Training medical students in motivational interviewing using a blended learning approach: a proof-of-concept study.

Background: Difficulties in implementing behavior change in patients with chronic diseases are common in clinical practice. Motivational interviewing (MI) helps clinicians to support patients in overcoming ambivalence while maintaining self-determination. The inclusion of MI in German medical training curricula is still rare. Furthermore, the effects of systematic teaching of MI, especially via blended learning, have hardly been investigated. Methods: Medical students participated in three curricular events related to MI, consisting of instructional videos and theoretical and practical components in a blended learning format. The aim of the study was to investigate the effect of teaching MI in students' medical education. A controlled, non-randomized study was conducted with an intervention group and a control group. Both groups completed questionnaires on their experience and knowledge related to MI, completed a knowledge test and rated their satisfaction with the course. MI was taught in the 6th semester of medical coursework as part of a psychosomatic course, in the 8th semester during a psychiatry course and in the 9th semester during a weekly psychiatry clerkship. Results: Data from the intervention group (n = 35) and control group (n = 14) were analyzed, with 65.7% of students participating in all three parts of the curriculum. Overall interest in learning MI was high, with M = 2.92 (SD = 1.00). The results indicate a greater increase in knowledge over time in the intervention group. The majority (62.86%) stated that the curriculum was relevant to their future career. Free-form text responses indicated a high level of satisfaction with practical relevance. Conclusion: This study demonstrates the usefulness of an MI curriculum for medical students. The integration of MI into medical curricula is a promising curricular addition to improve doctor-patient communication. Future research should address patient perceptions of MI competencies and the persistence of acquired competencies.

Cognitive and social congruence in peer-assisted learning - A scoping review.

This scoping review presents an overview of cognitive and social congruence in peer assisted learning (PAL), as the positive effects of PAL have been shown to rely on these critical factors. The scoping review followed the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Databases were systematically searched for articles that focus on PAL and cognitive and social congruence. Participants of the studies included were medical, health science, polytechnic, law and paramedic students. Studies that assessed cognitive and social congruence by questionnaires with a 5-point Likert scale were regarded for meta-analytic pooling. Sixteen of 786 identified articles were included in the review, whereof 9 studies were considered for meta-analytic pooling. The meta-analytic pooling showed that tutees tend to see their student tutors as cognitively (Mweighted = 3.84; range of Mweighted = 2.69-4.56) and socially congruent (Mweighted = 3.95; range of Mweighted = 2.33-4.57). Further, characteristics of student tutors are summarized. This scoping review presents an overview and operationalization of cognitive and social congruence in PAL. Based on the presented meta-analytic pooling, cognitive and social congruence were found to represent relevant key factors in the PAL context. Thus, this theoretical background should be acknowledged as a core concept for tutorials within the medical curriculum.

Face yourself! - learning progress and shame in different approaches of video feedback: a comparative study.

BACKGROUND: Feedback is a crucial part of medical education and with on-going digitalisation, video feedback has been increasingly in use. Potentially shameful physician-patient-interactions might particularly benefit from it, allowing a meta-perspective view of ones own performance from a distance. We thus wanted to explore different approaches on how to deliver specifically video feedback by investigating the following hypotheses: 1. Is the physical presence of a person delivering the feedback more desired, and associated with improved learning outcomes compared to using a checklist? 2. Are different approaches of video feedback associated with different levels of shame in students with a simple checklist likely to be perceived as least and receiving feedback in front of a group of fellow students being perceived as most embarrassing? METHODS: Second-year medical students had to manage a consultation with a simulated patient. Students received structured video feedback according to one randomly assigned approach: checklist (CL), group (G), student tutor (ST), or teacher (T). Shame (ESS, TOSCA, subjective rating) and effectiveness (subjective ratings, remembered feedback points) were measured. T-tests for dependent samples and ANOVAs were used for statistical analysis. RESULTS: n = 64 students could be included. Video feedback was in hindsight rated significantly less shameful than before. Subjectively, there was no significant difference between the four approaches regarding effectiveness or the potential to arise shame. Objective learning success showed CL to be significantly less effective than the other approaches; additionally, T showed a trend towards being more effective than G or ST. CONCLUSIONS: There was no superior approach as such. But CL could be shown to be less effective than G, ST and T. Feelings of shame were higher before watching one's video feedback than in hindsight. There was no significant difference regarding the different approaches. It does not seem to make any differences as to who is delivering the video feedback as long as it is a real person. This opens possibilities to adapt curricula to local standards, preferences, and resource limitations. Further studies should investigate, whether the present results can be reproduced when also assessing external evaluation and long-term effects.

Teaching history taking to medical students: a systematic review.

BACKGROUND: This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students' interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program's efficacy. METHODS: The databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students' history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: Seventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students' history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65). CONCLUSIONS: These findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping them to focus on interview skills and not being distracted by thinking about differential diagnoses or clinical management. The heterogeneity of outcome data and the varied ways of assessment strongly suggest the need for further research as many studies did not meet basic methodological criteria. Randomized controlled trials using external assessment methods, standardized measurement tools and reporting long-term data are recommended to evaluate the efficacy of courses on history taking.