Behavior change counseling (BCC) in the medical setting has progressed from simple advice-giving to strategic patient-centered methods of communication such as motivational interviewing (MI). Research is needed to evaluate the effect of BCC training interventions on clinician proficiency. The purpose of this investigation was to describe the role of a clinical research coordinator (CRC) in MI training research for clinicians that promote weight management (WM). In this observational study, a self-selected group of 13 female clinicians (62% physicians/mid-levels) were evaluated before and after an introductory training in MI. Two experienced trainers conducted a standard 2-day workshop that focused on WM. Trainees were taught how to independently practice, code and supervise each other in small groups (triads) for the purpose of ongoing skill development. On completion of the workshop, the CRC randomized fifty percent of the trainees to receive 3 additional 1-hour guided practice sessions over a 6-week period. These practice sessions took place independently in the assigned triads and included the opportunity of supervision from peers that had completed the training workshop. The clinicians were evaluated with the CARE Measure for 4-weeks before and 6-weeks after the workshop. This confidential 10-item questionnaire assessed relational empathy from the patient perspective on completion of clinical visits (n=531). The CARE Measure was scored on a 1-5 Likert scale. The clinicians provided an audio-taped recording of a clinical visit of their choice pre workshop, post workshop (PW) and 6-week PW. The CRC downloaded the recorded sample into a secure site on the Blackboard system within the institution’s Simulation Center. The recording was anonymously analyzed by a coding expert who was blind to the recording time point and group assignment. The MITI 4.2 Coding Instrument scored the visits on global ratings that used a 1-5 scale and an objective behavioral count to determine MI proficiency. A pre workshop and post workshop clinician self-evaluation measured perceived proficiency and intent to use MI. The CRC managed and facilitated all methods used to evaluate the proficiency of the clinicians. The study required timely coordination with multiple professional groups; which included the clinicians, the Simulation Center, medical assistants, and data analysts. The data for this observational study is currently being analyzed. A MI training intervention needs to be evaluated in terms of measurable outcomes with a variety of methods. There are obstacles and challenges in the implementation process of high quality research. The project management role of a CRC is essential to healthcare communications training research.
Motivational interviewing (MI) is a focused method of communication that has demonstrated success in improving the health behaviors of clinical populations. However, MI is not generally taught in health science school programs. This pilot study was designed to evaluate two methods of teaching motivational interviewing (MI) in a physical therapy (PT) school program. Fifty-four first and second year PT students (76% female) with no prior teaching in MI volunteered as participants in the study. The students were randomly assigned to receive 1.5-hours of classroom (N=25) or computer-based (N=29) teaching in MI. The content of the two interventions were standardized for consistency and focused on two of twelve topics that are typically taught in a standard two-day MI training workshop. The teaching methods in both groups were designed to be interactive and included a demonstration of MI. The classroom intervention was taught by two experienced MI trainers and the computer-based approach to teaching MI used multimedia technology in the form of a DVD prototype. A series of confidential questionnaires were used evaluate the teaching process and the impact on learning. Dependent and independent sample t-tests were used to determine the difference between pre and post-testing in both groups and also make a comparison between the groups. The students in both groups significantly improved self-evaluation scores of perceived proficiency in MI (p<0.05), attitude consistent with MI (p<0.05), intentions to use MI (p<0.05) and scores on a knowledge test (p<0.05). In addition, both groups gave a high rating for the extent to which the interventions helped the learner meet predetermined teaching objectives. There were no significant differences between groups on any of the outcome measures (p>0.05). The findings of this preliminary investigation show that it is feasible to teach MI in a PT school program. It is recommended that a computer-based program be developed to teach an entire course on MI and that it be compared with classroom teaching.