Motivational interviewing in health care: results of a brief training in endocrinology

动机式访谈在医疗保健中的应用:内分泌学短期培训成果

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Abstract

BACKGROUND: Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. OBJECTIVE: The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. METHODS: We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. RESULTS: The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. CONCLUSIONS: Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers.

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