Training primary care clinicians in motivational interviewing: A comparison of two models

• Few health professionals utilize motivational interviewing (MI) as part of routine practice due to lack of expertise and training.
• This study evaluated two training models for motivational interviewing and tobacco cessation counseling for primary care clinicians.
• Using enhancement strategies (i.e., MI clinical champions as peer coaches and telephone interactions with simulated patients) to supplement or boost initial training workshops is feasible in busy primary care settings.
• Booster training sessions improve proficiency of MI training programs for primary care clinicians.

ObjectivesTo evaluate implementing two training models for motivational interviewing (MI) to address tobacco use with primary care clinicians.MethodsClinicians were randomized to moderate or high intensity. Both training modalities included a single ½ day workshop facilitated by MI expert trainers. The high intensity (HI) training provided six booster sessions including telephone interactions with simulated patients and peer coaching by MI champions over 3 months. To assess performance of clinicians to deliver MI, an objective structured clinical evaluation (OSCE) was conducted before and 12 weeks after the workshop training.ResultsThirty-four clinicians were enrolled; 18 were randomly assigned to HI. Compared to the moderate intensity group, the HI group scored significantly higher during the OSCE for three of six global Motivational Interviewing Treatment Integrity scale scores. There was also significant improvement for three of the four measures of MI counseling knowledge, skills and confidence.ConclusionsUsing champions and telephone interactions with simulated patients as enhancement strategies for MI training programs is feasible in the primary care setting and results in greater gains in MI proficiency.Practice implicationsResults confirm and expand evidence for use of booster sessions to improve the proficiency of MI training programs for primary care clinicians.