Motivational Interviewing education leading to a social justice learning outcome

Background: Social justice concepts of advocacy, collaboration, and equality are important components in health communication when the goal is to facilitate change by understanding behavior choices. Motivational Interviewing (MI) is a guiding communication style that has demonstrated significant impact in trials on patient change moving beyond traditional advice giving. Evoking change talk, honoring autonomy and collaboration are MI cornerstones. Various health care providers use MI in clinical practice, yet the fit for nursing needs to be assessed. Researchers of MI communication are moving toward a theory of MI to support best practice in training, therefore, exploring MI training techniques is a necessary step. This qualitative study focused on exploring the perceptions and understanding of RN students about MI and assessed learning differences between online or face to face MI education. Methods: This retrospective study analyzed online discussion forums and reflective assignments in hybrid and fully online courses conducted from Fall 2005 – Spring 2008. Students are post-licensure nurses returning for their baccalaureate degree. Results: Analysis demonstrates levels of MI proficiency in online and face to face sessions. Qualitative themes reflect the perceptions of the RN on the use of MI in practice and the social justice themes inherent in the MI spirit. For example: “During interactions with older immigrants I learned about their health by just listening. I used reflection, affirmation, and summarizing, and, at the time, advice giving. I knew they had heard my information many times before, but I felt that it was my professional duty to "educate" them again and again. Now I know I would try to elicit solutions from the clients themselves.” “Open ended questions and reflective statements are great tools for assessments, I felt my patients could confide in me more …I had patients complain about an ailment saying, ‘I waited to tell you because you listen better and will do something about it.'" Conclusions: MI has potential as a component within nursing communication competencies. Beyond the impact of MI on behavior change, it provides a practical application of social justice for individual and population based practices.