Do No Harm… When Counselling Patients
Motivational interviewing
Primun non nocere ! This principle also applies when health professionals give their patients advice concerning the adoption of healthier behaviours. It has been shown that the attitude of a professional during a medical visit can slow down or speed up an individual's process of change.
The Chair in Medical Education has contributed to training future physicians in motivational interviewing. This approach, developed by Miller and Rollnick, is both directive and focused on the individual; it also aims to increase motivation which is intrinsic to change. Such training has been integrated into the clerkship in community medicine. After taking a theory course on the principles of motivational interviewing, each student is invited to put into practice what has been learnt by conducting an interview with a patient-actor.
Simulated interviews are set up to emphasize a specific aspect of counselling; for instance, avoid provoking resistance or spotting ambivalence in a patient. They concern current clinical situations such as smoking cessation, physical activity, alcohol abuse, adherence to medications and vaccination refusal. Small group discussions composed of the student who conducted the interview, three extern observers and the supervisor reinforce the theoretical aspects.
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