Lozano Paula, McPhillips Heather A, Hartzler Bryan, Robertson Andrea S, Runkle Cecilia, Scholz Kelley A, Stout James W, Kieckhefer Gail M
Center for Child Health Behavior and Development, Seattle Childrens Research Institute, 1100 Olive Way, Seattle, WA 98101, USA.
Arch Pediatr Adolesc Med. 2010 Jun;164(6):561-6. doi: 10.1001/archpediatrics.2010.86.
That pediatric resident trainees would demonstrate increased counseling skill following training in brief motivational interviewing (MI).
Randomized controlled trial.
University of Washington Pediatric Residency.
Pediatric residents (N = 18), including residents in postgraduate years 1, 2, 3, and 4.
Collaborative Management in Pediatrics, a 9-hour behavior change curriculum based on brief MI plus written feedback on communication skills (based on a 3-month Objective Standardized Clinical Evaluation [OSCE]).
The percentage of MI-consistent behavior (%MICO), a summary score for MI skill, was assessed via OSCEs in which standardized patients portray parents of children with asthma in 3 clinical scenarios (stations). The OSCEs were conducted at baseline and 3 and 7 months. Blinded coders rated videotaped OSCEs using a validated tool to tally communication behaviors. Training effects were assessed using linear regression controlling for baseline %MICO. Global ratings of counseling style served as secondary outcome measures.
Trained residents demonstrated a trend toward increased skill (%MICO score) at 3 months compared with control residents. At 7 months, %MICO scores increased 16% to 20% (P < .02) across all OSCE stations after the combined intervention of Collaborative Management in Pediatrics training plus written feedback. The effect of training on global ratings supported the main findings.
Pediatric trainees' skills in behavior change counseling improved following the combination of training in brief MI plus personalized feedback.
儿科住院医师学员在接受简短动机性访谈（MI）培训后，咨询技能会有所提高。
随机对照试验。
华盛顿大学儿科住院医师项目。
儿科住院医师（N = 18），包括研究生一年级、二年级、三年级和四年级的住院医师。
儿科协作管理，这是一门基于简短MI的9小时行为改变课程，外加关于沟通技巧的书面反馈（基于为期3个月的客观标准化临床评估[OSCE]）。
MI一致性行为百分比（%MICO），这是MI技能的综合评分，通过OSCE进行评估，其中标准化患者在3个临床场景（站点）中扮演哮喘患儿的家长。OSCE在基线、3个月和7个月时进行。盲法编码员使用经过验证的工具对OSCE录像进行评分，以统计沟通行为。使用控制基线%MICO的线性回归评估培训效果。咨询风格的总体评分作为次要结局指标。
与对照组住院医师相比，接受培训的住院医师在3个月时技能（%MICO评分）有增加的趋势。在7个月时，在儿科协作管理培训加书面反馈的联合干预后，所有OSCE站点的%MICO评分提高了16%至20%（P < .02）。培训对总体评分的影响支持了主要发现。
在简短MI培训加个性化反馈相结合后，儿科受训人员在行为改变咨询方面的技能有所提高。
