Exploring motivational interviewing in chiropractic education: A mixed methods study of chiropractic students in North America

This study explored chiropractic students' self-reported understanding and attitudes regarding motivational interviewing (MI), and examined the relationship between students' patient-centered communication (PCC)-related attitudes and beliefs and intent to use MI.

An explanatory sequential mixed methods study was conducted with full-time chiropractic students enrolled across 7 North American doctor of chiropractic degree programs. Eligible students completed an online survey; descriptive statistics and logistic regression were used to examine the relationship between PCC-related attitudes and beliefs and intent to use MI. Following the survey, students were invited to participate in virtual interviews; qualitative data were analyzed using thematic analysis.

Of the 426 survey respondents (7% response rate), most reported completing PCC-related coursework (75.85%). While 69.73% reported understanding MI principles, only 13.51% felt proficient in its use. Over half (53.25%) intended to use MI, yet many endorsed beliefs misaligned with MI principles. The mean PCC-related attitudes and beliefs score was 143.39 (SD 18.42). Higher PCC-related attitudes and beliefs was significantly associated with greater odds of intent to use MI (odds ratio 1.03 [1.01-1.04], P < .001). Qualitative data responses reflected positivity toward MI, inconsistent exposure and training in MI, and student viewpoints that may be inconsistent with the spirit of MI.

This study contributes toward the understanding of North American chiropractic students' understanding of MI and its relationship with PCC-related attitudes and beliefs. Further research is needed to investigate how MI is introduced, taught, and longitudinally supported within chiropractic education programs.