Malas Nasuh, Rofey Dana, Kuchera Anne Marie, Pletcher Jonathan, Ortiz-Aguayo Roberto, Douaihy Antoine, Gold Melanie
Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA.
Department of Pediatrics, University of Michigan Health System, Ann Arbor, Michigan, USA.
Clin Teach. 2017 Feb;14(1):20-26. doi: 10.1111/tct.12503. Epub 2016 Feb 3.
Motivational interviewing (MI) is a collaborative, evidence-based, person-centred counselling style for addressing ambivalence about behaviour change. Despite its proven effectiveness, there is little formal instruction of MI in paediatric training programmes.
Second-year paediatric residents participated in a 4-hour MI workshop, followed by a 1-hour small group review course and hands-on supervision during their Adolescent Medicine rotation. After the MI workshop, and again after their refresher course, we assessed residents' attitudes and skill with written and online surveys, as well as with a modified Helpful Responses Questionnaire (HRQ).
Results revealed a statistically significant improvement in residents' confidence in eliciting health behaviour change [t-score(59) = 3.76, p = 0.008]. HRQ scores for all three clinical scenarios improved significantly following the workshop (p < 0.000). Residents most valued the interactive components of the workshop and review course, particularly the practice exercises, videos/video vignettes, feedback and coaching.
A standardised MI curriculum for paediatric residency training improved residents' confidence in eliciting health behaviour change and use of empathic, reflective language. The curriculum is both feasible and widely accepted by residents, with opportunities for residents to practise MI under supervision during resident training. In conclusion, providing a 4-hour MI workshop for paediatric residents, with reinforcement through a review course and clinical opportunities to practise MI under supervision, improved confidence in eliciting health behaviour change and the use of MI-consistent language. This innovative and time-sensitive effort could serve as a future model for MI training for paediatric residents. There is little formal instruction of MI in paediatric training programmes.
动机性访谈（MI）是一种协作式、基于证据、以患者为中心的咨询方式，用于解决行为改变方面的矛盾心理。尽管其有效性已得到证实，但儿科培训项目中对动机性访谈的正规指导却很少。
二年级儿科住院医师参加了一个为期4小时的动机性访谈工作坊，随后在青少年医学轮转期间参加了一个为期1小时的小组复习课程并接受实践指导。在动机性访谈工作坊之后，以及在复习课程之后，我们通过书面和在线调查以及一份经过修改的《有益回应问卷》（HRQ）对住院医师的态度和技能进行了评估。
结果显示，住院医师在引发健康行为改变方面的信心有统计学意义的显著提高[t分数(59)=3.76，p=0.008]。工作坊之后，所有三种临床情景的HRQ分数均有显著提高（p<0.0
