A new paradigm for teaching behavior change

Implications for residency training in family medicine and psychiatry

A. Catalina Triana, Michael M. Olson, Dorothy B. Trevino

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Primary care physicians (PCPs) provide ∼50% of all mental health services in the U.S. Given the widening gap between patient mental health needs and resources available to meet those needs, there is an increasing demand for family medicine and psychiatry trainees to master competencies in both behavioral medicine and primary care counseling during residency-if for no other reason than to accommodate the realities of medical practice given the oft present gap between the need for psychiatric services and the availability, quality, and/or affordability of specialized psychiatric care. To begin to address this gap, a skills-based, interactive curriculum based on motivational interviewing (MI) as a teaching method is presented. Methods. The curriculum described in this paper is a four-week block rotation taught in the second year of residency. Motivational interviewing (MI) is used as a teaching approach toward the goal of clinical behavior change. Residents strengths, personal choice and autonomy are emphasized. Each week of the rotation, there is a clinical topic and a set of specific skills for mastery. Residents are offered a menu of skills, role modeling, role/real play, practice with standardized patients (SP), and direct supervision in clinic. Results: Thirty-nine residents have completed the curriculum. Based on residents subjective reporting using pre-post scales (i.e., importance and confidence), all participants to date have reported substantial increases in confidence/self-efficacy using primary care counseling skills in their continuity clinic. Conclusions: This paper presents an innovative, empirically based model for teaching the essential skills necessary for physicians providing care for patients with mental/emotional health needs as well as health-behavior change concerns. Implications for training in the broader context, particularly as it relates to multi-disciplinary and collaborative models of teaching/training are discussed.

Original languageEnglish (US)
Article number64
JournalBMC Medical Education
Volume12
Issue number1
DOIs
StatePublished - 2012

Fingerprint

Internship and Residency
psychiatry
Psychiatry
Teaching
Medicine
medicine
Curriculum
resident
paradigm
Motivational Interviewing
curriculum
Counseling
counseling
Primary Health Care
Mental Health
psychological care
confidence
mental health
physician
Behavioral Medicine

Keywords

  • Counseling skills
  • Curriculum
  • Motivational interviewing
  • Primary care training
  • Psychiatry training
  • Teaching method

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

A new paradigm for teaching behavior change : Implications for residency training in family medicine and psychiatry. / Triana, A. Catalina; Olson, Michael M.; Trevino, Dorothy B.

In: BMC Medical Education, Vol. 12, No. 1, 64, 2012.

Research output: Contribution to journalArticle

Triana, A. Catalina ; Olson, Michael M. ; Trevino, Dorothy B. / A new paradigm for teaching behavior change : Implications for residency training in family medicine and psychiatry. In: BMC Medical Education. 2012 ; Vol. 12, No. 1.
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