Learning motivational interviewing: Scripting a virtual patient

OBJECTIVES: This article describes a written assignment for a first-year professional communication course to facilitate the understanding and mastery of motivational interviewing in dealing with patient ambivalence and resistance. The goal was to immerse students in how motivational interviewing differs from traditional biomedical counseling with regard to phrasing individual responses to the patient and managing the flow of interaction. METHODS: Students were required to write a script for a working prototype of the Auburn University Virtual Patient. The script had to specify the text for the virtual patient's comments, 2-5 possible responses for the student pharmacist to choose from, and multiple interactional paths representing motivational interviewing, biomedical counseling, and a mix of the 2. RESULTS: Student feedback and test results are reported. Qualitative analysis of written student feedback indicated that (1) the project took too much time because of the complexities of the computer procedures resulting from the Virtual Patient being a prototype, and (2) the computer procedures deflected attention from the critical thinking involved in writing the script. Quantitative item analysis of final examination results indicated that students scored an average one full-letter grade better on the questions about motivational interviewing than on the questions covering other topics. CONCLUSION: The scriptwriting assignment is a challenging exercise in assimilating the verbal skills necessary for using motivational interviewing in patient counseling. Many students exhibited greater interest in motivational interviewing, greater knowledge of why motivational interviewing is successful, greater facility with wording responses, and greater confidence in their ability to use motivational interviewing in the future. Because almost all students had negative reactions to the difficulty and time involved in making their scripts actually work with the virtual patient prototype, future assignments should delete this requirement.