Adapting an Effective Counseling Model from Patient-centered Care to Improve Motivation in Clinical Training Programs

Abstract

The value of establishing a patient-centered relationship within the context of the clini­cal encounter is well documented. The learner-centered method of medical education parallels the patient-centered clinical method; therefore, it should be explored as a method for teaching in the context of the learning encounter. In Japan and other Asian countries, rotations through services not related to the learner’s chosen medical specialty are mandatory parts of the medical intern­ship. Participation and effort in these rotations are often met with resistance from learners and are a common problem for medical educators. We adapted the counseling method for patients based on patient-centered methods such as motivational interviewing and solution-focused therapy to ad­dress this common problem. We show one case of a medical resident who lost his motivation to learn during his training. A resi­dent has many kinds of mental and physical stress. One such problem arises from the gap between what they want to do and what they have to do. Strategies from motivational interviewing and so­lution-focused therapy were adapted to successfully resolve a common teaching problem in Japan. A physician teacher (preceptor) helped this resident solve the issue for himself instead of arguing in favor of change. The positive aspects of the counseling method were based on patient-centered medicine and proved useful and effective in counseling for medical residents. We may take the les­sons learned from using patient-centered counseling methods to further develop a clear and system­atic process of counseling methods for residents to conduct learner-centered medical education. Keywords: learner-centered, patient-centered, motivational interview, solution-focused therapy, resident counseling