Abstract
We designed and evaluated a program to teach internal medicine residents behavioral counseling skills for multiple risk factor modification. Integrating physician-patient communication, negotiation skills, and the transtheoretical model of behavior change, we used small group discussion and standardized patients. The 18 participating residents increased their ability to modify patient behavior during videotaped interviews, mean pretest/posttest score: 33.1/40.1 (Student’s pairedt test, p<.0001). Physician self-efficacy in screening for risk factors and effecting behavioral change in patients was increased (p<.0001), as were positive attitudes toward psychosocial factors (p<.003). Our teaching effectively increased the residents’ self-efficacy and performance of behavioral counseling.
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References
US Preventive Services Task Force. Guide to Clinical Preventive Services. Baltimore, Md: Williams and Wilkins; 1996.
Healthy People 2000: National Health Promotion and Disease Prevention Objectives. US Public Health Service, Department of Health and Human Services. Washington, DC: US Government Printing Office; 1991.
Southard DR, Winett RA, Walberg-Rankin JL, et al. Increasing the effectiveness of the National Cholesterol Education Program: dietary and behavioral interventions for clinical settings. Ann Behav Med. 1992;14:21–30.
Valente CM, Sobal J, Murcie HL, Levine DM, Antlitz AM. Health promotion: physician beliefs, attitudes and practices. Am J Prev Med. 1986;2:82–8.
Wells KB, Lewis CE, Leake B, Ware J. Do physicians preach what they practice? JAMA. 1984;252:2846–8.
Lewis CE, Clancy C, Leake B, Schwartz JS. The counseling practices of internists. Ann Intern Med. 1991;144:54–8.
Moser R, McCance KL, Smith KR. Results of a national survey of physicians’ knowledge and application of preventive capabilities. Am J Prev Med. 1991;7:384–90.
Borhani NO, Beran RL, Blackburn HW, et al. Task Force 5: the preparation of future medical practitioners (medical education at the under-graduate, graduate and post-graduate level). Am J Cardiol. 1981;47:769–76.
Muller S. Physicians for the twenty-first century: report of the project panel on the general professional education of the physician and college preparation for medicine (pt 2). J Med Educ. 1984;59:1–55.
Ockene JK, Quirk ME, Goldberg RJ, et al. A residents’ training program for the development of smoking intervention skills. Arch Intern Med. 1988;148:1039–45.
Levenkron JC, Greenland P. Validation of the University of Rochester risk factor interview scale. Am J Prev Med. 1987;3(3):152–6.
Pololi LH, Coletta EM, Kern DG, et al. Developing a competency-based curriculum for medical schools. Am J Prev Med. 1994;10:240–4.
Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integratlve model of change. J Consult Clin Psychol. 1983;51:390–5.
Janis IL, Mann L. Decision making; a psychological evaluation of conflict, choice and commitment. New York, NY: Free Press; 1977.
Bandura A. Self efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.
Stillman PL, Burpeau-DiGregoriao MY, Nicholson GI, et al. Six years’ experience using patient-instructors to teach interviewing skills. J Med Educ. 1983;58:941–6.
Lazare A, Putnam SM, Lipkin M. Three functions of the medical interview. In: Lipkin M, Putnam SM, Lazare A, eds. The Medical Interview. New York, NY: Springer-Verlag; 1995;11–4.
Quill TE. Partnerships in patient care: a contractual approach. Ann Intern Med. 1983;98:228–34.
Parlow J, Rothman Al. ATSIM: a scale to measure attitudes toward psychosocial factors in health care. J Med Educ. 1974;49:385–7.
Prochaska JO, Goldstein MG. Process of smoking cessation: implications for clinicians. Clin Chest Med. 1991;12:727–35.
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Presented at Prevention 94, Atlanta, Ga., March 1994.
Supported in part by a grant from The Rhode Island Foundation.
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Pololi, L.H., Potter, S. Behavioral change in preventive medicine. J Gen Intern Med 11, 545–547 (1996). https://doi.org/10.1007/BF02599603
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DOI: https://doi.org/10.1007/BF02599603