“Talking the walk to walk the talk”: A qualitative report of patients’ experiences of undergraduate nursing students using motivational interviewing

Abstract

Background and objective: Motivational interviewing (MI) is a communication style adopted by health professionals to support patient-centered decision making about behavior change. Little is known about how patients respond to this relational approach when it is used by baccalaureate students. Thus, the study aim was to explore how patients experience MI by undergraduate nursing students when it is used to support health behavior change for vascular risk reduction.

Methods: A focused ethnography was undertaken to explore the tacit and explicit dimensions of patient health behavior change as it evolved through MI encounters with nursing students. The research setting was a post-secondary institution in Canada and comprised a sample of 16 patients who received MI by the nursing students, 2 clinical instructors who teach MI, and 20 third-year nursing students who used MI as part of a 13-week community based clinical experience. Data sources included participant observations, field notes and one-to-one interviews.

Results: Patients described their encounters with nursing students using MI as novel, relative to typical instances with health providers, and foundational to supporting lifestyle change. The patients’ overall experience is characterized by a thematic arc of ‘talking the walk to walk the talk’. Motivational interviewing helped patients integrate personalized information about the meaning of vascular health, deliberate on options and initiate lifestyle changes to promote health. In most cases, patients translated knowledge and experience from their motivational encounters with nursing students into subsequent health management activities.

Conclusions: Through their experiences of nursing students using MI, patients understood the personal implications of vascular health, took action on relevant goals and applied lessons learned to future behavior change efforts. The results contribute new information about how patients respond to MI from baccalaureate nursing students and reinforce current understanding of how change talk contributes to subsequent change behavior.