Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Patient Educ Couns. 2012 Nov;89(2):281-7. doi: 10.1016/j.pec.2012.08.001. Epub 2012 Aug 19.
To determine whether a motivational interviewing (MI) curriculum is effective in teaching internal medicine residents core MI skills and the empathic, nonjudgmental MI style.
Nineteen third-year residents met for 12 h with a faculty instructor. Teaching methods included lecture, written exercises, a simulated patient exercise, and discussion of residents' behavior change issues.
Residents' adoption of MI skills was evaluated before and after the course with the Helpful Responses Questionnaire. Residents decreased use of closed-ended questions (from a score of 1.13 to 0.37, p=0.036) and MI roadblocks (4.00-1.08, p<0.001), and increased the use of reflections (1.87-4.87, p<0.001), and use of MI strategies (0.45-0.97, p=0.017). Residents' use of open-ended questions decreased from 1.97 to a mean of 1.05, p=0.023. Residents' ratings of the course on a 5-point scale varied from 3.7 for written exercises to 4.6/5 for the simulated patient exercise. After the course, residents rated behavior change counseling skills as more important.
A 12-h course increased residents' use of core MI communication skills in a written measure, and was highly rated.
Future work should examine whether teaching of the empathic, collaborative MI stance impacts patient outcomes.
确定动机性访谈（MI）课程是否能有效地教授内科住院医师核心 MI 技能和共情、非评判性的 MI 风格。
19 名三年级住院医师与一名教师导师一起参加了 12 小时的课程。教学方法包括讲座、书面练习、模拟患者练习和讨论住院医师的行为改变问题。
使用帮助性反应问卷（Helpful Responses Questionnaire）在课程前后评估住院医师对 MI 技能的采用情况。住院医师减少了使用封闭式问题（从 1.13 分降至 0.37 分，p=0.036）和 MI 障碍（4.00-1.08，p<0.001），增加了使用回应（1.87-4.87，p<0.001）和使用 MI 策略（0.45-0.97，p=0.017）。住院医师使用开放式问题的次数从 1.97 次降至 1.05 次，p=0.023。住院医师对课程的评分在 5 分制中从书面练习的 3.7 分变化到模拟患者练习的 4.6/5 分。课程结束后，住院医师认为行为改变咨询技能更重要。
为期 12 小时的课程增加了住院医师在书面测量中使用核心 MI 沟通技能的频率，且得到了高度评价。
未来的研究应探讨教授共情、协作的 MI 立场是否会影响患者的结果。
