Teaching Brief Motivational Interventions for Diabetes to Family Medicine Residents

Abstract

Background and objectives: As time and resource constraints grow in primary care, so does the value of efficient strategies to promote patient self-management, particularly for chronic diseases such as diabetes mellitus (DM). To that end, incorporating motivational interviewing (MI) into clinical practice has been shown to improve outcomes for patients with DM. Brief motivational interventions (BMI) draw from MI and may be integrated into more concise office visits. Little research has investigated strategies for BMI training for family medicine residents, particularly in the care of patients with DM. This study evaluates the impact of BMI training on improving DM self-management.

Methods: Family medicine residents were trained in BMI for DM over four sessions, then implemented BMI during routine office visits for 1 year. Pre- and post-implementation surveys were compared between residents who received BMI training and those who did not.

Results: After BMI training, residents' self-reported use of MI-adherent approaches to managing unhealthy behaviors in patients with DM doubled, and knowledge of MI increased by nearly 50%. BMI-trained residents showed 19% improvement in the application of MI skills, using an objective measure of open-response questions to behavioral change statements.

Conclusions: After fewer than four training sessions in BMI, residents not only improved in their ability to apply motivational skills but also altered their clinical approaches to counseling patients with DM. BMI can also be used to evoke health behavior changes, thereby improving self-management. Training family medicine residents in BMI is effective and can be easily incorporated into a residency curriculum.