Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, 94300, Malaysia.
BMC Med Educ. 2024 Aug 8;24(1):856. doi: 10.1186/s12909-024-05845-w.
Motivational interviewing (MI) is a person-centred approach focused on empowering and motivating individuals for behavioural change. Medical students can utilize MI in patient education to engage with patients' chronic health ailments and maladaptive behaviours. A current scoping review was conducted to 1) determine the types of MI (conventional, adapted, brief and group MI) education programs in medical schools, delivery modalities and teaching methods used; 2) classify educational outcomes on the basis of Kirkpatrick's hierarchy; and 3) determine the key elements of MI education via the FRAMES (feedback, responsibility, advice, menu of options, empathy, self-efficacy) model.
This scoping review was conducted via the framework outlined by Arksey and O'Malley. Two online databases, CINAHL and MEDLINE Complete, were searched to identify MI interventions in medical education. Further articles were selected from bibliography lists and the Google Scholar search engine.
From an initial yield of 2019 articles, 19 articles were included. First, there appears to be a bimodal distribution of most articles published between the two time periods of 2004--2008 and 2019--2023. Second, all the studies included in this review did not use conventional MI but instead utilized a variety of MI adaptation techniques. Third, most studies used face-to-face training in MI, whereas only one study used online delivery. Fourth, most studies have used a variety of interactive experiences to teach MI. Next, all studies reported outcomes at Kirkpatrick's Level 2, but only 4 studies reported outcomes at Kirkpatrick's Level 3. According to the FRAMES model, all studies (n=19; 100%) reported the elements of responsibility and advice. The element that was reported the least was self-efficacy (n = 12; 63.1%).
Our findings suggest that motivational interviewing can be taught effectively in medical schools via adaptations to MI and a variety of teaching approaches. However, there is a need for further research investigating standardized MI training across medical schools, the adequate dose for training in MI and the implementation of reflective practices. Future studies may benefit from exploring and better understanding the relationship between MI and self-efficacy in their MI interventions.
动机性访谈（MI）是一种以个人为中心的方法，专注于为行为改变赋能和激励个人。医学生可以在患者教育中利用 MI 来处理患者的慢性健康问题和适应不良行为。目前进行了一项范围界定审查，以 1）确定医学院中 MI（常规、改编、简短和小组 MI）教育计划的类型、使用的交付方式和教学方法；2）根据 Kirkpatrick 层次结构对教育成果进行分类；3）通过 FRAMES（反馈、责任、建议、选项菜单、同理心、自我效能）模型确定 MI 教育的关键要素。
本范围界定审查是通过 Arksey 和 O'Malley 概述的框架进行的。在 CINAHL 和 MEDLINE Complete 两个在线数据库中搜索 MI 干预措施在医学教育中的应用。从参考文献列表和 Google Scholar 搜索引擎中选择了更多文章。
从最初的 2019 篇文章中，选取了 19 篇文章。首先，大多数文章的发表时间似乎呈双峰分布，分别在 2004-2008 年和 2019-2023 年两个时期。其次，本综述中包含的所有研究均未使用常规 MI，而是使用了各种 MI 改编技术。第三，大多数研究使用面对面培训来教授 MI，而只有一项研究使用在线教学。第四，大多数研究使用各种互动体验来教授 MI。接下来，所有研究都报告了 Kirkpatrick 第 2 级的结果，但只有 4 项研究报告了 Kirkpatrick 第 3 级的结果。根据 FRAMES 模型，所有研究（n=19；100%）报告了责任和建议要素。报告最少的是自我效能（n=12；63.1%）。
我们的研究结果表明，通过 MI 改编和各种教学方法，可以在医学院有效教授动机性访谈。然而，需要进一步研究调查标准化 MI 培训在医学院中的应用、MI 培训的适当剂量以及反思性实践的实施。未来的研究可能会受益于探索和更好地理解 MI 干预措施中 MI 与自我效能之间的关系。
