Randomized trial of teaching brief motivational interviewing to pediatric trainees to promote healthy behaviors in families.

HYPOTHESIS

That pediatric resident trainees would demonstrate increased counseling skill following training in brief motivational interviewing (MI).

DESIGN

Randomized controlled trial.

SETTING

University of Washington Pediatric Residency.

PARTICIPANTS

Pediatric residents (N = 18), including residents in postgraduate years 1, 2, 3, and 4.

INTERVENTIONS

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]).

MAIN OUTCOME MEASURE

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.

RESULTS

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.

CONCLUSIONS

Pediatric trainees' skills in behavior change counseling improved following the combination of training in brief MI plus personalized feedback.