Evaluating the Implementation and Impact of a Motivational Interviewing Workshop on Medical Student Knowledge and Social Cognitions Towards Counseling Patients on Lifestyle Behaviors

Abstract

Problem: Although motivational interviewing is an effective patient-centered counseling method that healthcare providers can adopt to promote positive behavior change among patients, motivational interviewing is not routinely taught in medical schools. Intervention: A 3.5-hour motivational interviewing workshop was delivered to second year students at a Canadian medical school. Students were first introduced to the concept of motivational interviewing, and then given an opportunity to apply this knowledge in smaller seminar groups to increase their competency within the context of lifestyle behaviors. Context: Using the Theory of Planned Behavior, this study sought to evaluate the impact of the workshop on medical students’ motivational interviewing knowledge and social cognitions. Questionnaires were distributed to students pre- and immediately post-workshop to gather student demographics, previous motivational interviewing experience, current motivational interviewing knowledge and Theory of Planned Behavior social cognitions for using motivational interviewing. Repeated-measures ANOVAs assessed changes in motivational interviewing knowledge and social cognitions. During the workshop, a process evaluation assessing fidelity to and quality of motivational interviewing instruction was conducted. Outcome: The process evaluation indicated high fidelity and high quality of delivery of the workshop by all facilitators. Students (N = 27; M_age = 24 ± 2 years) reported significant increases in motivational interviewing knowledge from pre- to post-workshop (p = 0.001). Although not significant, small-to-moderate effect sizes in changes in social cognitions were reported from pre- to post-workshop. Lesson Learned: Medical students hold motivational interviewing in a high regard, as evidenced by the relatively high social cognitions observed prior to the commencement of the workshop. We learned that while a shorter, workshop-style approach is successful in increasing motivational interviewing knowledge, future workshops should allocate more time to skill acquisition to ensure proficiency in clinical use.

Practice Points

• Motivational interviewing (MI), an effective patient-centred counseling method that promotes positive patient behavior change, is not routinely taught in medical schools.

• The theory-based evaluation of the implementation and impact of an MI workshop for second year medical students revealed high quality of delivery and significant improvements in self-reported MI knowledge.

• While the workshop was implemented as intended and based on the Theory of Planned Behavior, no significant changes in students’ social cognitions for using MI with future patients was seen from pre- to post-workshop.

• The fulsome workshop description and suggestions for future workshop modifications may be adopted by others interested in incorporating MI-specific training into the medical school curriculum.

Keywords:

• theory of planned behavior
• counseling
• lifestyle medicine
• curriculum

Acknowledgements

The authors wish to thank all of the medical students who participated in the workshop. Additionally, we are grateful for the time and expertise that all facilitators and observers dedicated to the Expo.

Disclosure statement

CB and SD were interventionists in the MI workshop and also contributed to the research project. RH was the course instructor who provided class time for the intervention and research study and was not aware of which students participated in the study. All other authors report no conflicts of interest.