Improving medical students' success in promoting health behavior change: A curriculum evaluation
Improving medical students' success in promoting health behavior change: A curriculum evaluation
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DOI：
10.1007/s11606-008-0678-x
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发表时间：
2008-09-01
影响因子：
5.7
通讯作者：
Cole, Britney A.
中科院分区：
文献类型：
--
作者：
Bell, Kristin;Cole, Britney A.
导读：有效的行为改变咨询是患者最佳护理的重要组成部分，但目前只有少数医学院将此类培训纳入其课程。目的：设计和评估一门正式课程，教授医学生动机性访谈（MI）的原则，以提高他们在咨询患者健康行为改变方面的知识、技能和信心。参与者：加州大学圣地亚哥分校53名医学院三年级学生。项目描述：一个为期四周的课程，包括四个2小时的课程，以小组形式（8-12名学生）。教育策略包括简短教学、视频演示、小组角色扮演和互动练习的结合。项目评估：学生完成了相同的前后评估，包括测量信心和知识的问卷调查，以及使用模拟遭遇视频评估-修订（VASE-R）工具进行的绩效评估。知识显著提高（前均值：7.04，后均值：11.54,P < 0.001），技能发展也显著提高（前均值：7.02，后均值：9.47,P < 0.001）。学生对行为改变辅导培训的满意度从3.6分提高到8.1分（P < 0.001）。学生在评估病人对改变的准备程度和在课程结束后就行为改变向病人提出建议的能力方面明显更有信心（P < 0.001）。讨论：参与动机性访谈技术的重点课程，可以显著提高医学生在行为改变咨询领域的知识、信心和技能。这些收获可能有助于学生成功地在他们未来的病人中推广良好的健康习惯。
INTRODUCTION: 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.AIM: 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.PARTICIPANTS: Fifty-three 3rd year medical students at the University of California, San Diego.PROGRAM DESCRIPTION: 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.PROGRAM EVALUATION: 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.DISCUSSION: 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.