Brogan Hartlieb Kathryn, Engle Brett, Obeso Vivian, Pedoussaut Maryse A, Merlo Lisa J, Brown David R
Assistant Professor, Department of Humanities, Health and Society, Herbert Wertheim College of Medicine, Florida International University.
Associate Professor of Medicine, Herbert Wertheim College of Medicine, Florida International University.
MedEdPORTAL. 2016 Sep 16;12:10455. doi: 10.15766/mep_2374-8265.10455.
Medical settings are critical access points for behavior change counseling, and lifestyle behavior change is considered a key component of chronic disease management. The Association of American Medical Colleges recommends that future physicians be competent in shared decision making and patient-centered behavioral guidance to prevent illness and improve patient self-management of chronic disease. Motivational interviewing (MI) is a patient-centered, directive method of communication to enhance behavior change. Specific teachable strategies underlie the collaborative MI communication style that aims to reduce discord and build motivation for change.
We present our three-session 12-hour MI curriculum as an advanced form of patient-centered communication. Each session includes presession assignment, large-group interactive lecture, and small-group activities for practice. An interdisciplinary team consisting of medical educators and health behavior change research-educators who are also members of the Motivational Interviewing Network of Trainers created the submission. The purpose of this resource is to provide medical educators with a short curriculum that incorporates materials and learning activities to promote skill in MI.
In addition to positive feedback from student evaluations including the areas of relevance to training and self-rated skills improvement, preliminary pre- and posttraining scores from the medical students show significant improvement in expression of empathy and the ratio of reflections to questions.
Implementation of the curriculum allows learners the opportunity to practice evidence-based communication that promotes intrinsic motivation for health behavior change in patients, a key treatment focus in chronic disease management.
医疗机构是行为改变咨询的关键切入点，生活方式行为改变被视为慢性病管理的关键组成部分。美国医学院协会建议，未来的医生应具备共同决策能力和以患者为中心的行为指导能力，以预防疾病并改善患者对慢性病的自我管理。动机性访谈（MI）是一种以患者为中心的指导性沟通方法，旨在促进行为改变。协作性MI沟通风格有特定的可传授策略作为基础，其目的是减少分歧并激发改变的动机。
我们将我们为期三节课、共12小时的MI课程作为以患者为中心的沟通的一种高级形式呈现。每节课都包括课前作业、大型小组互动讲座以及用于实践的小型小组活动。由医学教育工作者和健康行为改变研究教育工作者组成的跨学科团队创建了该课程内容，这些教育工作者也是动机性访谈培训师网络的成员。本资源的目的是为医学教育工作者提供一个简短的课程，其中包含各种材料和学习活动，以提升MI技能。
除了学生评估中的积极反馈，包括与培训的相关性以及自我评估的技能提升等方面，医学生的培训前和培训后初步分数显示，在同理心表达以及回应与提问的比例方面有显著提高。
该课程的实施让学习者有机会实践基于证据的沟通，这种沟通能促进患者健康行为改变的内在动机，而这是慢性病管理中的一个关键治疗重点。
