Motivational Advising Workshop: Utilizing Motivational Interviewing Theory to Facilitate and Engage Intrinsic Motivation to Change Learners' Behavior

Maintaining Medical Student Motivation During Remote Clinical Learning

PURPOSE

Remote clinical learning (RCL) may result in learner disengagement. The factors that influence medical student motivation during RCL remain poorly understood. The authors aimed to explore factors that affect medical student motivation during RCL and determine potential strategies to optimize student motivation during RCL.

METHOD

In December 2020, the authors conducted semistructured interviews with third- and fourth-year medical students at the University of California, San Francisco, who had experienced RCL. The authors coded transcripts and conducted an inductive thematic analysis using self-determination theory (SDT), which describes autonomy, competence, and relatedness as essential for motivation, as a sensitizing framework.

RESULTS

Twelve students were interviewed. Four themes were identified and aligned with SDT: balancing flexibility and structure (autonomy), selecting appropriate resources (competence), setting reasonable expectations (competence), and building and maintaining community (relatedness). Students described a sense of tension between desiring flexibility and appreciating structure and accountability during RCL; a preference for high-yield, curated resources presented in an organized format during RCL; instances in which the remote curriculum fell short of their expectations or professional goals or in which they felt they had missed out on key clinical learning; and support sought from peers, mentors, and instructors during RCL, as well as the contribution of remote learning technology to a sense of community.

CONCLUSIONS

The authors propose 4 guiding principles to address implementation of remote clinical curricula: provide students with choice within the bounds of a well-defined curriculum, curate and organize learning materials carefully and intentionally, orient students to the goals and objectives of the curriculum and discuss students' expectations for professional development, and incorporate structured opportunities for remote mentorship and peer-peer interaction and optimize these opportunities using technology. Educators can draw on the themes, guiding principles, and potential strategies identified to promote and maintain learner motivation during RCL.

Motivational Interviewing Training: A Case-Based Curriculum for Preclinical Medical Students

Introduction

With the rise of chronic medical problems involving lifestyle behaviors and the benefits of patient involvement in preventative care, medical students need to learn how to help patients change health risk behaviors and improve patient involvement in order to improve health outcomes. Motivational interviewing (MI) is a patient-centered therapeutic approach that is effective in the treatment of lifestyle behaviors and diseases.

Methods

This 2-hour didactic training session, along with a 3-hour case-based practice session involving role-plays and a 3-hour evaluated session utilizing standardized patients, was delivered to 68 preclinical medical students. Knowledge, attitudes, and self-efficacy were evaluated via pre- and posttraining surveys, and satisfaction with the training was assessed upon completion.

Results

Students who completed both pre- and postsurveys (n = 48) showed a statistically significant improvement in knowledge of MI (t = -29.73, df = 47, p < .001), attitudes regarding implementing MI in health care settings (t = -3.04, df = 47, p < .005), and self-efficacy (t = -10.699, df = 47, p < .001) in talking with patients about behavior change. Students were also highly satisfied with the MI training package (M of 4.4, SD = 0.6, out of 5.0).

Discussion

A training package to teach preclinical medical students about MI was effective in helping students learn the knowledge and skills necessary to deliver MI in a broad range of clinical cases.