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向医学生教授动机访谈:系统评价。

Teaching Motivational Interviewing to Medical Students: A Systematic Review.

机构信息

S. Kaltman is professor, Department of Psychiatry, Georgetown University School of Medicine, Washington, DC; ORCID: https://orcid.org/0000-0002-5805-5536. A. Tankersley is doctoral candidate, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia; ORCID: https://orcid.org/0000-0003-0145-3354.

出版信息

Acad Med. 2020 Mar;95(3):458-469. doi: 10.1097/ACM.0000000000003011.

Abstract

PURPOSE

Medical students must be prepared to work with patients with maladaptive health behaviors and chronic health conditions. Motivational interviewing (MI) is an evidence-based, patient-centered, directive communication style designed to help patients address behaviors that are detrimental to their health (e.g., substance abuse, poor diet). In this study, the authors systematically reviewed the evidence pertaining to MI curricula in medical schools. Their aims were to describe the pedagogical and content-related features of MI curricular interventions and to assess the effectiveness of the interventions and the quality of the research evidence.

METHOD

In March 2019, the authors searched databases, seeking studies on MI in medical schools. They manually extracted descriptive information, used the Medical Education Research Study Quality Instrument to assess the quality of the included studies, and synthesized the included studies' results.

RESULTS

Sixteen studies met inclusion criteria. The majority of included studies were pre-post evaluation designs; the most rigorous were randomized controlled trials. MI curricula were heterogeneous, varying in timing, content, pedagogical approaches, and outcomes measured.

CONCLUSIONS

The results of this review suggest that the implementation of MI curricula in medical schools can be feasible and effective and that students can achieve beginning levels of proficiency. The results support the inclusion of MI in undergraduate medical education curricula and highlight next steps to advance this area of medical education research: achieving consensus around essential early MI skills that should be taught in medical schools and identifying the most effective scaffolding strategies to teach this complex mode of communication.

摘要

目的

医学生必须能够与存在适应不良健康行为和慢性健康状况的患者合作。动机性访谈(MI)是一种基于证据、以患者为中心、指导式的沟通方式,旨在帮助患者解决对健康有害的行为(例如,药物滥用、不良饮食)。在这项研究中,作者系统地回顾了医学院中 MI 课程的相关证据。他们的目的是描述 MI 课程干预措施的教学和内容相关特征,并评估干预措施的效果和研究证据的质量。

方法

2019 年 3 月,作者在数据库中搜索了有关医学院中 MI 的研究。他们手动提取了描述性信息,使用医学教育研究学习质量工具评估了纳入研究的质量,并综合了纳入研究的结果。

结果

符合纳入标准的研究有 16 项。大多数纳入的研究是前后评估设计;最严谨的是随机对照试验。MI 课程多种多样,在时间、内容、教学方法和测量的结果方面存在差异。

结论

本综述的结果表明,在医学院中实施 MI 课程是可行且有效的,并且学生可以达到初步的熟练程度。结果支持将 MI 纳入本科医学教育课程,并强调了推进医学教育研究这一领域的下一步措施:就应在医学院教授的基本早期 MI 技能达成共识,并确定教授这种复杂沟通模式的最有效支架策略。

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