Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation.

OBJECTIVE

To determine whether a motivational interviewing (MI) curriculum is effective in teaching internal medicine residents core MI skills and the empathic, nonjudgmental MI style.

METHODS

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.

RESULTS

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.

DISCUSSION AND CONCLUSION

A 12-h course increased residents' use of core MI communication skills in a written measure, and was highly rated.

PRACTICE IMPLICATIONS

Future work should examine whether teaching of the empathic, collaborative MI stance impacts patient outcomes.