Training residents to employ self-efficacy-enhancing interviewing techniques: randomized controlled trial of a standardized patient intervention.
BACKGROUND
Current interventions to enhance patient self-efficacy, a key mediator of health behavior, have limited primary care application.


OBJECTIVE
To explore the effectiveness of an office-based intervention for training resident physicians to use self-efficacy-enhancing interviewing techniques (SEE IT).


METHODS
Randomized controlled trial.


METHODS
Family medicine and internal medicine resident physicians (N = 64) at an academic medical center.


METHODS
Resident use of SEE IT (a count of ten possible behaviors) was coded from audio recordings of the physician-patient portion of two standardized patient (SP) instructor training visits and two unannounced post-training SP visits, all involving common physical and mental health conditions and behavior change issues. One post-training SP visit involved health conditions similar to those experienced in training, while the other involved new conditions.


RESULTS
Experimental group residents demonstrated significantly greater use of SEE IT than controls, starting after the first training visit and sustained through the final post-training visit. The mean effect of the intervention was significant [adjusted incidence rate ratio for increased use of SEE IT = 1.94 (95% confidence interval = 1.34, 2.79; p < 0.001)]. There were no significant effects of resident gender, race/ethnicity, specialty, training level, or SP health conditions.


CONCLUSIONS
SP instructors can teach resident physicians to apply SEE IT during SP office visits, and the effects extend to health conditions beyond those used for training. Future studies should explore the effects of the intervention on practicing physicians, physician use of SEE IT during actual patient visits, and its influence on patient health behaviors and outcomes.
Jerant
Anthony
A
Department of Family and Community Medicine, University of California Davis School of Medicine, 4860 Y Street, Suite 2300, Sacramento, CA 95618, USA. afjerant@ucdavis.edu
Kravitz
Richard L
RL
Azari
Rahman
R
White
Lynda
L
García
Jorge A
JA
Vierra
Heather
H
Virata
Maria Catrina
MC
Franks
Peter
P
D000328:Adult; D000368:Aged; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D020377:Self Efficacy