1. To examine whether a workshop in Behavioral Change Counseling led to measurable changes in medical students’ knowledge, skills, and attitudes. CONCLUSIONS A Randomized-Controlled Trial of Behavior Change Counseling Education for Medical Students INTRODUCTION Motivational Interviewing (MI) is a “patient-centered, directive method for negotiating behavior change by exploring and resolving ambivalence.” 1 Behavior Change Counseling (BCC) is an adaptation of MI for medical settings developed to be used in brief consultations. Interventions utilizing adaptations of MI and BCC have found improved outcomes for substance misuse 2 smoking cessation 3 increasing exercise 4 improving diet 5 and decreasing weight. 6 BCC appears to be a useful method of patient-centered care and might be applicable for medical education. This was a prospective, randomized study of 36 2 nd year medical students. Both groups received informational material on diabetes lifestyle modification guidelines (LMG). The intervention group (Group B) received a 2-hour workshop on BCC theory and methods including both didactic and role-play elements. Both groups received pre- and post-assessment of knowledge, skills and attitudes related to BCC. Knowledge was assessed with a 6-item multiple choice quiz on BCC principles and practice, with total scores ranging from 0-6. Skills were assessed with a standardized patient examination with BCC measured using the Behavior Change Counseling Index (BECCI), an 11 item scale 7 with total scores ranging from 0-44. Attitudes were assessed using 2 sets of videos, each with a BCC vignette and a “usual care” (UC) vignette. Students were asked to rate which style they thought would be most effective, which they would use, and which they preferred and why. All data were analyzed using analysis of covariance (ANCOVA) with pretest scores as a covariate. J Spollen 1, CR Thrush 2, MB Woods 2, E Hicks 2, S Tariq 1, DV Mui 1 University of Arkansas for Medical Sciences, 1 College of Medicine, 2 Office of Educational Development METHODS Brief interventions can be used to teach medical students about Behavior Change Counseling and improve their knowledge and skills in this method. Medical students appear to prefer BCC, a patient-centered style, over usual care when exposed to both approaches. Future Directions: Incorporate the use of video vignettes during educational interventions. Define a minimum score on the BECCI that would indicate competence, allowing for more detailed analyses such as the “Number Needed to Teach” 8 metric. Assess the efficacy of BCC interventions in other learner populations, including medical residents. Determine whether short-term improvements in BCC knowledge and skills are retained over time. % Knowledge: Mean scores at pretest were 2.4 (SD=.92) for the control group and 2.6 (SD=.96) for the intervention group. At posttest they were 3.2 (SD=.86) for the control group and 4.9 (SD=1.4) for the intervention group. An ANCOVA for posttest knowledge scores, controlling for pretest knowledge scores showed a significant intervention effect F(1,33)=17.76, p<.0001, (effect size=.34). Skills: Mean scores at pretest were 11.1 (SD=5.2) for the control group and 13.0 (SD=5.7) for the intervention group. At posttest they were 13.9 (SD=4.8) for the control group and 20.8 (SD=3.8) for the intervention group. An ANCOVA for posttest BECCI scores, controlling for pretest BECCI scores showed a significant intervention effect F(1,33)=9.35, p<.001, (effect size=.36). Attitudes: Most students preferred BCC over UC at pretest and at posttest (72-94% for control group, 68-100% for intervention group at pretest; 88-89% for control group, 89-95% for intervention group at posttest). There were no significant changes in attitude scores from pretest to posttest. PURPOSE DISCUSSIONRESULTS _________________________________________________________________________ 1. Miller, W. R., & Rollnick, S. Motivational interviewing: Preparing people for change (2nd ed.) (2002). New York: Guilford Press. 2. Dunn C, Deroo L, Rivara FP. (2001). The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction, Dec; 96(12):1725-42. 3. Stotts, A. L., Diclemente, C. C., & Dolan-Mullen, P. (2002). One-to-One - a Motivational Intervention for Resistant Pregnant Smokers. Addictive Behaviors, 27, 275-292. 4. Harland J, White M, Drinkwater C, Chinn D, Farr L, Howel D. The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. BMJ. 1999 Sep 25;319(7213):828-32. 5. Resnicow K, Jackson A, Wang T, De AK, McCarty F, Dudley WN, Baranowski T (2001). A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: Results of the Eat for Life trial. American Journal of Public Health, 91 (10), 1686-93. 6. Woollard, J., Beilin, L., Lord, T., Puddey, I., MacAdam, D., & Rouse, I. (1995). A controlled trial of nurse counselling on lifestyle change for hypertensives treated in general practice: Preliminary results. Clinical and Experimental Pharmacology and Physiology, 22, 466-468. 7. Lane, C., Huws-Thomas, M., Hood, K., Rollnick, S., Edwards, K., & Robling, M. (2005). Measuring Adaptations of Motivational Interviewing: the Development and Validation of the Behavior Change Counseling Index (BECCI). Patient Education and Counseling, 56(2), 166-173. 8. Torgerson CJ and Torgerson DJ. (2003). The design and conduct of randomised controlled trials in education: Lessons from health care. Oxford Review of Education, 29(1), 67–80. The intervention was effective in improving both knowledge and skills related to Behavior Change Counseling. Attitudes were not significantly changed, most likely because of a ceiling effect. The vast majority of students preferred Behavior Change Counseling to Usual Care in the vignettes at baseline. Use of video vignettes demonstrating BCC methods prior to the skills assessments inadvertently exposed the control group to BCC principles and may have attenuated effect sizes. Randomized Group B N=18 Group A N=18 Lifestyle Modification Guidelines (LMG) Post Assessment Behavioral Change Counseling Training (BCC) Post Assessment Pre Assessment Not Enrolled Second Year Medical Students N=110 Enrolled Second Year Medical Students N=36