title: Challenges in developing primary care physicians' motivational interviewing skills.
abstract: BACKGROUND
  Motivational interviewing (MI) skills are relevant for primary care providers (PCPs) who are responsible for caring for patients with diseases affected by behavior. There are significant challenges associated with developing PCP's MI skills. We report on an effort to document the acquisition of MI skills by PCPs using an objective measure of MI competence, the Motivational Interviewing Treatment Integrity (MITI) coding system.
  
  
  METHODS
  Eleven PCPs volunteered to participate in 6 MI workshops over a period of 6 months and to submit work samples between each of these workshops to be assessed with the MITI coding system.
  
  
  RESULTS
  Thirteen of the expected 55 work samples were submitted before the final workshop. A revised approach was implemented in which each participant completed 2 simulated patient encounters. None of the providers reached the MITI's Beginning Proficiency threshold of MI skill.
  
  
  CONCLUSIONS
  Six MI workshops were not sufficient to help motivated PCPs achieve Beginning Proficiency as measured by the MITI. Participants failed to submit most of the work samples for feedback on their MI practice, which may have contributed to their limited acquisition of MI skills. Helping PCPs develop MI skills likely requires more than participation in a series of workshops totaling 18 h. Questions remain about the feasibility of training PCPs to be competent in MI. Approaches such as use of simulated patients, peer observation, or specific protected time for obtaining work samples may be required. (PsycINFO Database Record
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School.
authors.forename: Daniel J
authors.identifier: 0000-0001-7121-9403
authors.initials: DJ
authors.lastname: Mullin
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute.
authors.forename: Lisa
authors.initials: L
authors.lastname: Forsberg
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Savageau
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School.
authors.forename: Barry
authors.initials: B
authors.lastname: Saver
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D062405:Motivational Interviewing; D058007:Physicians, Primary Care; D010865:Pilot Projects