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

Abstract

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.