背景:动机访谈(MI)是一种以人为本的方法,专注于授权和激励个人进行行为改变。医学生可以在患者教育中利用MI参与患者的慢性健康疾病和适应不良行为。当前的范围审查进行了1)确定MI的类型(常规,适应,医学院的简短和小组MI)教育计划,使用的交付方式和教学方法;2)根据柯克帕特里克的层次结构对教育成果进行分类;3)通过框架确定MI教育的关键要素(反馈,责任,建议,选项菜单,同理心,自我效能感)模型。
方法:本范围审查是通过Arksey和O'Malley概述的框架进行的。两个在线数据库,CINAHL和MEDLINEComplete,进行了搜索,以确定医学教育中的MI干预措施。从书目列表和GoogleScholar搜索引擎中选择了更多文章。
结果:从2019年文章的初始产量来看,共包括19篇文章。首先,在2004--2008年和2019--2023年这两个时间段之间发表的大多数文章似乎都是双峰分布。第二,纳入本综述的所有研究均未使用常规MI,而是使用了多种MI适应技术.第三,大多数研究在MI中使用面对面的训练,而只有一项研究使用在线交付。第四,大多数研究都使用了各种互动体验来教授MI。接下来,所有研究均报告了Kirkpatrick2级结局,但只有4项研究报告了Kirkpatrick3级结局.根据FRAMES模型,所有研究(n=19;100%)报告了责任和建议的要素.报告最少的元素是自我效能感(n=12;63.1%)。
结论:我们的研究结果表明,通过适应MI和多种教学方法,可以在医学院有效地教授动机性访谈。然而,有必要进一步研究调查跨医学院的标准化MI培训,足够的剂量进行MI培训和实施反思性实践。未来的研究可能会受益于探索和更好地理解MI和自我效能之间的关系在他们的MI干预措施。
BACKGROUND: Motivational interviewing (MI) is a person-centred approach focused on empowering and motivating individuals for behavioural change. Medical students can utilize MI in patient education to engage with patients\' chronic health ailments and maladaptive behaviours. A current scoping review was conducted to 1) determine the types of MI (conventional, adapted, brief and group MI) education programs in medical schools, delivery modalities and teaching methods used; 2) classify educational outcomes on the basis of Kirkpatrick\'s hierarchy; and 3) determine the key elements of MI education via the FRAMES (feedback, responsibility, advice, menu of options, empathy, self-efficacy) model.
METHODS: This scoping review was conducted via the framework outlined by Arksey and O\'Malley. Two online databases, CINAHL and MEDLINE Complete, were searched to identify MI interventions in medical education. Further articles were selected from bibliography lists and the Google Scholar search engine.
RESULTS: From an initial yield of 2019 articles, 19 articles were included. First, there appears to be a bimodal distribution of most articles published between the two time periods of 2004--2008 and 2019--2023. Second, all the studies included in this review did not use conventional MI but instead utilized a variety of MI adaptation techniques. Third, most studies used face-to-face training in MI, whereas only one study used online delivery. Fourth, most studies have used a variety of interactive experiences to teach MI. Next, all studies reported outcomes at Kirkpatrick\'s Level 2, but only 4 studies reported outcomes at Kirkpatrick\'s Level 3. According to the FRAMES model, all studies (n=19; 100%) reported the elements of responsibility and advice. The element that was reported the least was self-efficacy (n = 12; 63.1%).
CONCLUSIONS: Our findings suggest that motivational interviewing can be taught effectively in medical schools via adaptations to MI and a variety of teaching approaches. However, there is a need for further research investigating standardized MI training across medical schools, the adequate dose for training in MI and the implementation of reflective practices. Future studies may benefit from exploring and better understanding the relationship between MI and self-efficacy in their MI interventions.