). With planning, adequate resources/support, and iterative processes for adjustment, practitioners can improve their MI skill set in a short period of time with modest investment of practitioner resources.

Closing the gap in substance use disorder treatment through paraprofessional counselor training

ABSTRACT There is currently an insufficient supply of licensed substance use disorder counselors (SUDCs) to meet demand for services and the gap between supply and demand is projected to grow. Paraprofessional SUDCs offer one path to helping close this gap. The current study presents outcomes from a paraprofessional SUDC certificate program for Bachelor of Social Work (BSW) students. Student data (N = 66) were used to examine pre- to post-program changes in generalized SUDC knowledge and pre- to posttest changes in knowledge and self-efficacy from evidence-based workshops. Paired sample t-tests indicated that program participation significantly increased generalized SUDC knowledge. Participation in workshops significantly increased knowledge of motivational interviewing, integrative medicine, harm reduction, and grief and loss and self-efficacy related to integrative medicine and harm reduction. BSW students gain generalized and treatment-specific knowledge via participation in a SUDC certificate program. The deployment of paraprofessional SUDCs may provide one strategy to reduce treatment gaps

Implementing a workflow-integrated motivational interviewing training program for psychiatry trainees on an inpatient consultation-liaison rotation: lessons learned.

Effective consultation-liaison psychiatry (CLP) is proactive, collaborative, and requires providers to have proficiency with therapeutic skills beyond nosology and medication management. Motivational interviewing (MI) is an evidenced-based intervention that should be considered essential for CLP trainees to learn. Given that the demands of training and patient care are already experienced as stressful for many psychiatry trainees, the authors endeavored to create a MI training program that was integrated into trainees' normal CLP workflow. Twenty-two trainees on an inpatient CLP rotation participated in a six-week MI training program that was incorporated into their regular workflow. The program included didactic sessions with role-playing, as well as on-demand between-session coaching via an expert in MI. Trainee participation and perceptions of MI were measured via a questionnaire that was administered prior to each training session. Trainee participation in the didactic sessions was inconsistent. Questionnaire data revealed positive baseline perceptions of motivational interviewing and its usefulness in inpatient medical settings. Additionally, as trainees participated in the program, perceived knowledge of motivational interviewing as well as awareness of motivational issues among their patients increased. Finally, participation in program was not perceived as disruptive to daily workflow for the participants. This the first documented attempt at implementing a MI training program for CLP trainees that was integrated into their regular workflow. Preliminary data identified some encouraging trends, but also unexpected challenges. These lessons could inform how these types of training programs are implemented moving forward.

Development of the motivational interviewing for loved ones skills assessment (MILO-SA).

Expressed emotion of family members is a key target for intervention for bettering psychosocial outcomes for transitional-age youth experiencing mental health crises. Motivational Interviewing for Loved Ones (MILO) seeks to reduce expressed emotion by teaching parents motivational interviewing skills such as taking a non-judgmental stance, exploring their loved one's thoughts and feelings, expressing optimism and confidence, and avoiding taking an expert role. This report details the creation of the Motivational Interviewing for Loved Ones- Skills Assessment (MILO-SA), its psychometric properties, and convergent validity with other measures of motivational interviewing adeptness. Our sample (n=54) consisted of baseline assessments from parents participating in a pilot study of MILO. Parents were assessed for baseline knowledge of motivational interviewing as well as MILO skills with the MILO-SA and a traditional assessment clinician application of motivational interviewing skills. We found that the MILO-SA displayed high interrater reliability (k=0.81), and convergent validity with motivational interviewing knowledge (r=0.32) as well as traditional assessments of clinician adeptness applying motivational interviewing skills (r=0.67). Our findings suggest that the MILO-SA has strong psychometric properties and is a useful tool for assessing parent acquisition of motivational interviewing skills. Specifically, the MILO-SA can be used in future studies focused on teaching non-clinicians motivational interviewing skills.

Meaningful simulation: service user and academic collaboration supporting physiotherapy students with healthy conversations

Lifestyle factors are a significant cause of mortality and morbidity in England [1]. Physiotherapists are well placed to help people to make healthy lifestyle choices, however junior physiotherapists do not feel well equipped to have these conversations [2]. An innovative teaching session was carried out with physiotherapy students to 1) increase their confidence in addressing lifestyle choices and 2) equip them with communication skills to decrease fear of these difficult conversations. The session was grounded in the theory of motivational interviewing [3]. Teaching staff created role play scenarios. These were reviewed by service users for authenticity. The scenarios included a teenager with cystic fibrosis who was not compliant with chest clearance exercises and a person suffering falls secondary to alcohol misuse. The final scenario involved a discussion about smoking with a person recently diagnosed with a chronic lung condition and their partner. In a face-to-face immersive fishbowl setting, students took part in the scenarios with experienced actors as service users. The session was collaborative, where students could ‘time out’ to seek guidance from their peers. The actors adapted their communication depending on how they felt in the conversation. After each scenario the actors provided feedback from the service user perspective. There was excellent engagement in the session. Students found the final scenario the most challenging as they struggled to gain a rapport with the patient actor due to the partner frequently interrupting. The cohort expressed different ideas of how to manage this situation. Feedback from the actors helped the students to consider the perspective of the partner and how their interference was due to worry. Pre- and post-session data on a five-point Likert scale demonstrated improved knowledge of motivational interviewing and improved confidence to have lifestyle change conversations ( Likert scores to the pre- and post-motivational interviewing simulation training The immersive simulation experience motivated and empowered the physiotherapy students to talk about lifestyle change with service users. The participative forum felt ‘real’ and students left the session better equipped to have lifestyle change conversations with service users. This should help to create future physiotherapists who can help people to live healthy lives. 1. Office for National Statistics. What is happening to life expectancy in England? England: The King’s Fund; 2022. 2. Walkenden S, Walker KM. Perceptions of physiotherapists about their role in health promotion at an acute hospital: a qualitative study. Physiotherapy. 2015;101(2):226–231 3. Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Health Care. London: The Guildford Press, 2008.

Assessment of training of general practice interns in motivational interviews about vaccination

ABSTRACT The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.

Demonstration of caring and motivational interviewing in online simulation: A cross-sectional observational study

AimThe purpose of this paper is to describe an innovative educational approach for pre-licensure nursing students to learn and practice motivational interviewing skills in a telehealth simulation with standardized patients portraying pregnant women with substance use disorder. BackgroundGiven the ongoing need for online delivery of both nursing education and clinical practice, providers must continue to find approaches to facilitate the provision of empathetic and personalized care to achieve optimal patient outcomes. Motivational interviewing integrates a person-centered approach with specific communication strategies to encourage and support patients' commitment to change. Motivational interviewing skills can be implemented across a wide variety of patient situations, including mental health and primary nursing care. DesignThe study followed a pre-/post-test cross-sectional observational design. MethodsAfter completing an online training course to learn motivational interviewing skills, students participated in an online simulation with a standardized patient portraying a woman with substance use disorder during pregnancy. Prior to the simulation, students completed the Caring Behaviors Inventory-24 and the Opening Minds Scale for Health Care Providers. After the simulation, students and standardized patients completed the Simulated Clinical Interview Rating Scale and a 5-item version of the Caring Behaviors Inventory-6. ResultsOf the 252 students in the course, 85 (34%) participated in the study. Twenty-six student participants completed both pre- and post-simulation questionnaires; 40 completed only pre-simulation questionnaires; and 19 completed only post-simulation questionnaires. Prior to the simulated patient encounter, students rated themselves most favorably on ability to demonstrate assurance behaviors. After the training and simulation, students and standardized patients reported successful student demonstration of motivational interviewing skills and caring behaviors consistent with fundamental therapeutic communication and motivational interviewing knowledge. There was no statistically significant difference between self-reported student performance and the standardized patients’ observations. ConclusionsStudents attained and applied motivational skills and demonstrated caring behaviors in a virtual setting with standardized patients.

Teaching brief motivational interviewing to medical students using a pedagogical framework

ObjectiveMedical schools are charged with assisting medical students to acquire the confidence, knowledge and skills for behavior change conversations in primary healthcare. The present study evaluated teaching brief motivational interviewing (MI) to pre-clinical medical students. MethodsForty-six students participated in an educational intervention premised on the Learn, See, Practice, Prove, Do, Maintain pedagogical framework, comprising 2 × 2-h lectures, a 2-h role-play triad session, and 3 × 2-h small group simulated patient encounters supported by scaffolding strategies. Measures of brief MI knowledge (MI Knowledge and Attitudes Test & Multiple-Choice Knowledge Test) and confidence (MI Confidence Scale) were taken at baseline, post-training, and 3-month follow-up, and skills (Behavior Change Counseling Index) were assessed at three intervals during simulated patient encounters. ResultsStudents who received brief MI training improved in knowledge and confidence from baseline to post-training and gains remained at 3-months. Brief MI skills improved across the simulation sessions. ConclusionPre-clinical medical students can attain knowledge, confidence and skills in brief MI after participation in a short intervention and improvements are sustainable. Practice implicationsOur results support the use of an evidence-based pedagogical framework for teaching brief MI in pre-clinical years of medical curricula and our scaffolding strategy affords promise.

5.23 Understanding Parent-Child Communication in the Context of ADHD

Adolescents with ADHD are at higher risk for health risk behaviors and adverse consequences. Their parents, in turn, experience greater parenting stress and lower quality of life. The objective of this study is to conduct a needs assessment of parent-adolescent communication (PAC) in this population, which will in turn be used to develop a parenting skills class that includes motivational interviewing (MI) skills to address the challenges in PAC in a developmentally appropriate way. We recruited 22 parents and 17 adolescents through outpatient clinics in an urban safety net health system. Participants engaged in interviews about PAC and a health risk discussion. In addition, they answered surveys covering demographic information, parenting stress, parenting styles, adolescent symptom burden, and MI. There are many notable sample characteristics. Twenty-seven percent of parents had taken a parenting class for children with ADHD or for divorced parents in the past; 87% of parents reported that they were having a close and supportive relationship with their adolescents; and 50% of parents felt that a parenting class should target PAC. Other common concerns included coping with mental health problems, behavioral issues, and how to provide support for the adolescents. Fifty-five percent of parents are interested or extremely interested in taking a parenting class designed for the parents of teenagers with ADHD. The Helpful Responses Questionnaire was scored on 3 dimensions of MI (MI Spirit [SP], MI Skills [MI], and promoting change talk [CT]) according to MI adherent responses (1), neutral responses (0), or MI nonadherent responses of persuasion and confrontation (–1). The average scores were –0.67 for SP, –0.79 for MI, and –0.55 for CT. Parents scored an average of 4.6 out of 16 on the MI Knowledge and Attitudes Test (MIKAT). The majority of the parents had an involved and positive parenting style as measured by the Alabama Parenting Questionnaire. Parents expressed a high level of interest in taking a parenting class that targets PAC. The parents have a low level of knowledge of or alliance with MI, despite positive and involved styles. Future directions include qualitative analysis of the parent and adolescent interviews to guide the development of a parenting class including MI skills for parents.

A Virtual Reality Resident Training Curriculum on Behavioral Health Anticipatory Guidance: Development and Usability Study.

BackgroundBehavioral health disorders have steadily increased and been exacerbated by the COVID-19 pandemic. Though behavioral health disorders can be successfully mitigated with early implementation of evidence-based parent management strategies, education for pediatric residents on behavioral health anticipatory guidance has been limited to date, with training challenges compounded by the physical distancing requirements of the COVID-19 pandemic. Virtual reality (VR) simulations provide an opportunity to train residents on this complex competency by allowing deliberate practice of necessary skills while adhering to current social distancing guidelines.ObjectiveThis study explored the usability of a VR-based behavioral health anticipatory guidance curriculum for pediatric residents.MethodsThis mixed methods study included 14 postgraduate third-year pediatric residents who completed the behavioral health anticipatory guidance VR curriculum. Residents completed the MEC Spatial Presence Questionnaire to assess immersion in the virtual environment. Semistructured interviews were used to elucidate residents’ perspectives on the curriculum’s content and format. The interviews were analyzed using conventional content analysis.ResultsQuantitatively, residents reported a high degree of immersion, spatial presence, and cognitive involvement. Most residents (11/14, 79%) agreed or strongly agreed that it seemed as though they took part in the action of the simulation. Qualitatively, two themes emerged from the data: (1) the curriculum expands behavioral health anticipatory guidance and motivational interviewing knowledge and skills and (2) VR technology is uniquely positioned to develop competence. These themes revealed that the curriculum expanded their current level of knowledge and skill, addressed training gaps, and was applicable to all residents. Additionally, residents experienced VR as immersive, feasible, realistic to the clinic setting, and a safe space to practice and learn new skills.ConclusionsPilot data indicates that VR may be an effective tool to teach pediatric residents behavioral health anticipatory guidance, meeting a current gap in medical education training. This VR curriculum is particularly relevant in the context of the COVID-19 pandemic given the increased behavioral health concerns of families.

Exploring nicotine dependence treatment commitment and quality of care among Portuguese substance use disorder treatment professionals

BackgroundSmoking is highly prevalent among individuals with substance use disorder (SUD). No specific treatment policy exists for nicotine dependence treatment (NDT) in patients with SUD in Portugal, such as in most countries. MethodsWe used the Index of Treatment Quality (ITTQ) and Tobacco Treatment Commitment Scale (TTCS) to assess NDT quality and commitment before and after training professionals who work in the Portuguese SUD treatment network (n = 203). The study assessed learning and competence through pre- and postknowledge tests, competence self-report, and intention-to-change questionnaires. The study carried out descriptive and inferential statistics using STATA software. We based the current study on the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0). ResultsCompared to psychologists, physicians/social workers had worse NDT perceptions (i.e., NDT should not be included in drug treatment programs; NDT could hinder client recovery; it is unfair to take tobacco away from these patients). The counseling offer level was low overall. However, the study found higher levels of smoking assessment in all regions. Knowledge of motivational interviewing, stages of motivation, and addressing return to use improved. Self-competency skills also increased following training. ConclusionTreatment providers should be encouraged to implement counseling within NDT. Physicians and social workers should be aware of the importance of NDT for individuals with SUD. Attitudes and commitment to NDT for this subpopulation were quite similar to those found in U.S. studies. Our educational intervention increased learning knowledge and competence.

Evaluation of an online motivational interviewing training program for rehabilitation professionals: A pilot study

Objective: To investigate the feasibility and effectiveness of an online motivational interviewing training program for rehabilitation professionals. Design: Pre-post design with two groups. Setting: Private rehabilitation hospital and an academic medical center Subjects: Group 1 included 19 motivational interviewing-experienced rehabilitation professionals. Group 2 included 25 motivational interviewing-naïve rehabilitation professionals. Interventions: Group 1 was exposed to an online motivational training program and Group 2 was exposed to an online motivational training program and a live booster session. Main measures: Motivational interviewing communication skills were measured with an adapted Helpful Responses Questionnaire. Knowledge and attitudes were measured with an adapted Motivational Interviewing Knowledge and Attitudes Test. Confidence, importance, and feasibility for implementing motivational interviewing were measured using the Motivational Interviewing Rulers. Results: Group 1 showed improvement in communication skills (2.6/5–3.3/5; P < 0.05) and confidence (6.0/01–7.4/10; P < 0.01) after online training. Improvements seen in skills and confidence were maintained at three months. Group 2 showed improvement in skills (2.1/5–3.3/5; P < 0.001), knowledge (7.7/10–8.5/10; P < 0.01), confidence (6.4/10–7.5/10; P < 0.01), and importance (8.3/10–8.9/10; P < 0.05) after online training. At three-months post-booster, improvements in communication skills and knowledge were maintained. Conclusions: Online training can be a cost and time effective approach to improve rehabilitation professionals’ skills in motivational interviewing. Follow-up training activities are needed to maintain the level of knowledge and skill improvement.

Motivational Interviewing Training for Advanced Practice Nursing Students to Address Prescription Opioid Use Disorder: A Mixed Methods Approach.

Prescription opioid use disorder in the United States has increased to epidemic proportions and poses a challenging problem to health care providers. Motivational interviewing (MI) is a patient-centered counseling style that can effectively reduce substance abuse, but MI training has not been well incorporated into advanced practice nursing curricula. Standardized patient (SP) simulation is an educational tool that is growing in popularity because of its success in improving nursing skills. Medical students and residents who underwent a formalized MI training with an SP simulation showed positive results. This study aimed to determine whether an MI training with an SP simulation improved NP students' knowledge, confidence, and skills in MI. A one-group pretest-posttest repeated measures design was used. Quantitative data were analyzed using descriptive statistics and repeated measures analysis of variance, and qualitative data were analyzed using content analysis. Results indicated that the MI training showed a significant impact on students' confidence in MI and promising impacts on students' MI knowledge and skills. Students valued the training, favoring the SP component, and plan to use MI in future practice. An MI training can be effectively incorporated into an advanced practice nursing program and would better prepare students to address prescription opioid use disorder and effectively encourage behavior change among their patients.

Motivational Interviewing Training: A Case-Based Curriculum for Preclinical Medical Students.

IntroductionWith the rise of chronic medical problems involving lifestyle behaviors and the benefits of patient involvement in preventative care, medical students need to learn how to help patients change health risk behaviors and improve patient involvement in order to improve health outcomes. Motivational interviewing (MI) is a patient-centered therapeutic approach that is effective in the treatment of lifestyle behaviors and diseases.MethodsThis 2-hour didactic training session, along with a 3-hour case-based practice session involving role-plays and a 3-hour evaluated session utilizing standardized patients, was delivered to 68 preclinical medical students. Knowledge, attitudes, and self-efficacy were evaluated via pre- and posttraining surveys, and satisfaction with the training was assessed upon completion.ResultsStudents who completed both pre- and postsurveys (n = 48) showed a statistically significant improvement in knowledge of MI (t = −29.73, df = 47, p < .001), attitudes regarding implementing MI in health care settings (t = −3.04, df = 47, p < .005), and self-efficacy (t = −10.699, df = 47, p < .001) in talking with patients about behavior change. Students were also highly satisfied with the MI training package (M of 4.4, SD = 0.6, out of 5.0).DiscussionA training package to teach preclinical medical students about MI was effective in helping students learn the knowledge and skills necessary to deliver MI in a broad range of clinical cases.

Teaching motivational interviewing in a blended learning environment

Background and purposeTo describe the implementation of blended learning in teaching motivational interviewing (MI) to third-year pharmacy students and evaluate changes in MI knowledge by assessing students' abilities to recognize and formulate responses using MI skills after the training and, for a subset of students, one year later. Educational activity and settingThe comMIt e-learning program was integrated into a third-year pharmacy communication course. Skills learned in the program were applied and assessed using e-learning quizzes, three in-class practice sessions and a 5-minute final assessment video. In addition, students completed a 22-item pre- and post-survey addressing their abilities to recognize and formulate statements using MI skills. This survey was voluntarily completed again one year later. FindingsSixty students completed the training and showed a statistically significant improvement between the pre- and post-surveys. Twenty-seven students voluntarily responded to the survey one year later. While overall performance dropped between the post-survey and the one-year follow-up, students sustained their ability to formulate appropriate MI responses to the open-response questions. SummaryThis study demonstrates that students can successfully learn and retain MI skills using blended learning via the comMIt e-learning program and in-class practice activities.

Practice and Dissemination of Motivational Interviewing: A Psychology Internship Curriculum.

Sufficient training in substance use issues has been identified as a common gap in professional psychology graduate training. Satisfactory training in evidence-based practices has also been identified as a common gap for providers who care for individuals with substance use problems. The "practice and dissemination" curriculum we developed seeks to address both of these gaps during the predoctoral internship training year by first training psychology interns to competently deliver motivational interviewing (MI) to individuals with substance use problems and then train community providers and volunteers to do so. From 2012-2013, a total of 55 community providers and volunteers from a homeless shelter, a substance use treatment facility, and a community mental health facility received training in MI through this curriculum by attending continuing education events delivered by 17 psychology interns. Evaluation of the dissemination portion of the curriculum as part of an exempt educational research project revealed that community providers were able to achieve significant increases in MI knowledge, readiness to implement MI, and MI skill as assessed with a video analogue measure by the end of the workshop. They also reported satisfaction with the workshop. These evaluation findings provide preliminary support for the curriculum as a novel and efficacious way to disseminate MI to community providers. Research is necessary to determine long-term outcomes of such training and to identify strategies to overcome potential barriers such as the substantial faculty effort necessary to implement the intensive curriculum.