Academic journal article American Journal of Pharmaceutical Education

A Motivational Interviewing Course for Pharmacy Students

Academic journal article American Journal of Pharmaceutical Education

A Motivational Interviewing Course for Pharmacy Students

Article excerpt

Modern pharmacy practice requires pharmacists to develop effective counseling skills, use of which can lead to a variety of positive health outcomes for patients. (1-4) The Accreditation Council for Pharmacy Education (ACPE) and the American Association of Colleges of Pharmacy (AACP) Center for the Advancement of Pharmaceutical Care (CAPE) stress the importance of tailoring communication to the audience to improve patient health and wellness. (5,6) Consistent with these goals, accreditation standards require that pharmacy students develop specific patient-centered care competencies. (5) Specifically, students need to become proficient in: (1) providing patient care in collaboration with the patient and medical team through the application of therapeutic principles, evidence-based data, and consideration of factors that might impact therapeutic outcomes; (2) using and managing health care system resources in collaboration with the patient and medical team to promote health, appropriate medication distribution, and improve therapeutic outcomes; and (3) promoting disease prevention and improved health in collaboration with patients, communities, at-risk populations, and the medical team. In order to meet these important competencies, practitioners will need to develop skills for effective communication at every level of patient contact.

Despite this emphasis on the development of effective patient-centered counseling skills, a review of the Web-posted curriculums of 40 randomly selected US PharmD programs revealed that less than half (n=19) had a course that focused on the development of these important skills. Of the programs that did list a communication skills course, many were offered as an elective rather than a required course. Further, 10 relied solely on undergraduate general communication courses, which often lack a specific focus on the pharmacy setting. Another opportunity for students to develop patient counseling skills is during their introductory and advanced pharmacy practice experiences (IPPEs, APPEs). However, approaches to patient counseling vary across settings and with the skills and philosophy of the preceptors. Even though each students' AAPE experience is grounded in common programmatic outcomes, their schedules vary, making it challenging to deliver the consistent and comprehensive training necessary for them to fully develop

individual counseling skills. More importantly, APPE experiences occur at the end of a students' program and there may not be adequate time to develop competencies before graduation if they do not enter APPEs with a strong foundation in effective patient counseling. Given the emphasis on developing competencies and the observed paucity of structured opportunities to do so, well-designed courses that specifically focus on the development of brief and effective patient-centered counseling skills for the pharmacy setting are needed.

Motivational Interviewing is a style of patient-centered counseling that is brief and has demonstrated efficacy in addressing a variety of health issues (eg, medication adherence, health screenings, substance use, smoking cessation, fruit and vegetable intake, and physical exercise) that are often the focus of pharmacy consultations. (7-16) Motivational interviewing has been defined as a directive, client-centered counseling style for eliciting behavior change by helping clients explore and resolve ambivalence. (17) Unlike more authoritative counseling styles, motivational interviewing is a positive, empathetic, and nonconfrontational approach where patients are assisted in articulating and resolving their ambivalence about specific health behavior changes. The central tool in motivational interviewing is reflective listening which allows practitioners to empathetically guide patients to their own solutions. A wide variety of professionals have successfully been trained to use motivational interviewing effectively in research and clinical settings. …

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