Linking a Motivational Interviewing Curriculum to the Chronic Care Model
- 25 August 2010
- journal article
- research article
- Published by Springer Nature in Journal of General Internal Medicine
- Vol. 25 (S4), 620-626
- https://doi.org/10.1007/s11606-010-1426-6
Abstract
BACKGROUND Unhealthy lifestyle choices frequently cause or worsen chronic diseases. Many internal medicine residents are inadequately trained to provide effective health behavior counseling, in part, due to prioritization of acute care in the traditional model of medical education and to other systemic barriers to teaching psychosocial aspects of patient care. AIM To address this gap in training, we developed and piloted a curriculum for a Primary Care Internal Medicine residency program that links a practical form of motivational interviewing (MI) training to the self-management support (SMS) component of the chronic care model. PARTICIPANTS AND SETTING All 30 primary care residents at Alameda County Medical Center were trained in the curriculum since it was initiated in 2007 during the California Academic Chronic Care Collaborative. PROGRAM DESCRIPTION Residents participated in three modules during which the chronic care model was introduced and motivational interviewing skills were linked to the model’s self-management support component. This training was then reinforced in the clinical setting. Case-based interactive instruction, teaching videotapes, group role-plays, faculty demonstration, and observation of resident-patient interactions in the clinical setting were used to teach the curriculum. PROGRAM ASSESSMENT A preliminary, qualitative assessment of this curriculum was done from a program standpoint and from the perspective of the learners. Residents reported increased sense of confidence when approaching patients about health behavior change. Faculty directly observed residents during clinical encounters using MI and SMS skills to work more collaboratively with patients and to improve patient readiness for self-management goal setting. CONCLUSION A curriculum that links motivational interviewing skills to the chronic care model’s self-management support component and is reinforced in the clinical setting is feasible to develop and implement. This curriculum may improve residents’ confidence with health behavior counseling and with preparing patients to become active participants in management of their chronic conditions.Keywords
This publication has 33 references indexed in Scilit:
- General practitioners trained in motivational interviewing can positively affect the attitude to behaviour change in people with type 2 diabetesScandinavian Journal of Primary Health Care, 2009
- Improving Medical Students’ Success in Promoting Health Behavior Change: A Curriculum EvaluationJournal of General Internal Medicine, 2008
- Motivational Interviewing in Health Care: Helping Patients Change BehaviorCOPD: Journal of Chronic Obstructive Pulmonary Disease, 2008
- The Teamlet Model of Primary CareAnnals of Family Medicine, 2007
- Continuous care in the treatment of obesity: an observational multicentre studyJournal of Internal Medicine, 2005
- Teaching Motivational Interviewing to First-Year Medical Students to Improve Counseling Skills in Health Behavior ChangeMayo Clinic Proceedings, 2004
- Professional responses to innovation in clinical method: diabetes care and negotiating skillsPatient Education and Counseling, 1996
- In search of how people change: Applications to addictive behaviors.American Psychologist, 1992
- In search of how people change: Applications to addictive behaviors.American Psychologist, 1992
- Evaluating the interview performance of internal medicine internsAcademic Medicine, 1989