Designing Motivational Interviewing Instruction Employing the First Principles of Instruction

Abstract

Health care reform emphasizes prevention of chronic disease through the reduction of modifiable risk factors as a way to reduce health care costs, morbidity, and mortality. Motivational interviewing (MI) is an effective method of health behavior counseling. It has been used successfully applied in health related behavior change and self- management of chronic disease. The knowledge, skills, and attitude of MI are acquired through learning as other techniques used in the health professions. Nurse practitioner faculty need guidance on how to design instruction in MI that incorporates competencies and utilizes innovative strategies. Prescriptive instructional design theory utilizes knowledge from educational research to establish the steps in the design process. The purpose of this research was to apply prescriptive instructional theory to the design of effective, efficient, and engaging instruction in MI resulting in beginning proficiency in the NP students. A formative design was used for this study. The First Principles of Instruction served as the prescriptive design theory used in the design of instruction in MI. Data sources included the researcher’s design journal, observation during interaction with the instance, demographics of authentic users, authentic user reaction, and knowledge testing. Four cycles of design-redesign were completed. Results of the study point to improvements in the First Principles of Instruction. The instruction was effective, based on the improved scores from pretest to posttest on the Helpful Response Questionnaire. The improved scores also indicated an increase in knowledge of MI. Efficiency was not improved from pretest to posttest. The definition of efficiency as less time to completion of the task did not apply to MI communication skills. The First Principles of Instruction were useful in the design of the techniques of MI. However, there is little guidance for the affective component of MI such as empathy. The prescriptions of the First Principles of Instruction were useful in designing the instruction in MI. NP students indicated in post instruction interviews that engagement in the instruction was related to the relevance of the subject matter to practice and interactive exercises.