Randomized trial of teaching brief motivational interviewing to pediatric trainees to promote healthy behaviors in families.

Hypothesis: That pediatric resident trainees would demonstrate increased counseling skill following training in brief motivational interviewing (MI).

Design: Randomized controlled trial.

Setting: University of Washington Pediatric Residency.

Participants: Pediatric residents (N = 18), including residents in postgraduate years 1, 2, 3, and 4.

Interventions: Collaborative Management in Pediatrics, a 9-hour behavior change curriculum based on brief MI plus written feedback on communication skills (based on a 3-month Objective Standardized Clinical Evaluation [OSCE]).

Main Outcome Measure: The percentage of MI-consistent behavior (%MICO), a summary score for MI skill, was assessed via OSCEs in which standardized patients portray parents of children with asthma in 3 clinical scenarios (stations). The OSCEs were conducted at baseline and 3 and 7 months. Blinded coders rated videotaped OSCEs using a validated tool to tally communication behaviors. Training effects were assessed using linear regression controlling for baseline %MICO. Global ratings of counseling style served as secondary outcome measures.

Results: Trained residents demonstrated a trend toward increased skill (%MICO score) at 3 months compared with control residents. At 7 months, %MICO scores increased 16% to 20% (P < .02) across all OSCE stations after the combined intervention of Collaborative Management in Pediatrics training plus written feedback. The effect of training on global ratings supported the main findings.

Conclusions: Pediatric trainees' skills in behavior change counseling improved following the combination of training in brief MI plus personalized feedback.