Short communicationEffect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices
Introduction
Motivational interviewing (MI) has 30 years of evidence showing its positive effect on patient health and satisfaction [1]. MI has only recently been introduced into health care encounters and has much less evidence of its efficacy. Some studies suggest its promise however [2], [3]. It is suggested that when clinicians use MI and their patients make more changes, clinicians will find their career more satisfying and feel less burnout. This has not been studied yet, though. MI includes understanding patients’ perspectives, recognizing and accepting desire for change, facilitating collaborative solutions, motivation via “change talk,” affirming autonomy, and mobilizing commitment to action.
Despite the promise of MI, teaching physicians MI using in-person trainings or online modules is challenging: curricula lack standardization, teaching is difficult to disseminate, and few include real-world feedback [3], [4], [5], [6], [7], [8], [9]. Our previous online interventions included audio recording and coding of encounters, and were costly and time consuming. The long-term effect of these online interventions is unknown.
A promising adult-learning strategy for teaching interpersonal skills is communication coaching: the shadowing of participants and giving immediate feedback. This pilot's aim was to test an MI communication coaching model in primary care and pediatric obesity-focused clinics. We hypothesized that in the intervention clinics (1) patients would report greater provider satisfaction and (2) clinicians would report less burnout and greater mastery of MI skills.
Section snippets
Recruitment
This protocol was approved by the Duke University School of Medicine IRB. Two primary care and two pediatric obesity-focused clinics participated in the study. The primary care clinics were randomized to control or intervention; the pediatric clinics were assigned, given the proximity of one of the clinics to the MI preceptors. Clinicians in all four clinics gave written consent and completed baseline and post-intervention surveys.
Intervention
Coaches trained intervention staff using a comprehensive
Results
Table 1 shows demographic characteristics of the 29 clinicians included in the study.
Discussion
This is the first study to teach MI to both staff and clinicians in a shared clinical environment. Coaching reduced clinician burnout, barriers for discussing behavior change, and improved self-rated MI skills. There were slight increases in patient satisfaction as well.
The results are promising as the intervention was delivered within the clinic, different from previous face-to-face formats that did not include feedback on actual encounters [3], [4], [5], [6], [7], [8]. These findings are
Conflicts of interest
The authors have no conflicts of interest to disclose.
I confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story.
All authors take responsibility for the integrity of the conclusions drawn in the paper. They have all added significantly to the science of the project and the writing of this manuscript. We have not published this paper elsewhere and no intent to do so
Role of the funding source
Community Care of North Carolina funded this work.
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Transitioning a home-based, motivational interviewing intervention among families to remote delivery during the COVID-19 pandemic: Key lessons learned
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