Applying Motivational Interviewing to Improve Counseling on Glaucoma Management and Medication Adherence: A Pilot...

Motivational interviewing (MI) is a patient-centered counseling style that has been shown to be effective in promoting behavioral change. However, it has not been commonly used in ophthalmology, despite its myriad applications, such as for improving topical medication adherence in glaucoma management. The purpose of this study was to develop, implement, and evaluate an MI workshop for ophthalmology residents focused on glaucoma counseling.

From 2022 to 2023, A 1-hour interactive workshop was developed, which included a brief lecture, original videos demonstrating glaucoma counseling with and without MI, as well as role-play scenarios to practice MI skills. A standardized patient encounter (SPE) requiring glaucoma counseling assessed MI skills. Ten PGY-2 and 10 PGY-1 ophthalmology residents were randomized to complete the SPE either before the workshop (control group) or after (intervention group).

This was conducted with a residency program at an academic medical center.

Ophthalmology residents at the New York Eye and Ear Infirmary of Mount Sinai.

Residents in the intervention group performed better in the SPE (average score 82.2% [16.4/20] vs. 63.9% [12.8/20], p = 0.006), with no significant differences between PGY-1 and PGY-2 cohorts. The control group demonstrated 12.5% (0.5/4) of MI-specific skills on the SPE, whereas the intervention group covered 75% (3/4) of the MI-specific skills. Resident confidence using MI improved from 2.9/5 before the workshop to 4.65/5 to following it (p < 0.0001). All residents reported they were likely to use MI skills in future patient encounters and recommended it be offered to future residents.

A brief MI workshop improved residents' confidence and MI skills in glaucoma counseling. This specialty-specific adaptation of MI for resident education may be extended to other fields seeking to integrate MI education into their specialty.