Improving medical students' success in promoting health behavior change: a curriculum evaluation

Effective behavior change counseling is an important component of the optimal care of patients, yet only a minority of medical schools currently include such training in their curriculum.

To design and evaluate a formal curriculum to teach medical students the principles of motivational interviewing (MI) that will improve knowledge, skills, and confidence in the area of counseling patients for health behavior change.

Fifty-three 3rd year medical students at the University of California, San Diego.

A 4-week curriculum consisting of four 2-h sessions, in a small group format (8-12 students). Educational strategies included a combination of short didactics, video demonstrations, small group role plays, and interactive exercises.

Students completed identical pre- and post-assessments, consisting of a questionnaire measuring confidence and knowledge, and a performance assessment using the Video Assessment of Simulated Encounters-Revised (VASE-R) tool. Knowledge improved significantly (pre-mean: 7.04, post-mean: 11.54; P < 0.001), as did skill development (pre-mean: 7.02, post-mean: 9.47; P < 0.001). Student satisfaction with behavior change counseling training improved from 3.6 to 8.1 (P < 0.001). Students were significantly more confident (P < 0.001) in their abilities to assess a patient's readiness for change and counsel the patient on behavior change after the course.

Participation in a focused curriculum on the use of motivational interviewing techniques significantly improved 3rd year medical students' knowledge, confidence, and skills in the area of behavior change counseling. These gains may help students succeed in promoting good health habits in their future patients.